TAG:
private payer
2011’s Top 10 Lab Stories Point to a Busy 2012
CEO SUMMARY: Given the specific news stories that make up THE DARK REPORT’S list of the “Top Ten Lab Stories for 2011,†it might be said that 2011 was a rather quiet year overshadowed by anticipation of the coming reforms mandated by the Accountable Care Act of 2010. For the clinica…
LabCorp’s BeaconLBS Aims To Manage Genetic Tests
CEO SUMMARY: BeaconLBS is a new business created by Laboratory Corporation of America. It says it wants to help health insurance plans manage molecular diagnostics and genetic testing. BeaconLBS is now recruiting other clinical labs to join its network and is meeting with payers to offer …
Palmetto Execs Explain Molecular Test Policies
CEO SUMMARY: To create more transparency in the process clinical labs use to submit claims for genetic tests, molecular diagnostic tests, and for laboratory-developed tests (LDT), the nation’s largest Medicare Administrative Contractor (MAC) has proposed two new local coverage determina…
Anatomic Path Insourcing Expected to Be Ongoing
CEO SUMMARY: Insourcing of anatomic pathology services by office-based physicians has been especially prevalent and is increasing among three specialties (gastroenterology, urology, and dermatology), according to a survey conducted last month. Survey respondents also indicated that the tr…
Economics of Lab Testing to Be Challenged
BY ANY MEASURE, 2012 IS SHAPING UP TO BE A YEAR OF MAJOR CHANGE for healthcare and the clinical laboratory testing industry. Unfortunately, an early reading of the tea leaves indicates that the outcomes are not likely to be favorable for most clinical laboratories and anatomic pathology groups. Letâ…
Medicare Carrier Plans to Reject Molecular Claims
CEO SUMMARY: In September, Palmetto, a Medicare carrier serving California and seven other states, made public two draft local coverage determinations (LCDs) that revamp its coverage guidelines for molecular diagnostic tests (MDT) and laboratory-developed tests (LDT). All labs su…
AP Labs in Doc’s Clinics Now an Established Fact
CEO SUMMARY: It started about eight years ago and shows no signs of slowing down. Specialist physicians, particularly urologists and gastroenterologists, have learned about the benefits of operating their own in-clinic anatomic pathology laboratories. One-by-one, these specialty …
Why Insurers Are Buying Office-Based Physicians
WHEN THE NEWS BECAME PUBLIC earlier this month that UnitedHealth Group was quietly purchasing physician groups in selected areas of the country, there was a flurry of news articles recognizing this as a new trend. These news stories came after July 1. That’s the date when Kaiser Health N…
Will Lawsuits Re-shape Current Lab Practices?
CEO SUMMARY: Recent events in California, triggered by a lab whistleblower lawsuit filed in 2005 and unsealed in 2009, provide the latest example of how these lawsuits and related government enforcement actions can cause fundamental changes in the pricing and marketing p…
Labs Learn About ACOs And Medical Homes
IN JUST SEVEN MONTHS, the age of accountable care organizations (ACO) begins. On January 1, 2012, the Centers for Medicare and Medicaid Services (CMS) will commence contracting with ACOs. ACOs are one of the major reforms spelled out in the 2,700-page health reform law that President Obama si…
CURRENT ISSUE
Volume XXXII, No. 13 – September 15, 2025
The Dark Report examines a new bill that would reform PAMA and avoid reimbursement rate cuts scheduled for January 2026. Clinical laboratory leaders are urged to make their voices heard in Congress. Also, an expert describes how labs can fix pre-analytical errors and avoid disaster.
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