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TOP 10 LAB STORIES OF 2017

1. CMS Sticks by Decision to Deeply Cut Medicare Part B Lab Test Fees SHORT OF A MIRACLE, the clinical laboratory industry is less than three weeks from the single most financially-disruptive event of the past 30 years. On Jan. 1, the federal Centers for Medicare and Medicaid Service…

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Fla. Lab Sells to Labcorp, But Keeps Nursing Homes

CEO SUMMARY: Vista Clinical Diagnostics of Clermont, Fla., is betting big on the nursing home sector just when many labs serving nursing homes are worried about steep Medicare cuts coming Jan. 1. After selling its physician office referral testing, 35 patient service centers, and a mobile…

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CMS Publishes Final CLFS Rates, Labs Prepare to Cut Staff or Close

MEDICARE OFFICIALS PUBLISHED the final Part B Clinical Laboratory Fee Schedule for 2018 last Friday. Some changes clinical labs will welcome. The rates remain deeply flawed, however, and will cause many labs to lay off staff and others to close, experts said Saturday. How CMS set the rates remains p…

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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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Labs Serving Nursing Homes, Rural Areas to Suffer Most

CLINICAL LABORATORIES WITH A HIGH percentage of Medicare Part B lab test reimbursement are expected to suffer the most under the Part B Clinical Laboratory Fee Schedule (CLFS) cuts that the Centers for Medicare and Medicaid Services proposed Sept. 22. With the proposed rates schedul…

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Can Fee Cuts Be Delayed? Courts Are One Option

CEO SUMMARY: Some lab companies may be prepared to challenge in court the methodology CMS used in setting the requirements of the Protecting Access to Medicare Act of 2014 to conduct a study of private payer market prices for lab tests and use that data to propose new prices for the Part …

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For Top 20 Tests, CMS to Cut Payment by 28% in 2018-2020

ON SEPT. 22, MEDICARE OFFICIALS RELEASED THE DRAFT PRICES for the 2018 Clinical Laboratory Fee Schedule. The bad news for the lab industry is that the fee cuts are deeper than the federal Centers for Medicare and Medicaid Services had predicted earlier. The price cuts to clinical la…

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NILA Asks Labs to Speak about PAMA Rule’s Flaws

CEO SUMMARY: In a call to action, the National Independent Laboratory Association is urging lab owners, lab managers, and pathologists to educate their members of Congress about the biases and deep flaws built into the final rule for PAMA market price reporting and how the rule will resul…

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Hospital Lab Data Essential For CMS Market Price Study

CEO SUMMARY: In five months, Medicare officials will implement a new Part B clinical laboratory fee schedule based on private payer lab price data submitted by certain medical laboratories required to report that data. At this year’s Executive War College, the CEO of XIFIN, Inc., reported o…

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Genetic Test Pre-Authorization Goes Mainstream

IT IS ALWAYS A BIG DEAL WHEN ONE OF THE NATION’S LARGEST HEALTH INSURERS TAKES A MAJOR STEP. That is certainly true of Anthem’s decision to launch a new program that requires physicians to obtain pre-authorization when ordering genetic tests for its members. THE DARK REPORT is f…

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