Oct 19, 2011 | Compliance, Legal, and Malpractice, Laboratory News, Laboratory Pathology
Nation’s clinical laboratories may see significant reductions in federal funding for medical laboratory tests in the 2012 federal budget
Unprecedented cuts in funding for clinical laboratory services are expected from Congress in coming months. That’s because federal legislators need deep cuts from many sources to cope with the current budget crisis. It is also why some Beltway insiders predict that fees for medical laboratory testing will be substantially reduced.
Although many lab industry associations have alerted their members to certain of these proposals—such as the proposed plan to reinstitute the patient co-pay/co-insurance requirement for Medicare Part B Medical Laboratory Tests—few clinical laboratory managers and pathologists know that there are at least three separate proposals to reduce funding for medical laboratory tests. Each proposal has a chance to make it through the legislative pipeline and become part of the final 2012 federal budget.
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Aug 27, 2010 | Laboratory Management and Operations, Laboratory Pathology, Management & Operations
GAO Gives Congress a Poor Report on Direct-to-Consumer Genetic Tests Sold by Web-Based Companies
According to the Wall Street Journal, Direct-to-consumer (DTC) genetic tests from the four companies 23andMe, Navigenics, deCODE genetics, and Pathway Genomics Corp, are generating results “that are misleading and of little or no practical use.” This was the finding of the U.S. General Accounting Office (GAO) in its recently released report.
Pathologists and clinical laboratory managers will be interested to know that the GAO sent multiple specimens to these four companies—each of which is organized to sell genetic tests and molecular diagnostics directly to consumers via the Internet. The GAO determined that, even when given identical DNA samples, the tests from these four companies yielded contradictory results.
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Jan 22, 2010 | Laboratory News, Laboratory Pathology
Pathologists and clinical laboratories can expect a new type of federal oversight
One consequence following passage of the massive health bill now being considered by Congress is a significant expansion in the role of the Internal Revenue Service for certain healthcare activities. So writes Phil Galewitz and Christopher Weaver of Kaiser Health News about developments that are not auspicious for pathology and clinical laboratory testing.
They note that the job of enforcing the legislative mandate that requires every citizen of the United States to have health insurance (or pay a penalty tax) will fall to the IRS. The federal agency would look for this information on income tax returns. Americans would have to show proof of coverage on their income tax returns starting in either 2013 (House bill) or 2014 (Senate bill).
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Aug 7, 2009 | Laboratory News, Laboratory Pathology
MedPAC recommendation targets high-cost imaging done in physician’s offices
Following the lead of some private insurers, Medicare may soon require preauthorization for high-cost imaging tests—including CT, MRI and PET scans—done in physician offices. This is one of two strategies aimed at reducing payments for Part B physician radiology services that was recommended by the Medicare Payment Advisory Commission (MedPAC) in its report to Congress in March.
The General Accounting Office (GAO) estimates that preauthorization could save the Medicare program $220 million by 2014 and about $1 billion by 2019. To make preauthorization work, the Centers for Medicare & Medicaid Services would establish a panel of experts, to be known as a Radiology Benefits Managers (RBMs), to assist in evaluating and adjusting payment for potentially overvalued imaging services ordered by physicians with their own imaging facilities.
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Jul 6, 2009 | Laboratory News, Laboratory Pathology
Rescinding health policies of 20,000 people in past five years saved health insurers $300 million
For years, Americans have heard news stories about the sick patient whose health insurance policy was rescinded in the midst of a health crisis. Now comes public acknowledgement—at a Congressional hearing no less—that this business practice exists!
Executives from three of the nation’s largest health insurers admitted to this practice when testifying at a Congressional investigation recently. Observers believe the surprisingly candid acknowledgement about health insurance recissions pretty much guarantees insurers will be excluded from the health care reform debate. It may even ensure inclusion of a government health insurance plan in the final legislation which passes. (more…)
