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Top 10 2014 Biggest News Stories

Story no.1 SGR Fix by Congress Spawns PAMA; Lab Industry Wary of Law’s Impact ON APRIL 1, PRESIDENT BARACK OBAMA signed into law the Protecting Access to Medicare Act of 2014 (PAMA). As written, it has the potential to be the most impactful federal legislation on the clinical lab industry s…

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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…

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Physicians and Labs Wary of United’s Lab Test Program

CEO SUMMARY: Providers seem to have a natural distrust of health insurers, particularly when payers introduce new programs with the stated purpose of improving quality and ensuring that physicians deliver evidence-based medicine. Doctors serving members of UHC’s HMO plans in Florida are…

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UnitedHealthcare, BeaconLBS Respond with Statements

IN FLORIDA, BOTH CLINICAL LABS and physicians have expressed concerns UnitedHealthcare’s Laboratory presented in full on this page and the following page. about Benefit Management Program that formally becomes effective on October 1. From that date forward, physicians will be requi…

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Aurora Diagnostics Acquires Two Pathology Group Practices

TWO MORE PATHOLOGY GROUPS gave up their independence in recent weeks. Both groups were acquired byAurora Diagnostics of Palm Beach Gardens, Florida. Early in June, Aurora announced the acquisition of Mid-Atlantic Pathology Services, Inc. (MAPS), of Sterling, Virgini…

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Lab Copay on the Table, But for Now, It’s Australia

CEO SUMMARY: Patient copayment is the idea that always appeals to government health officials who want to control healthcare costs. In Australia, Parliament has yet to vote on a bill that would, starting in July 2015, institute a patient copayment of $7.00 Australian for …

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Pathologists Face Unsettling Times

THESE ARE UNSETTLING TIMES FOR PATHOLOGISTS, particularly those who practice in a private pathology group that serves one or more community hospitals. Blame it on healthcare’s unfolding transformation and the new aggressiveness of payers to cut the prices they pay for anatomic pathology services. …

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Maine’s Spectrum Medical Group Offers Multiple Specialties

CEO SUMMARY: Pathologists looking for a viable future in a healthcare system marked by integration of clinical care and value-based reimbursement will be interested to learn about Spectrum Medical Group based in Portland, Maine. This 180-member multispecialist group includes 22 pathologis…

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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 …

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Pathology Groups Respond to Eroding Finances

THESE ARE NOT THE BEST OF TIMES FOR ANATOMIC PATHOLOGY GROUPS. The various Medicare fee cuts enacted in the past couple of years have eroded the financial stability of a substantial number of the nation’s 3,300 independent pathology practices and laboratories. The consequences of eroding finances …

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