Tag: Medicare

U of Florida Health Improves Patient Care with PGx Testing

By Joseph Burns, from the Volume XXV No. 17 – December 3, 2018 issue

CEO SUMMARY: Since 2011, the University of Florida Health System has used pharmacogenetic test (PGx) results to guide physicians when they prescribe certain drugs. This initiative has improved patient outcomes, reduced the overall cost per episode of care, and gained partial reimbursement from health insurers for PGx test claims. As this testing becomes more widespread, clinical

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Attorney Explains Risks from New ‘Support Act’

By Joseph Burns, from the Volume XXV No. 17 – December 3, 2018 issue

CEO SUMMARY: Legislation signed into law on Oct. 24 was designed to stem the nation’s opioid crisis. But in addition to applying to sober homes and addiction treatment centers, the law also applies to clinical laboratories. Called the ‘Support for Patients and Communities Act,’ the law could authorize criminal penalties for labs that pay sales

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New Opioid Law Hits Labs Paying Sales Commissions

By Joseph Burns, from the Volume XXV No. 17 – December 3, 2018 issue

CEO SUMMARY: At the last minute, Congress added all clinical laboratories to a far-reaching anti-kickback provision in the newly-enacted Support for Patients and Communities Act. This provision applies to all payers, both government and private. Lab experts say this new law could have a negative effect on patient care because it could make relatively innocuous

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If 2019 Is a Tough Year, Blame Government, Payers

By R. Lewis Dark, from the Volume XXV No. 17 – December 3, 2018 issue

Traditionally, the new year is a time of optimism. People make resolutions such as exercising more and losing weight. Companies get to start the year with a fresh budget and the new opportunity to achieve their goals.

Unfortunately, events of the last 90 days of this year are not auspicious for clinical laboratories and anatomic pathology

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CMS Adjustments for Medicare Fee Schedule Might Be Too Late

By Mary Van Doren

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 Schedule for 2019. CMS says it will expand

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Sonic Adds More Value to Help Physicians Treat CKD Patients

By Joseph Burns, from the Volume XXV No. 16 – November 13, 2018 issue

BUILDING ON THE LESSONS IT LEARNED by developing lab services that helped primary care physicians identify, diagnose, and treat diabetes patients in their practices, Sonic Healthcare USA was ready to do the same for another disease.

Sonic wanted to go beyond simply reporting an accurate and timely lab test result. Instead, it wanted to leverage the

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Sonic Uses Lab Data, Patient-Contact Tools, to Improve Outcomes

By Joseph Burns, from the Volume XXV No. 16 – November 13, 2018 issue

CEO SUMMARY: In its work for a federally qualified health center, Sonic Healthcare USA helped physicians use a data-driven approach to population health management that incorporated integrated financial and clinical analytics. Also, Sonic developed technologies that give ordering physicians clinical decision support and targeted patient engagement tools. It then developed a way to contact patients

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Project Santa Fe Labs Deliver Value with Tests

By Joseph Burns, from the Volume XXV No. 16 – November 13, 2018 issue

CEO SUMMARY: No bigger threat looms over the financial security of the nation’s clinical laboratories than healthcare’s transition from fee-for-service payment to value-based reimbursement. To navigate that transition successfully, medical labs and pathology groups will need to adopt the Clinical Lab 2.0 model. Member labs of Project Santa Fe are themselves working to develop and

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NILA, ACLA Respond to CMS 2019 Final Lab Rule

By Joseph Burns, from the Volume XXV No. 16 – November 13, 2018 issue

CEO SUMMARY: On Nov. 2, the federal Centers for Medicare and Medicaid Services released its Physician Fee Schedule for 2019. It says it will expand the number of labs from which it collects data about the lab test prices paid by private health insurers. While some labs may welcome these changes, groups representing clinical laboratories

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More Medicare Price Cuts Coming in 2019, 2020

By R. Lewis Dark, from the Volume XXV No. 16 – November 13, 2018 issue

How many consecutive 10% and 15% cuts to the prices Medicare pays for clinical laboratory tests can smaller community labs absorb before they are forced to shut their doors and go out of business? This nation is about to find out. As this happens, Medicare beneficiaries (and their physicians) in small towns and rural areas

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Volume XXV No. 17 – December 3, 2018

DID CONGRESS JUST PASS A LAW that makes innocent labs guilty of criminal acts? At the last minute, Congress added all clinical laboratories to a far-reaching anti-kickback provision in the newly-enacted Support for Patients and Communities Act -- a provision that makes common practices such as paying commissions to sales staff or placing phlebotomists in labs could be illegal. Worse: The experts are baffled by the language of the new law. Notes one of these experts in this issue, "Someone in the clinical lab industry may have to get prosecuted before we get some clarity, unless the Secretary of HHS issues clarifying regulations."

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Tag: Medicare

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