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CMS Expected to Revise Condo Lab & TC/PC Rules

CEO SUMMARY: Expectations are that the Centers for Medicare & Medicaid Services (CMS) will take further action to rein in anatomic pathology arrangements used by physicians to capture revenue from their patient referrals. This may happen as soon as next month, when CMS publishes the 2…

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Healthcare Has First Standards for Use of Bar Codes and RFID

THREE ORGANIZATIONS have jointly developed information technology standards to be used in identifying patients, drugs, and medical devices. These standards use bar code, radio frequency identification (RFID), and two-dimensional symbol technologies. The American National Standards Institute …

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Powerful Trends Reshaping Anatomic Path Profession

CEO SUMMARY: THE DARK REPORT presents its newest biannual review of macro trends reshaping the anatomic pathology profession. These macro trends reveal a profession undergoing change and transformation on multiple fronts. New competitors are crowding into the market, payers and accreditin…

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CMS Spotlights AP as It Delays Anti-Markup Rule

CEO SUMMARY: When Medicare officials postponed implementing a new anti-markup rule late last month, it did so because of questions about how the new rule will be applied. However, the Centers for Medicare & Medicaid Services (CMS) did implement an aspect of the anti-markup rule on Jan…

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October 29, 2007 “Intelligence: Late Breaking Lab News”

Microsoft Corporation is the latest company to offer a digital health record (DHR) aimed at consumers. Called “Healthvault,” it can be found at www.healthvault.com. This secure Web site allows consumers to manage and monitor their personal health information, including w…

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Shiel Medical Lab Grows In Tough NYC Market

CEO SUMMARY: There’s a new lab player emerging in the New York metropolitan market. Shiel Medical Laboratory of Brooklyn, New York, is growing steadily and now reports $50 million in annual revenue. It is taking full advantage of the managed care contracting turmoil and adding new clien…

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Laboratory Error Results In Mistaken Mastectomy

CEO SUMMARY: In New York, because of a laboratory error and wrong diagnosis, a woman underwent a needless double mastectomy. In reporting the case, New York newspapers discovered another case of lab error and both women are suing the labs involved. Each case is a reminder that the public …

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Michigan Derm Convicted On 31 Fraud Charges

CEO SUMMARY: Last year, dermatologist Robert W. Stokes, D.O., of Grand Rapids, Michigan, was indicted by the federal government for 72 counts relating to various offenses, including upcoding, and improper coding. Of this total, 35 counts against Stokes involved his billing payers for labo…

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Path Group Responds to FBI Visits in Stokes Case

CEO SUMMARY: As the FBI launched its investigation of fraudulent billing by Michigan dermatologist Robert W. Stokes, D.O., two years ago, staff at several pathology labs found themselves “up close and personal” with federal healthcare fraud prosecutors. One pathology lab, based on wha…

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Are Feds Ready to Strike at TC/PC Arrangements?

CEO SUMMARY: Pathologists and laboratory directors will want to pay attention to the proposed rules published by the Centers for Medicare and Medicaid Services on July 2, 2007. The document is a grab bag of proposals and rules that would significantly curb many common ancillary services a…

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