LAB INDUSTRY’S UNDER-REPORTED STORY: FOUR MONTHS INTO 2013, CLINICAL LABORATORIES STILL WAITING FOR PAYMENT FROM GOVERNMENT AND PRIVATE PAYERS FOR MOLECULAR TEST CLAIMS

PRESS RELEASE

THE DARK REPORT

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FOR IMMEDIATE RELEASE

Media Contact: Katherine Sklar

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AUSTIN, Texas (April 25, 2013) — It’s a story that is familiar to every clinical laboratory and anatomic pathology group performing molecular diagnostic tests that are billed under the 114 new molecular CPT codes. Government and private payers failed to prepare for the January 1, 2013, implementation of these new CPT codes. That means most labs have gone unpaid for most of these CPT codes for almost four months.

The consequences of this situation are significant. Having gone months without payment for these legitimate claims, labs are laying off staff, ceasing to offer these molecular diagnostic assays to physicians and patients, or even shutting down and going out of business. To provide medical laboratory executives and pathologists with a full overview of unfolding events—along with strategies to help their labs respond— The Dark Report published a special issue on April 15, 2013, devoted entirely to the molecular test payment morass.

This is a story of bureaucratic mismanagement at the Centers for Medicare and Medicaid Services, and the harm it’s visiting on the diagnostic testing industry,” declared Scott Gottlieb, M.D., in an essay published by Forbes on March 27. Gottlieb, interviewed by The Dark Report, has the knowledge to make this charge. He served as Senior Adviser to the Administrator of Medicare and Medicaid Services, where, among other things, he was involved in decisions about coverage and payment, including consideration of new medical technologies.

To provide the fullest picture, the latest issue of The Dark Report is devoted entirely to the chaos and cash flow disruptions to labs caused by the fact that the Medicare program and private payers have failed to pay labs for these molecular test claims since January 1. Interviews with knowledgeable experts range from Stephanie Denham, Client Services Director (Laboratory Billing) for McKesson Corporation to Jane Pine Wood, Attorney for McDonald Hopkins, plus five other experts.

The information presented explains why payers were unprepared to process and pay claims for the new 114 molecular test CPT codes. Most importantly, it reveals what strategies labs are using to resolve this situation and accelerate settlement and payment for their growing backlog of unpaid molecular test claims.

To obtain a copy of this comprehensive special issue of The Dark Report, editors and reporters can contact the media relations contact listed below. Laboratory executives and pathologists who would like a copy of this report can go to www.darkreport.com (at URL: http://www.darkreport.com/recent-Dark-Report-Molecular-CPT-Codes-Reimbursement-System-Falls-Short.htm to order their personal copy of this issue of The Dark Report.

For additional information, Contact:  Katherine Sklar, 512-264-7103

About THE DARK REPORT

Established in 1995, THE DARK REPORT  is the leading source of exclusive business intelligence for laboratory CEOs, COOs, CFOs, Pathologists and Senior industry executives. It is widely-read by leaders in laboratory medicine and diagnostics. The DARK REPORT produces the famous Executive War College on Laboratory and Pathology Management (every spring, which showcases innovations by the nation’s and globe’s leading laboratory organizations. Dark Daily is an Internet-based e-briefing intelligence service, read worldwide by thought leaders in laboratory and pathology management. Other well-known conferences conducted by THE DARK REPORT are Lab Quality Confab (on the use of Lean and Six Sigma methods in labs and hospitals), Molecular Summit (on the integration of in vivo and in vitro diagnostics). THE DARK REPORT co-produces Frontiers in Laboratory Medicine annually in the United Kingdom; Executive Edge bi-annually in Canada; and The Business of Pathology bi-annually in Australia.

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