News, Analysis, Trends, Management Innovations for
Clinical Laboratories and Pathology Groups

Hosted by Robert Michel

News, Analysis, Trends, Management Innovations for
Clinical Laboratories and Pathology Groups

Hosted by Robert Michel
Sign In

UnitedHealthcare Pushes Back Start Date for Making Claims-Payment Decisions Based on its Florida Pilot Management Program for Medical Laboratory Tests

Health plan sets no new date for BeaconLBS claims-payment decisions but promises 30-days’ notice before making decisions on claims payment

Physicians, pathologists, and clinical laboratories in Florida got a late Christmas present last week. UnitedHealthcare (UHC) (NYSE:UNH) postponed the date when its medical laboratory benefit-management pilot program in Florida, administered by BeaconLBS, would affect claims payments.

This was welcome news, because, beginning January 1, if physicians serving UHC patients had failed to use the BeaconLBS system to obtain pre-notification or pre-authorization for 82 medical laboratory tests, the physicians or labs performing the tests would not be paid by UHC—nor could clinical labs and pathology groups in the UHC provider network bill patients for these tests. (more…)

Nation’s Clinical Laboratories and Pathology Groups Face Greatest Pressure to Cut Costs and Deliver More Value Than at Any Other Time in Past 25 Years

Blame it on shrinking hospital budgets and reduced lab testing prices; successful labs are using Lean, Six Sigma, and process improvement to reduce expenses and boost quality

Topic number one at clinical laboratories and anatomic pathology groups across the nation is cost-cutting, for two reasons. First, it is budget time at hospitals and labs are being told to aggressively reduce their costs in 2015. Second, health insurers are paying less for medical lab testing.

Simply said, labs are experiencing one of the toughest financial squeezes in two decades. Dark Daily has written about the underlying trends responsible for this financial pressure. Nationally, hospital inpatient admissions are down at the same time that hospitals are being paid less per inpatient. In response, hospitals are asking all clinical departments—including their clinical laboratories—to prune staff and cut budgets for 2015. (more…)

Clinical Chemists and Medical Laboratory Scientists Gather in Chicago for American Association of Clinical Chemistry and ASCLS Joint Meeting

Among the hundreds of lab industry vendors exhibiting, there were more companies showing LIS and lab informatics products this year than last year

CHICAGO, ILLINOIS—Anytime 20,000 clinical chemists and medical laboratory scientists gather in the same place, at the same time, there is sure to be many different opinions about the state of laboratory medicine and key trends in the clinical laboratory testing marketplace.

That was certainly true of this year’s annual meetings of the American Association of Clinical Chemistry (AACC) and the American Society of Clinical Laboratory Scientists (ASCLS) that took place here in the Windy City and ended yesterday. Your Dark Daily editor was in attendance and saw many interesting things during the exhibition, which opened on Tuesday and closed Thursday.

(more…)

Facing the Looming End of Fee-for-Service, Clinical Laboratories and Anatomic Pathology Groups Look for New Business Models

Failing finances at technical pathology laboratories may be the most immediate concern for many pathology group practices

Many clinical laboratories and anatomic pathology groups now recognize the new reality of the American healthcare system: less reimbursement for laboratory testing. On one hand, the fee-for-service prices for lab tests paid by government and private payers have been aggressively slashed.

On the other hand, all payers have become stubbornly resistant to issuing coverage guidelines and setting adequate prices for the flood of new molecular assays and gene tests coming to market.

These trends have already brought a handful of medical laboratories and pathology practices to the point of bankruptcy, sale, or closure. This is definitely true for the technical laboratories owned by many local pathology groups, which have become unprofitable due to fee cuts. (See below.) (more…)

23andMe Socked with FDA Warning Letter and Class Action Lawsuit over Company’s Genetic Testing Services

FDA’s assertion of power to regulate genetic tests is a familiar argument to pathologists and clinical laboratory scientists, but does create problems for 23andMe

It has been national news since November 22, when the Food and Drug Administration (FDA) sent a letter to 23andMe ordering it to stop the sale of direct-to-consumer genetic tests. The FDA said that 23andMe had failed to prove the validity of its genetic tests and gave the company 15 days to respond and  identify the steps it would take to address  FDA concerns.

This event has fulfilled the predictions of many pathologists and clinical laboratory professionals. Having dealt with the FDA throughout their careers, experienced medical laboratory scientists knew that the FDA would eventually take enforcement action against 23andMe, if the company did not provide adequate scientific information to support the clinical validity of its genetic tests. (more…)

;