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Medicare

January 23, 2023, Intelligence: Late-Breaking Lab News

New data from the Association of American Medical Colleges (AAMC) offers further evidence of a decreasing talent pool of pathologists in the United States. Active physicians in anatomic and clinical pathology dropped from 13,201 in 2016 to 12,180 in 2021—a 7.7% decrease, according to the AAM…

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Eight Macro Trends for Clinical Labs in 2023

CEO SUMMARY: Laboratory administrators and pathologists will want to carefully study eight important trends that will guide their business strategies in 2023. Many of these macro trends center on financial and operational difficulties and ways to steer around these obstacles. Anothe…

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January 3, 2023, Intelligence: Late-Breaking Lab News

At the moment, it appears that the controversial Verifying Accurate Leading-edge IVCT Development (VALID) Act will have a hard time passing in Congress. The bill, which is intended to shift regulation of laboratory-developed tests (LDTs) to the federal Food and Drug Administration…

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Two Positive Messages to Focus on at Year’s End

Clinical laboratory managers and anatomic pathologists are winding down another tumultuous year for the healthcare industry. It was a year marked by unexpected twists and turns.  It was also a year marked by two positive developments for labs. First, the…

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Lab Allegedly Billed Medicare for Tests It Did Not Perform

Following up on a Sept. 19 intelligence briefing, an attorney told The Dark Report that a federal case alleging genetic test fraud showed hallmarks of pass-through billing.  As such, it raises questions about whether reference l…

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Labs Face Powerful and Unwelcome Forces

OVER THE PAST 25 YEARS, THERE HAS BEEN WIDESPREAD RECOGNITION THAT HEALTHCARE IN THE UNITED STATES is on an unsustainable path. The obvious argument was that year-over-year increases in healthcare costs would eventually overcome the ability of employers (private health plans) and the government (Medi…

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1999’s ‘To Err Is Human’ Still an Opportunity for Labs

NOT ONLY DID THE 1999 PUBLICATION OF ‘TO ERR IS HUMAN” trigger a wave of national news coverage about patient harm in hospitals, it also launched this nation’s healthcare system on a multi-decade journey to boost the quality of care, reduce medical errors, and increase the transparency of both pati…

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June 27, 2022 Intelligence: Late-Breaking Lab News

Efforts to revise the much-criticized methods Medicare officials use to establish prices the government pays clinical laboratories under the Protecting Access to Medicare Act (PAMA) of 2014 got a boost last week. On June 22, a bipartisan bill to accomplish that was introduced in the U.S. Senate. The …

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Federal Prosecutors Describe Illegal Lab Bribes to Physicians

PATHOLOGISTS AND CLINICAL LAB MANAGERS SHOULD WELCOME every federal prosecution of a physician who accepts illegal bribes and inducements in exchange for laboratory test referrals. If physicians understood that federal prosecutors would file criminal charges against them for this behavior, fewer doct…

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Labs Should Be Cautious about ‘Surprising’ EKRA Ruling

CONFUSION ABOUT WHEN IT IS LEGAL UNDER TWO FEDERAL LAWS to pay commissions to sales reps based on volume and/or revenue has existed since the passage of the federal Eliminating Kickbacks in Recovery Act of 2018 (EKRA). Now, a district court judge in Hawaii has surprisingly ruled that payments of perc…

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