CEO SUMMARY: In an unusually strong move, health insurer Cigna is auditing laboratories, including some labs that do toxicology testing. In these audits, the health insurer seeks documentation that the testing is medically necessary and that the laboratories are collecting copayments and deductibles from patients before Cigna pays the labs for the toxicology test claims. A lawyer working on these cases says that tactic may violate some state prompt-payment laws.
Tag: patient billing
FINALLY, A MAJOR HEALTH INSURER IS taking a hard line against clinical laboratories it suspects of committing fraud. Aetna Health, Inc., and Aetna Life Insurance Company, of Hartford, Connecticut, have sued one lab company and included physicians as defendants in that case. Aetna officials indicate that other lawsuits against labs can be expected.
At a minimum,
CEO SUMMARY: Federal investigators are looking into possible violations of the antikickback law by a number of labs offering cardiology tests. The labs under investigation are alleged to have paid physicians processing fees of up to $20 per patient, the Journal reported in a front page story. The labs under scrutiny deny that they violated
REIMBURSEMENT FOR CLINICAL laboratory testing has declined, particularly for molecular tests. As a consequence, the nation’s two largest laboratory testing companies are feeling the negative effect of lower lab test prices.
Both Quest Diagnostics Incorporated and Laboratory Corporation of America issued their third quarter earnings reports last week. Their respective performances provide insights into several unfolding
CEO SUMMARY: When 330-bed Botsford Hospital of Farmington Hills, Michigan, got interested in laboratory outreach 10 years ago, it brought in a new laboratory leader, invested in new analyzers and informatics, and then let the quality of the operation attract new business from the community. Today, Botsford’s outreach program performs 2.4 million tests per year