TAG:
MolDx
Some Labs Report Faster Pay for Molecular, Genetic Tests
DURING RECENT MONTHS, some labs are reporting improvement in how their claims for certain molecular and genetic tests are being reimbursed. This is progress from the financial crises experienced during 2013 for many labs performing molecular and genetic tests….
Some Labs Report Faster Pay For Molecular, Genetic Tests via New CPT Code Reimbursement Program
DURING RECENT MONTHS, some labs are reporting improvement in how their claims for certain molecular and genetic tests are being reim…
Medicare Special Stain LCD May Hinder Pathology Workflow
CEO SUMMARY: Under a proposed rule for Medicare region J-11, a pathologist will no longer be able to use “reflex templates or pre-orders for special stains and/or IHC stains prior to review of the routine H&E.” While the proposed LCD is designed to target a relatively small number…
New Pricing Formula for Advanced Diagnostic Tests
CEO SUMMARY: One section of the federal H.R. 4302: Protecting Access to Medicare Act of 2014 is getting positive reviews from many lab experts. The law defines advanced diagnostic tests (ADTs) and directs CMS to assign a temporary HCPCS code and use list prices to pay labs for such tests …
Anatomic Pathology Business Faces Uncertain Future
CEO SUMMARY: There’s a day of reckoning on the way for the traditional business model of the private pathology group practice. At most risk are smaller pathology groups that typically have five or fewer pathologists. Blame it on the reduced prices that Medicare and private insurers are …
Medicare Price Cuts Drive Labs to Sell or File BK
CEO SUMMARY: Professional investors are smart with their money. Thus, it is no surprise that clinical lab and pathology companies owned by private equity firms are the first to be sold or closed. These investors are acting in response to the cumulative negative financial impact of recent …
Labs Push to Cut Costs As Budgets, Prices Shrink
CEO SUMMARY: Cost-cutting is now the prime directive at progressive labs because nearly every laboratory organization in the United States is under sustained financial pressure. This is due to shrinking budgets for hospital labs and more aggressive price-cutting by private payers. Even Ob…
Palmetto: ‘We Are Processing & Paying Clean Claims without Undue Delay’
SEEING THAT PALMETTO, GBA, the nation’s largest Medicare Administration Contractor, seems to be at the center of the controversy over how Medicare is to pay for molecular pathology (MoPath) tests, THE DARK REPORT sent a list of questions to Palmetto Vice President Mike Barlow. Here…
Medicare Taken to Task about Molecular Test Pricing Method
EDITOR’S NOTE: Submitted by Lâle White, CEO of XIFIN, Inc., of Carlsbad, California, this letter describes the problems caused by the Medicare program’s failure, as of January 1, 2013, to be ready to process and reimburse lab test claims for more than 100 new mo…
Low 2013 Molecular Rates May Bankrupt Some Labs
CEO SUMMARY: Many of the recently issued reimbursement rates for molecular diagnostic tests are inadequate and in fact are lower than the cost of running the tests, lab experts say. Smaller laboratories that specialize in developing and selling molecular tests could be forced to close. As…
CURRENT ISSUE
Volume XXXII, No. 6 – April 21, 2025
Now that a federal judge has vacated the FDA’s LDT rule, The Dark Report analyzes the judgement and notes the various steps the FDA could take in response. Also, lab testing at pharmacies is proving to be less successful than was once anticipated.
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