Sep 16, 2013 | Coding, Billing, and Collections, Laboratory Management and Operations, Laboratory News, Laboratory Operations, Laboratory Pathology, Laboratory Sales and Marketing, Management & Operations, News From Dark Daily
Clinical laboratories and pathology groups serving Cigna beneficiaries can expect to see new requirements for genetic tests used to diagnose breast cancer, colon cancer and long QT syndrome
Effective this week, Cigna (NYSE: CI) in Bloomfield, Connecticut, is implementing a new program that requires genetic counseling and pre-authorization for certain genetic tests. This is an important development and clinical laboratory executives can expect to see other health insurers take similar steps.
Cigna wants to control costs and improve the appropriateness of ordering expensive genetic tests. It will start with tests for three conditions and may require counseling for other types of genetic tests if this program is successful. Industry observers expect other health insurers will follow Cigna’s example and also require genetic counseling for a compelling reason: all insurers recognize that more than 50% of all genetic tests may be ordered inappropriately, experts say.
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Apr 3, 2013 | Coding, Billing, and Collections, Compliance, Legal, and Malpractice, Digital Pathology, Instruments & Equipment, Laboratory Hiring & Human Resources, Laboratory News, Laboratory Operations, Laboratory Pathology, Laboratory Sales and Marketing, Managed Care Contracts & Payer Reimbursement, Management & Operations, News From Dark Daily
Financial and clinical fortunes may soon shift for many medical laboratory organizations
By every measure, the clinical laboratory industry is entering a high-stakes period during the next 24 months. Powerful trends are reducing lab budgets and payers are cutting the prices paid for medical laboratory testing. The question on everyone’s mind is “will it get better or worse in the months ahead?”
This question will be asked plenty of times to speakers at the nation’s largest gathering of clinical lab executives and pathology business leaders. On April 30-May1, the upcoming 18th Annual Executive War College on Laboratory and Pathology Management will take place in New Orleans, Louisiana. A record crowd has already registered to attend. (more…)
Oct 10, 2012 | Coding, Billing, and Collections, Laboratory News, Laboratory Pathology
This finding is reinforced by the fact that high-deductible health plans are now the second most popular plan option offered by the nation’s employers
Getting paid for expensive genetic cancer tests is likely to be tougher for clinical laboratories when the patient is covered by a high-deductible health plan. There are two trends that are contributing to this situation, each highlighted by recently-published studies.
One trend is the rapid growth of consumer-driven health plans (CDHPs). The second trend is growing evidence that patients, if they need to pay much money out of pocket, will decline to undergo genetic testing that is suggested by their physicians. (more…)
Jun 27, 2012 | Compliance, Legal, and Malpractice, Laboratory News, Laboratory Operations, Laboratory Pathology, Laboratory Sales and Marketing, Managed Care Contracts & Payer Reimbursement
Study evaluated the Western European market for in vitro diagnostic manufacturers
Are clinical laboratories in the United States and other developed nations around the world capable of meeting the expected surge of medical laboratory testing that is expected to come as large numbers of people age into their 60s and 70s? That is a question which has yet to be answered with much confidence by leading healthcare experts.
Recently a respected research firm offered its best guess at what lab specimen growth rates may be and its predictions may surprise many pathologists and clinical laboratory managers. At the same time, the right answer to this important question is critical for lab administrators when planning strategy.
It Takes Years to Expand Capacity of a Clinical Pathology Laboratory
That is because it typically requires years to expand the capacity of a medical laboratory organization. Then there is the challenge of hiring additional pathologists, Ph.D.s, and laboratory scientists at a time when many developed countries already report an acute shortage of trained medical laboratory professionals.
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Jan 4, 2012 | Digital Pathology, Laboratory News, Laboratory Pathology
Separate genetic and molecular test registries proposed by the National Institutes of Health and by Palmetto GBA draw detailed public comments from medical lab groups
Registries for genetic tests and molecular diagnostic assays don’t seem to be going over well with clinical laboratories and pathology groups. Two different genetic test registries are drawing criticisms from pathologists and laboratory medicine professionals.
One molecular test registry was proposed last year by the National Institutes of Health (NIH). For different purposes, this fall, Palmetto GBA, the Medicare Carrier based in Columbia, South Carolina, proposed a molecular test registry that would be used by laboratories billing for molecular testing services provided in the Medicare J1 region, which includes California, Hawaii, and Nevada.
This second registry is part of what Palmetto GBA has named the “Molecular Diagnostic Program” (MolDx). Palmetto expects this registry will help resolve problems created by code stacking claims for genetic and molecular tests. (See Dark Daily “Palmetto GBA Execs Explain MolDx, Its New “Molecular Diagnostic Services” Program for Clinical Pathology Laboratories,” November 15, 2011.) The MolDx program has already attracted public comments, both positive and negative.
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