Feb 20, 2013 | Coding, Billing, and Collections, Compliance, Legal, and Malpractice, Laboratory News, Laboratory Operations, Laboratory Pathology
Medical laboratory continues to operate, retains its CLIA certificate, and maintains that the PT violations at heart of CMS case were inadvertent
One nationally prominent clinical laboratory organization closed its chapter in the ongoing story of CLIA enforcement of the regulations governing the inadvertent referral of proficiency testing specimens. But this chapter ended with an unexpected twist for the Ohio State University Wexner Medical Center (OSUWMC), which was given severe sanctions by officials of the Centers for Medicare & Medicaid Services (CMS), despite recent enactment of a new federal law on the subject of enforcement of CLIA proficiency testing errors.
The settlement between OSUWMC and CMS was announced on January 16. It calls for OSUWMC to:
- Appoint a new medical director for the clinical laboratory,
- Pay $268,000, and
- Provide additional training to the medical laboratory staff in proficiency testing (PT).
New Medical Director Named at OSUWMC’s Clinical Laboratory
OSU named Daniel Sedmak, M.D., to the position of medical director of the clinical laboratory, as part of this resolution with federal officials who administer the Clinical Laboratory Improvement Amendments (CLIA). Sedmak is currently the Chair of the OSU College of Medicine, Department of Pathology and a professor of pathology.
Last month, Ohio State University Wexner Medical Center issued a press release stating that it had resolved pending sanctions assessed against its clinical laboratory by the Centers for Medicare & Medicaid Services for violations of CLIA requirements, including the inadvertent referral of proficiency testing specimens. (Photo by Wikipedia.com.)
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Feb 18, 2013 | Coding, Billing, and Collections, Laboratory Management and Operations, Laboratory News, Laboratory Operations, Laboratory Pathology, Management & Operations
Medical laboratories have yet to learn how much to expect in payment for molecular pathology test claims submitted to the Medicare program
Concern is rising among pathologists and clinical laboratory directors about what the Medicare program will pay this year for the 104 new molecular test CPT codes. These new CPT codes became effective on January 1, 2013.
Few–if any–medical laboratories have received payments for Medicare claims submitted early in January. That’s because contractors for the federal Centers for Medicare & Medicaid Services (CMS) are just beginning to process those invoices. The first payments for these molecular test claims are expected within the next several weeks.
Help for Clinical Laboratories and Pathology Groups
To help clinical labs and pathology groups address this problem, CodeMap, LLC, a billing and coding consulting company in Schaumburg, IL, is encouraging clinical labs to post the payment amounts for the molecular test claims they get from the nation’s Medicare Administrative Contractors on the CodeMap website at www.codemap.com. CodeMap then will make this information available to participating medical laboratories and the public.
To fill the knowledge vacuum that exists as different Medicare Administrative Contractors use the gap-fill method to develop reimbursement for the 104 new molecular test CPT codes, CodeMap, LLC, of Schaumburg, IL, is using the crowdsourcing solution. Also known as distributed problem solving, CodeMap is inviting clinical laboratories and pathology groups to voluntarily provide data about their payments for Medicare claims involving the new molecular test codes. (Graphic by HBS.edu.)
Feb 15, 2013 | Coding, Billing, and Collections, Compliance, Legal, and Malpractice, Laboratory News, Laboratory Operations, Laboratory Pathology
Raising the out-of-pocket costs for Medicare beneficiaries with Medigap policies not likely to be favorable for medical laboratories
If federal officials have their way, Medicare beneficiaries with comprehensive Medigap polices are likely to pay a greater share of the cost of their medical care. The goal is to reduce use of unnecessary medical services and save Medicare money.
For clinical laboratories and anatomic pathology groups, this may not be a welcome development. That’s because any requirement for labs to collect more money directly from Medicare beneficiaries will raise the cost of billing and collections—even as medical laboratories also see a rise in bad debt from Medicare beneficiaries, who are not accustomed to paying any money out-of-pocket for most of their medical laboratory tests.
May Be Some Good News for Pathologists
However, there is some good news for pathologists and clinical laboratory managers in this story. A credible source has warned the federal government that increasing the Medicare beneficiary’s costs will not reduce unnecessary utilization of healthcare services. Nor will it save the Medicare program any money. In fact, such actions may have the opposite effect!
The government is considering requiring higher out-of-pocket cost sharing from the 9 million seniors with Medigap policies to cut down on use of unnecessary medical services. The National Association of Insurance Commissioners contend, however, that this would raise Medicare costs over time. (Graphic by Kaiser Health News)
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Feb 13, 2013 | Laboratory Hiring & Human Resources, Laboratory News, Laboratory Operations, Laboratory Pathology, Management & Operations
Medical laboratory technicians, as well as pathologists, clinical laboratory managers and medical technologists, may disagree that MLT is a low-risk, low-stress job
Medical laboratory technicians, rejoice. Your vocation has been officially proclaimed one of the least stressful jobs for 2013. Do you agree?
According to online career site, CareerCast.com, medical laboratory technician ranked number 5 on the list of the 10 least stressful jobs for this year. Forbes.com reported the story.
Difference between Medical Laboratory Technicians, MTs, and CLSs
Before going further, it is helpful for DarkDaily.com readers to be reminded that news reporters and journalists often fail to make the distinction that there are significant differences in the education and competencies of medical technologists (MT) and clinical laboratory scientists (CLS), as compared to medical laboratory technicians. For that reason, readers should extend some forbearance to the authors of the CareerCast.com list of least stressful jobs for 2013.
Medical laboratory personnel might be amused to learn that MLTs are in good—or at least eclectic—company. Sharing top honors for least anxiety-producing métiers are university professor, tailor, librarian and drill press operator.
Many clinical laboratory professionals may not agree that the position of medical laboratory technician is stress-free enough to included on CareerCast.com’s list of the top ten stress-free jobs for 2013. (Photo by MedicalLaboratoryTechnicianHub.com)
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Feb 11, 2013 | Compliance, Legal, and Malpractice, Laboratory Management and Operations, Laboratory News, Laboratory Operations, Laboratory Pathology, Management & Operations
There will be more focused lab testing and public reporting of sepsis results as New York State addresses growing problem following death of 12-year-old boy.
New York State will implement tougher standards for the diagnosis and treatment of sepsis in hospitals. One consequence is expected to be more medical laboratory testing for patients suspected of having sepsis.
It may also mean that clinical laboratory test results will get increased scrutiny by physicians who, under the new requirements, must become faster at making an accurate diagnosis of sepsis. These developments were announced by New York Governor Andrew M. Cuomo in his State of the State message on January 9. (more…)
Feb 8, 2013 | Digital Pathology, Instruments & Equipment, Laboratory Instruments & Laboratory Equipment, Laboratory Management and Operations, Laboratory News, Laboratory Operations, Laboratory Pathology
Pathologists and clinical laboratory managers should fundamentally change how cancer specimens are handled
Three physicians at Scripps Health are calling for pathologists to rethink how they collect and store cancer tissue samples in two significant ways. They say that pathologists need to: 1) move away from formalin-fixed, paraffin-embedded (FFPE) tissue blocks and toward frozen samples; and, 2) start collecting larger samples.
These doctors used the Journal of the American Medical Association as a platform to issue their call for a change in what has been a long-standing standard of practice in anatomic pathology. Given the progressive nature of these opinions, there will certainly be dissenting voices within the pathology profession who are likely to add their voices to this debate.
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