medicare fee schedule Archives - The Dark Intelligence Group

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medicare fee schedule

Anthem Rolling Out More Anatomic Path Price Cuts

By Joseph Burns | From the Volume XXVI No. 9 – July 1, 2019 Issue

CEO SUMMARY: Anthem is making big changes to its relationships with anatomic pathology groups. Getting most of the attention at the moment are the insurer’s letters announcing price cuts for anatomic pathology services of 50% to 70% of Medicare fees. But another major change may also tr…

Anthem Rolling Out New Pathology CPT Code Cuts

By Mary Van Doren | From the Volume XXVI No. 9 – July 1, 2019 Issue

This is a synopsis of a 2,120-word article in the July 1, 2019 issue of THE DARK REPORT (TDR). The full articles are available to members of The Dark Intelligence Group. CEO SUMMARY: Anthem is making big changes to its relationships with anatomic pathology (AP) groups. Getting most o…

What Labs Can Expect from PAMA in 2019

By Joseph Burns | From the Volume XXVI No. 7 – May 20, 2019 Issue

CEO SUMMARY: Attendees at the Executive War College learned that CMS has taken steps to expand the number of hospital labs required to report their private payer lab test price data under the Protecting Access to Medicare Act, but the unbundling of certain test panels could be problematic…

CMS Adjustments for Medicare Fee Schedule Might Be Too Late

By Mary Van Doren | From the Volume XXV No. 16 – November 13, 2018 Issue

This is a summary of two articles in the Nov. 13, 2018 issue of THE DARK REPORT. The complete articles are available only to paid members of the Dark Intelligence Group. CEO SUMMARY: On Nov. 2, the federal Centers for Medicare and Medicaid Services released its Physician Fee S…

No relief in sight for 2018 Clinical Laboratory Fee Schedule, but critical issues remain

By Mary Van Doren | From the Volume XXV No. 14 – October 1, 2018 Issue

This is an excerpt from a 2,400-word article in the October 1, 2018 issue of THE DARK REPORT. The complete article is available at all times to paid members of the Dark Intelligence Group, and non-members may access one premium article per month. CEO SUMMARY: Many lab professionals a…

Lab Executives Declare Concerns about Fee Cuts

By Joseph Burns | From the Volume XXV No. 1 – January 2, 2018 Issue

CEO SUMMARY: Members of Joint Venture Hospital Laboratories in Michigan anticipate that the 2018 Clinical Laboratory Fee Schedule rates being implemented under PAMA will lower payment from Medicare to less than the cost of running tests, especially for rural and critical access hospitals….

ACLA hits Medicare fee schedule cuts with lawsuit

By Mary Van Doren | From the Volume XXIV No. 17 – December 11, 2017 Issue

This is an article from the Dec. 11, 2017 issue of THE DARK REPORT. The complete article is available for a limited time to all readers. This article plus a full analysis of 2017 developments in the PAMA process are available at all times to paid members of the Dark Int…

Time’s running out to stop Medicare lab fee schedule cuts

By Mary Van Doren | From the Volume XXIV No. 11 – August 7, 2017 Issue

This is an excerpt from an article in the August 7, 2017 issue of THE DARK REPORT. The complete article is available for a limited time to all readers, and available at all times to paid members of the Dark Intelligence Group. CEO SUMMARY: Only a few mo…

Hospital Lab Data Essential For CMS Market Price Study

By Joseph Burns | From the Volume XXIV No. 10 – July 17, 2017 Issue

CEO SUMMARY: In five months, Medicare officials will implement a new Part B clinical laboratory fee schedule based on private payer lab price data submitted by certain medical laboratories required to report that data. At this year’s Executive War College, the CEO of XIFIN, Inc., reported o…

Is CMS Manipulating Data to Increase Medicare Fee Schedule Cuts?

By Mary Van Doren | From the Volume XXIV No. 5 – April 3, 2017 Issue

This is an excerpt from a 2,150-word article in the April 3, 2017, issue of THE DARK REPORT. The complete article is available for a limited time to all readers, and available at all times to paid members of the Dark Intelligence Group. CEO SUMMARY: E…

Volume XXVII No. 8 – June 1, 2020

THE DARK REPORT brings news that the national media has overlooked: Lab revenues, cut precipitously during the coronavirus pandemic, will leave many labs without the resources to continue operation in the near future. As calculated by THE DARK REPORT, the nation’s clinical lab industry had lost $6.8 billion in revenue by week 12 of the crisis. Also reported is that in many cases, the culprit is a frustrating lack of supplies that would allow labs to replace lost routine testing with new COVID-19 testing.

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