Top Articles

New UnitedHealthcare Policy For Hospital Reference Tests

Policy prohibits billing for non-inpatient tests under a hospital’s facility participation agreement

>CEO SUMMARY: Under a new policy UnitedHealthcare will start in May, hospital laboratories will no longer be allowed to bill for reference testing for members who are not hospital patients. The policy is likely to affect clinical lab testing for patients whose testing goes ...

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Healthcare, Lab Market Trends Central Focus at Executive War College

Powerful forces are at work transforming the U.S. healthcare system and the clinical laboratories that serve it. These forces will be identified and discussed at the upcoming 25th annual Executive War College...

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Insurers Are Rejecting Many PLA, MAAA Codes

Hope fades for labs expecting to get paid for new PLA, MAAA codes that PAMA authorized

>>CEO SUMMARY: Clinical labs developing innovative tests face a challenge getting paid. While Medicare may reimburse for these tests, some commercial payers and state Medicaid programs are not paying for new proprietary laboratory analyses (PLA) codes and multianalyte assays...

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Northwell Lab Team Validates COVID-19 Test on Fast Timeline

Lab Will Have Capacity to Handle Large Volumes of Tests

CEO SUMMARY: Clinical labs are working with haste to test for the novel coronavirus, also called nCoV and SARS-CoV-2. Their efforts to prepare for high capacity testing for viral respiratory illness include validating molecular tests for the newly-identifie...

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COVID-19 Patient? Northwell Has Mobile Phlebotomy App

Smartphone app schedules mobile phlebotomist for home draw; useful with coronavirus outbreak

>CEO SUMMARY: What better way to limit the spread of a deadly novel coronavirus than to allow patients who suspect they have the COVID-19 illness to use a mobile phone to book an appointment with a phlebotomist who makes house calls? Northwell Laboratories started this service in Novem...

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OIG 2020 Plan of Work to Review Billing for Medicare Part B Tests

Since October, the federal Department of Health and Human Services Office of Inspector General (OIG) has published two versions of its plan of work for 2020. In both versions, the inspectors highlighted OIG’s efforts to review compliance with Medicare Part B billing requirements for clinical labora...

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Be Careful Payers, You May Get What You Wish For!

Few clinical laboratory executives and pathologists would disagree with the assertion that both government and private payers would like to see the prices they pay for medical laboratory testing and the amount of money they spend reimbursing labs to stay flat or shrink from one year to the next. Certainly the actions taken by Medicare officials and private health insurer...

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