TAG:
private payer
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…
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 …
Here Are the Arguments When Commenting on 2018 CLFS Rates
ALL LABORATORY PROFESSIONALS AND pathologists are encouraged to submit comments to CMS before the Oct. 23, as well as send letters to their elected officials in Congress to urge both to delay and to fix the market price study and revise the proposed Clinical Laboratory Fee Schedule for 2018. Bene…
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…
Drug Testing Labs in Texas, California Deal With Fraud Charges
CEO SUMMARY: Two toxicology lab companies accused of fraud are fighting to stay in business. In the case of Medicus Laboratories of Dallas, it is asking a federal judge to issue a temporary restraining order to prevent state and federal lab regulators from pulling its CLIA license. At Pro…
Proove Biosciences, Medicus Face Serious Fraud Charges
This is an excerpt from a 1,400-word article in the Sept. 18, 2017 issue of THE DARK REPORT. The complete article is available for a limited time to all readers, and available at all times to paid members of the Dark Intelligence Group. …
UnitedHealth to Start Gene Test Pre-Approval
CEO SUMMARY: With programs now at the nation’s two largest insurers, is it possible to argue that prior-authorization is going mainstream? Some observers say, yes, as THE DARK REPORT predicted. What is certain is that starting Nov. 1, UnitedHealthcare is requiring prior authorization fo…
LabCorp, Quest Talk about Medicare Lab Price Cuts
CEO SUMMARY: In an effort to forestall CMS’ efforts to implement the PAMA final rule on market price reporting, Laboratory Corporation of America and Quest Diagnostics are meeting with members of Congress, officials in the administration, and the new leadership of CMS. During recent con…
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…
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…
CURRENT ISSUE
Volume XXXI, No. 6 – April 29, 2024
Laboratory managers will want to note that The Dark Report itself was targeted by the fraudsters who hit Change Health in a cyberattack. Also, one lab has some innovative methods of combatting the chronic staffing shortage, including hiring college graduates and students.
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