TAG:
pathology practice
What Labs Need to Do as Payers Audit More Claims
CEO SUMMARY: Attorneys who advise pathologists and clinical laboratories on compliance issues say the number of audits from the government and third-party payers has increased sharply in recent years. In those audits, payers are looking for recoupment of overpayments. A lab’s fai…
Labs Have Strategies to Address Narrow Networks
IN TODAY’S EVOLVING HEALTHCARE SYSTEM, labs and pathology groups of all sizes in all communities are dealing with the issues of payers narrowing networks and the formation of ACOs, with all the unknowns about reimbursement that come with this new organizational model of healthcare. That is why you…
UnitedHealth Sets April 15 to Start Claims Impact of Lab Program
APRIL 15 IS THE DATE when UnitedHealthcare will begin denying laboratory claims in Florida that do not meet the requirements of its unpopular laboratory benefit management program. The health insurer sent out notices last month to alert physicians and laboratories that it will implement what it call…
Florida Doctors Refuse to Use UHC’s Lab Ordering System
CEO SUMMARY: It may not yet be open rebellion, but UnitedHealthcare faces strong opposition in Florida from physicians- and their medical societies-over the requirement that they obtain pre-notification and pre-authorization when ordering tests listed in UHC’s laboratory benefit …
Florida Pathologists Critical of UnitedHealth and BeaconLBS
CEO SUMMARY: In a letter to UnitedHealthcare, the Florida Society of Pathologists says UHC’s pilot laboratory management program will have a negative effect on patient care by delaying access to care and timely diagnoses of disease. Signed by more than 120 members…
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…
California Hospitals Become Health Insurers
WHAT CHANGES WHEN THE NATION’S HOSPITALS become health insurers? How do pathology practices and clinical laboratories contract to provide lab testing services when their parent hospital is also the insurer? We are about to learn the answers to these questions by watching California. News outlets a…
New Threat to Community-based Anatomic Pathology
THERE IS A NEW DEVELOPMENT that may be off the radar screens of CAP, ASCP, and the various subspecialty pathology associations. It is the requirement for second reviews and subspecialty reviews of certain complex pathology tests as part of the laboratory benefit mana…
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 …
Partners Consolidates AP Using Common IT System
CEO SUMMARY: Partners HealthCare of Boston, Massachusetts, is creating a single informatics platform for CP and AP across all six of the hospitals that it operates. It will replace 19 different pathology systems currently used at six sites with just seven integrated pathology systems. As …
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Volume XXXII, No. 6 – April 21, 2025
Now that a federal judge has vacated the FDA’s LDT rule, The Dark Report analyzes the judgement and notes the various steps the FDA could take in response. Also, lab testing at pharmacies is proving to be less successful than was once anticipated.
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