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medicare fee schedule

An Economic Perspective On Discounted PC Deals

CEO SUMMARY: By opening their own in-office pathology laboratories, specialist physicians are undermining a long-established referral relationship with the pathology profession. Pathologists are debating the merits of this market-based trend and its effect on their profession. However thi…

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Path Group Responds to FBI Visits in Stokes Case

CEO SUMMARY: As the FBI launched its investigation of fraudulent billing by Michigan dermatologist Robert W. Stokes, D.O., two years ago, staff at several pathology labs found themselves “up close and personal” with federal healthcare fraud prosecutors. One pathology lab, based on wha…

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Intense Competition for Market Share in New York

ONE OF THE MOST TURBULENT MARKETS FOR LAB SERVICES TODAY is New York City and the Tri-State area of New York, New Jersey, and Connecticut. This is ground zero in the fight for market share between Quest Diagnostics Incorporated and Laboratory Corporation of America a…

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Will OIG Reconsider Policy on Discriminatory Pricing?

HEIGHTENED COMPETITION in recent months for exclusive managed care contracts between the two blood brothers may trigger the law of unintended consequences. One such consequence could be renewed interest by Medicare regulators in what they call “discriminatory billing.” “In 2003, the federal …

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JVHL Signs a Contract with UnitedHealth Group

CEO SUMMARY: When UnitedHealth Group announced its exclusive national contract with Laboratory Corporation of America, Joint Venture Hospital Laboratories (JVHL) saw opportunity. That’s because LabCorp does not have a significant presence in Michigan. JVHL parlayed its statewide network…

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Pathologist Builds General Path Business From Office Lab

CEO SUMMARY: Doctors Pathology Services in Delaware is successful for two reasons. First it runs the largest pathology lab in the state. But more important, it runs one of the few successful mobile pathology services anywhere. The Mobile Intraoperative Consultation Service(MICS)allows the…

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Defense Attorneys Discuss Details Of UroCor Jury Trial

CEO SUMMARY: This was the first criminal case involving anti-kickback violations brought against executives of a public laboratory company. Federal prosecutors charged the defendants with offering inducements to referring physicians in several ways. Defense counsel rebutted the prosecutio…

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Connecticut Hospital Labs Win HMO Test Contracts

CEO SUMMARY: Connecticut Hospital Laboratory Network, LLC was formed in 1996 with the specific goal of winning managed care lab testing contracts. During the past five years it has steadily increased the number of patients covered by such contracts. Along the way, it has learned important…

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Abbott, CARESIDE, Bio-Reference Labs, DIANON Systems

SWARM OF LAWSUITS NOW PLAGUES ABBOTT LABS PAYING A $100 MILLION FINE TO THE Food and Drug Administration (FDA) did not end Abbott Laboratories, Inc.’s problems related to its diagnostic test kits and reagents. Since payment of the FDA fine last month, Abbott has been serv…

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To Protect Pathology Profits: Understand Managed Care

CEO SUMMARY: On November 8, 1997, THE DARK REPORT convened a private symposium restricted only to pathologists. The sole purpose of this event was to identify how pathologists could preserve and enhance their income. Within the confidential setting of a plush resort in Scottsdale, Arizona…

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