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molecular tests

Two Major, Disruptive Changes Coming to Labs

TWO MAJOR, DISRUPTIVE CHANGES lie ahead for both clinical laboratories and anatomic pathology group practices. Each disruptive factor has nothing to do with how payers select in-network labs or reimburse for lab testing services. Rather, one of these two major changes involves fundamental advances i…

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In Florida, More Tests Added to UHC’s Decision-Support Program

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 labor…

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XIFIN CEO White Analyzes Medicare 2018 Fee Cuts

CEO SUMMARY: If the draft lab rates that CMS published Sept. 22 for the Clinical Laboratory Fee Schedule for 2018 go into effect Jan. 1 as proposed, then clinical labs will see a cut of 28% in what they get paid for the top 20 most common tests, according to a recent analysis. The rates t…

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UnitedHealth to Start Gene Test Pre-Approval

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 fo…

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Two Largest Payers Start Lab Test Pre-Authorization

CEO SUMMARY: Once Anthem and UnitedHealthcare establish their respective genetic test prior-authorization programs, a new era for genetic testing will commence. The 80 million beneficiaries served by these two payers make up half of the individuals who have private health insurance. It is…

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Clinical Labs Bidding Up Lab Director Salaries

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 medic…

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Market Price Data Sample from: Molecular/Genetic Labs

Here is the market price data for molecular and genetic labs from XIFIN Inc. Lâle White, Founder and CEO of XIFIN, discusses the data with THE DARK REPORT. EDITOR: When you did this analysis of molecular and genetic…

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Elizabeth Holmes of Theranos Speaks at AACC To Skeptical PhDs, Pathologists, and Press

CEO SUMMARY: Elizabeth Holmes, Founder and CEO of Theranos, Inc., was given the ideal platform by AACC to show the science behind her lab company’s much-touted diagnostic technologies. But in a surprise to the assembled audience, Holmes, accompanied by three PhDs on her team, chose to d…

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How to Cover Genetic Tests Confounds Health Insurers

CEO SUMMARY: Managed care experts say health insurers are being overwhelmed by the number of new genetic tests and that many labs find it tough to get paid for these tests. UnitedHealthcare just announced it will require pre-authorization of molecular and genetic tests during 2016. Me…

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Despite Tough Anatomic Pathology Market, Bostwick Opens New Laboratory

CEO SUMMARY: Once again, entrepreneur and pathologist David G. Bostwick, MD, is starting up a new lab company. Granger Diagnostics is now open and is located in North Chesterfield, Virginia. It is designed to be an anatomic, clinical, and molecular pathology reference laboratory. In an ex…

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