Top Articles
No Surprises Act Sparks a Slew of Court Decisions
Law’s independent dispute resolution procedure triggers federal court challenges against HHS
CEO SUMMARY: Multiple lawsuits filed by the Texas Medical Association against the federal government have resulted in key decisions that affect provisions in the law. Qualifying payment amounts and ...
IVD and Lab Consolidation Reduces Choices for Labs
Three decades of IVDs buying IVDs, labs buying labs, has steadily concentrated economic power
CEO SUMMARY: Since the launch of The Dark Report in 1995, consolidation of hospitals, physician groups, clinical labs, pathology groups, and IVD manufacturers has been a major trend every year. Toda...
Don’t Automate Bad Work Processes in Microbiology
Labs should focus first on process improvement, then evaluate whether automated instruments are next step
CEO SUMMARY: Automation is not always right for every lab’s microbiology department, according to consultants from bioMérieux. When evaluating automated instruments, it is necessary to review wo...
Lab Data Crucial to Insurer Risk Adjustment Models
With Medicare Advantage payers, clinical labs can be paid for adding value
CEO SUMMARY: Payers who use risk adjustment models as part of Medicare Advantage need diagnostic data that helps them document ICD-10 diagnoses that earn them higher premium payments for sicker pat...
Private Health Insurers Are Aware of Problems with CPT Code 81408
EDITOR’S NO...
UHC Will Delay Enforcement of Z-codes for Genetic Test Claims
Oct. 1 transition date is no longer listed on a reimbursement policy update, though compliance is urged
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...
Lab News Briefs: Joint Commission, Bon Secours, Anthem, Walmart
Joint Commission Looks at Cyberattacks The Joint Commission issued a Sentinel Event Alert for hospitals to address cyberattacks. The alert pr...
Is Lab and IVD Consolidation Ready to Hit the Wall?
IN HUMAN HISTORY, ALL ERAS COME TO AN END. The majority of the time, the end of an era is disruptive and a new status quo emerges, with different winners and losers. Today, there is growing evidence that one era in clinical laboratory testing and IVD manufacturing may be close to ending. ...
Don’t Be at the Mercy of the Tumultuous Healthcare Revolution
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CURRENT ISSUE
Volume XXX, No. 13 – September 11, 2023
Recent court rulings involving the No Surprises Act are putting the government on the defensive about provisions of the law. Also, the continued consolidation of the IVD and national laboratory company markets has brought more influence to those lab companies. In addition, learn how clinical labs can earn money from their diagnostic data by helping private insurers navigate Medicare Advantage’s risk adjustment model.
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