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rina wolf

February 21, 2017 Intelligence: Late Breaking Lab News

Theranos, Inc., was in the news again recently. On Feb. 16, The Wall Street Journal reported that Theranos had just $200 million in cash. The information came from a conference call the discredited lab testing company conducted with its investors. During the call, Theranos officials …

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Payers Asking for Repayment When Labs Waive Fees

CEO SUMMARY: Health insurers appear to have stepped up their efforts to warn clinical laboratories not to waive patients’ fees in return for specimen referrals. Consultants also say that payers are increasing enforcement efforts. There are cases where, when insurers discover labs have n…

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How to Cover Genetic Tests Confounds Health Insurers

CEO SUMMARY: Managed care experts say health insurers are being overwhelmed by the number of new genetic tests and that many labs find it tough to get paid for these tests. UnitedHealthcare just announced it will require pre-authorization of molecular and genetic tests during 2016. Me…

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Price Cuts, Long Delays in Payment Are Expected – December 31, 2012

CEO SUMMARY:  In addition to a steep cut in the 88305 CPT code, anatomic pathology laboratories can expect cuts in the payment from Medicare for molecular and prostate biopsy testing. Two national experts in lab billing and reimbursement warn labs to expect confusion in how both pub…

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Labs React with Criticism to Proposed ADLT Rule

CEO SUMMARY: Some in the lab industry had high hopes that passage of the Protecting Access to Medicare Act (PAMA) last year would favorably resolve a number of important issues. However, those hopes were dashed following the September 25 release by CMS of a proposed rule setting out how i…

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New Pricing Formula for Advanced Diagnostic Tests

CEO SUMMARY: One section of the federal H.R. 4302: Protecting Access to Medicare Act of 2014 is getting positive reviews from many lab experts. The law defines advanced diagnostic tests (ADTs) and directs CMS to assign a temporary HCPCS code and use list prices to pay labs for such tests …

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Price Cuts, Long Delays in Payment Are Expected

CEO SUMMARY: In addition to a steep cut in the 88305 CPT code, anatomic pathology laboratories can expect cuts in the payment from Medicare for molecular and prostate biopsy testing. Two national experts in lab billing and reimbursement warn labs to expect confusion in how both public and…

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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…

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November 02, 2009 “Intelligence: Late Breaking Lab News”

Digital microfluidics and lab-on-a-chip technologies are being combined to create a new way to measure breast estrogen levels in women. An interdisciplinary group at the University of Toronto developed a lab-on-a-chip technique to analyze blood and breast tissue to identify women at …

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