Out of Network: 6 Frequently Asked Questions

By Richa Singh  bio As labs face an increasingly challenging reimbursement environment, more providers are doubling down on out-of-network strategies to maximize on collections … [Read more...]


Next-Gen Sequencing, AI Driving Investor Interest in Diagnostics Sector

There is "intense" investor interest and "substantial" investment occurring in the next generation of diagnostics and tools companies (Dx/Tools), according to a year-end report … [Read more...]


CMS Final Fee Schedule Will Impact Patient Access to Laboratories: COLA

The CMS Final Fee Schedule will hurt patient access to clinical laboratories, says the lab accreditation bureau COLA. The Centers for Medicare and Medicaid Services (CMS) has released its final rates … [Read more...]


CMS Ignores Flawed Processes, Finalizes 2018 PAMA Pricing; Labs Need to Take Immediate Action to Offset Impending Lean Times

By Kyle Fetter  bio The final 2018 clinical laboratory fee schedule (CLFS) is out, and it is evident that the argument that the Centers for Medicare & Medicaid Services (CMS) PAMA … [Read more...]


Association Representatives Say PAMA is #1 Concern for Lab Industry

In the kick-off event of G2 Intelligence's 2017 Laboratory Institute (Washington D.C.; Oct. 25-27), representatives of the biggest laboratory-related associations shared their top priorities, which … [Read more...]


Draft 2018 CLFS Reveals Fundamental Flaws in PAMA Reporting Exercise; Time to Take Action

By Lâle White  bio As XIFIN predicted, the PAMA reporting exercise has resulted in significant proposed laboratory fee cuts. In fact, the multi-year decrease for the top 20 laboratory tests … [Read more...]

Defense Dept. Extends Lab-Developed Test Demonstration for TRICARE

The Department of Defense announced June 20 that it approved a threeyear extension of the Defense Health Agency Evaluation of Non-United States Food and Drug Administration (FDA) Approved Laboratory … [Read more...]


Could the AHCA Slow Interest in Genetic Testing?

While it remains uncertain what the Senate will do with the American Health Care Act (AHCA), alarm is spreading about the legislation's implications for the estimated quarter of Americans under the … [Read more...]


Molecular Testing Avoids Significant Pay Cuts in 2017 CLFS

The Revamped G Codes for Definitive Drug Testing (underlined text represents changes from 2016 descriptor) The 2017 CLFS includes modified descriptors of the G codes for differential drug tests so … [Read more...]

Foundation Medicine’s Reimbursement Woes May Signal Broader Industry Challenge

Foundation Medicine (Cambridge, Mass.) candidly reported in quarterly financial filings that reimbursement challenges are stymieing the company's growth. The company's lack of Medicare coverage … [Read more...]