ENFORCEMENT

New Laws: Congress Doubles Penalties for Medicare Fraud & Abuse

Sneaky may be too strong a word. But what is fair to say is that the new hikes in federal health care fraud violation penalties have flown totally under the radar despite their obvious and immediate … [Read more...]

MARKET TRENDS

By the Numbers: Spike in M.D. Practice Acquisitions Drives Up Costs of Hospital Care

Hospitals are gobbling up M.D. practices at a record rate. In addition to endangering the independent physician practice, this trend is driving up the costs of hospital care by adding ever higher … [Read more...]

SAFETY

Diagnostic danger in the lab: Time to reform how we process orders

By Oleg Bess, M.D.  bio I don't know about you, but I was stunned by the findings from a recent report published by Coverys, a national liability insurer, which I feel should put the entire … [Read more...]

MARKETING

Theranos & Its CEO Settle Stock Fraud Charges with SEC

Seven years ago, Theranos was a $9 billion dynamo seemingly on the precipice of blowing the blood testing market wide open. Today, the company and its CEO and founder, Elizabeth Holmes, are a … [Read more...]

COVERAGE

Emerging Tests: Medicare to Cover Next Gen-Sequencing Tests for Advanced Cancer

In the PAMA era, there are two salient trends in Medicare Part B lab reimbursements: Sharply lower prices for traditional tests; and Wider coverage of newly emerging tests, including some that … [Read more...]

FEE SCHEDULES

Industry Buzz: ACLA Goes for Kill in PAMA Lab Fees Challenge Case

Attorneys for the American Clinical Laboratory Association asked the federal court for summary judgment in its lawsuit challenging the legality of the new PAMA-based Medicare Part B fee schedule for … [Read more...]

INSIDE THE LAB INDUSTRY

PAMA-geddon: Lab Industry Asks Court to Stop New Medicare Fee Schedule

With CMS refusing to back down, the lab industry has escalated the dispute and asked a U.S. District Court to step in and prevent enforcement of the 2018 PAMA-inspired Part B Clinical Lab Fee Schedule … [Read more...]

INDUSTRY BUZZ

Genetic Profiling: Study Casts Doubt on Cost-Effectiveness of Leading Breast Cancer Recurrence Assay

Among the many genetic profiling assays entering the commercial market, few have been more successful than Genomic Heath's Oncotype DX, which is now covered by most of the nation's biggest insurers. … [Read more...]

MEDICARE REIMBURSEMENT

CMS Finalizes Controversial PAMA Fee Schedule

It's official. CMS is going forward with its controversial 2018 PAMA Clinical Laboratory Fee Schedule (CLFS). Regrettably, the final version closely tracks the preliminary one (See GCA, Oct. 24, 2017, … [Read more...]

PAMA

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...]


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