CEO SUMMARY: By its name alone, the National Correct Coding Initiative (NCCI) Policy Manual implies that it will be accurate and consistent with other coding initiatives. But nine groups representing various clinical laboratories say NCCI guidelines that the federal Centers for Medicare and Medicaid Services issued in December and implemented on Jan. 1 are inconsistent
Tag: molecular pathology
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
CEO SUMMARY: Now that the FDA has cleared a digital pathology for use in primary diagnosis, interest in DP is building. Inspirata purchased Omnyx and its assets because the Omnyx Dynamyx digital pathology software has strong features that could be integrated into Inspirata’s digital pathology solution. In this interview with THE DARK REPORT, Inspirata CEO
IN THE FIRST BROAD EXPANSION OF ITS pilot decision-support program for clinical lab testing in Florida, UnitedHealthcare (UHC) will add genetic and molecular tests, drug tests, and pathology procedures, among other assays starting in two months.
On March 1, UHC will expand its laboratory benefit management program in Florida beyond the initial 80 routine anatomical and
CEO SUMMARY: Miraca Life Sciences amended its merger agreement with Avista Capital Partners after the lab lost value in the two months since the agreement was signed in September. Factors precipitating the revision were a significant decline in reimbursement rates, stiff competition from physician-office labs (POLs), and a loss of specimen volume to POLs and
CEO SUMMARY: With programs now at the nation’s two largest insurers, is it possible to argue that prior-authorization is going mainstream? Some observers say, yes, as THE DARK REPORT predicted. What is certain is that starting Nov. 1, UnitedHealthcare is requiring prior authorization for genetic and molecular tests for its fully-insured commercial members nationwide. That
AS YOU READ THE INTELLIGENCE BRIEFINGS IN THIS ISSUE about lab industry efforts to convince Congress, the administration, and the new leaders of the Centers for Medicare and Medicaid Services to delay implementation of the PAMA final rule on market price reporting, keep in mind that—for the nation’s two largest public lab companies—there is plenty
CEO SUMMARY: There’s great news for pathologists and PhDs with expertise in molecular and genetic testing. Salaries are on the rise as more clinical labs build up their molecular and genetic testing programs and need talent to implement and supervise this activity. One experienced medical recruiter recently surveyed all the current pathology openings nationally. He
ANOTHER ACADEMIC MEDICAL CENTER decided to cash in on the value of its outreach lab. On Jan. 10, Laboratory Corporation of America announced it would acquire the lab outreach business of Mount Sinai Health System of New York City.
Terms of the transaction and purchase price were not disclosed. The deal is expected to close by
ON THE SUBJECT OF LAB TEST MARKET PRICE REPORTING as required under PAMA, many clinical laboratory executives, pathologists, and industry experts see deep flaws in the process the federal Centers for Medicare & Medicaid Services has established. Yet, CMS itself seems blind to these flaws.
Fortunately, the clinical lab executives are not alone. The Office of