Walgreens to Close 60 VillageMD Locations

By Robert Michel | From the Volume XXXI, No. 5 – April 8, 2024 Issue

CEO SUMMARY: Following substantial losses in fiscal 2023, Walgreens is working to cut costs and reduce overhead. One casualty in this effort will be the closure of 60 of the 360 primary care clinics in retail pharmacy stores built by Walgreens in recent years. These actions demonstrate th…

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Labs Should Prepare for Arrival of ‘Perfect Storm’

By Robert Michel | From the Volume XXXI, No. 3 – February 26, 2024 Issue

CEO SUMMARY: In the near future, clinical labs and pathology groups will need to address three major developments. One involves the FDA proposed LDT rule. A second is the adoption by payers of guidelines that require genetic test claims to have Z-Codes. The third centers around coming ref…

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CMS Issues AI Guidance for Medicare Advantage

By Mary Van Doren | From the Volume XXXI, No. 3 – February 26, 2024 Issue

CEO SUMMARY: With its guidance on how Medicare Advantage plans should use artificial intelligence (AI) when making treatment decisions involving individual patients, the federal Centers for Medicare and Medicaid Services has opened one door in the coming debate on how the federal governme…

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Year’s Top 10 Lab Stories Contain Surprises & Twists

By Robert Michel | From the Volume XXX, Number 18 – December 26, 2023 Issue

CEO SUMMARY: With the SARS-CoV-2 pandemic now in the rearview mirror of the nation’s clinical labs and pathology groups, the important news stories of 2023 were mostly about developments where the consequences will influence laboratory operations in coming years. Artificial intelligence…

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Why Payers Bristle as Labs Submit Inpatient Fees for Outreach Tests

By Virchow | From the Volume XXX, Number 18 – December 26, 2023 Issue

        EDITOR’S NOTE: Our column, Virchow, is written…

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Payers Are Right to Be Wary of Claims for Some LDTs’ Value

By Virchow | From the Volume XXX, Number 17 – December 4, 2023 Issue

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How Certain Labs Can Crack into Health Plans’ Closed Networks

By Virchow | From the Volume XXX, Number 16 – November 13, 2023 Issue

EDITOR’S NOTE: Our column, Virchow, is written by anonymous insiders working within the managed…

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Outreach Nets Hospital Lab $2.5M in One Year

By Scott Wallask | From the Volume XXX, No. 14 – October 2, 2023 Issue

CEO SUMMARY: Tucson Medical Center had sold its outreach business to a commercial laboratory two decades earlier, but wanted to bring those services back to its in-house lab. Early work with the finance de…

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Private Health Insurers Are Aware of Problems with CPT Code 81408

By Virchow | From the Volume XXX, No. 13 – September 11, 2023 Issue

EDITOR’S NO…

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UHC Will Delay Enforcement of Z-codes for Genetic Test Claims

By Scott Wallask | From the Volume XXX, No. 13 – September 11, 2023 Issue

IN THE LATEST BACKPEDAL ON ITS NEW POLICY, UNITEDHEALTHCARE (UHC) appears to have dropped its requirement for genetic testing laboratories to use Z-codes for claims under commercial health plans—for now. Earlie…

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