May 1, 2013 | Coding, Billing, and Collections, Laboratory Management and Operations, Laboratory News, Laboratory Operations, Laboratory Pathology, Managed Care Contracts & Payer Reimbursement, Management & Operations
For more than a year Medicare contractors have been developing payment rates for the 114 molecular tests and without setting rates, they cannot make payments.
New Orleans, Louisiana, April 30, 2013—Getting paid for molecular test claims submitted under the new molecular CPT codes was a subject of high interest on the opening day of the Executive War College. Most clinical laboratories and pathology groups performing molecular tests nationwide report that they have not been paid for invoices submitted to Medicare contractors since January 1, 2013.
Several sessions were devoted to this important topic. Medicare contractors nationwide have not paid many of the molecular diagnostic test claims submitted since January 1 according to speakers and attendees at the first day of The Dark Report’s 18th Annual Executive War College in New Orleans. (more…)
Apr 22, 2013 | Coding, Billing, and Collections, Laboratory Management and Operations, Laboratory News, Laboratory Operations, Laboratory Pathology, Managed Care Contracts & Payer Reimbursement
Columnist Steve Gottlieb, M.D., wrote that “This sort of bungling may be without precedent, even for the Medicare agency”
Since the beginning of the year, most Medicare contractors and private health insurers have not paid clinical laboratories and anatomic pathology practices for molecular diagnostic test claims coded to the 114 new molecular test CPT codes.
This unprecedented situation of labs going unpaid for more than three months has created financial turmoil and uncertainty across the medical laboratory profession. In fact, the question must be asked: Did Forbes columnist Scott Gottlieb, M.D., wake up the nation’s Medicare contractors with his column published on March 27? (more…)
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…)
Nov 16, 2012 | Coding, Billing, and Collections, Compliance, Legal, and Malpractice, Laboratory Management and Operations, Laboratory News, Laboratory Operations, Laboratory Pathology, Managed Care Contracts & Payer Reimbursement
Organized by the National Association of Independent Laboratories, this effort attempts to educate lawmakers about the negative impact of cuts to Medicare Part B Clinical Laboratory Test fees
November 16, WASHINGTON, DC—This week, an intrepid group of clinical laboratory owners gathered in the nation’s capital specifically to visit their Senators and Representatives. The goal was to educate these elected officials about the tenuous financial condition of independent medical laboratory companies.
In particular, ongoing budget cuts to the Medicare Part B Clinical Laboratory Test Fee Schedule are undermining the ability of medical laboratories to deliver top-flight lab test services. This is particularly true for smaller independent clinical laboratories, particularly these located in communities not well-served by national lab companies. (more…)
Nov 8, 2012 | 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
Speakers at Sixth Annual Lab Quality Confab told attendees that ACOs and integration of clinical care now make it important for medical laboratories to use Lean and QMS to deliver more value while substantially reducing costs
DATELINE: SAN ANTONIO, TEXAS—Here at the 6th annual Lab Quality Confab and Process Improvement Institute (LQC), an enthusiastic crowd of clinical laboratory industry “first movers” gathered to learn how leading medical laboratories, pathology groups, and hospitals are harnessing the power of process improvement to drive gains in quality, customer satisfaction, and financial performance.
Institute of Medicine Report RecommendsContinuous Learning
LQC’s founder and host, The Dark Report‘s (TDR) Editor-in-Chief, Robert Michel, opened the general session on day one with a look at a recent report by the Institute of Medicine (IOM). The report, titled “Best Care at Lower Cost: The Path to Continuously Learning Health Care in America”, has significant implications for healthcare providers. Including clinical laboratories. (more…)
Aug 13, 2012 | Compliance, Legal, and Malpractice, Laboratory News, Laboratory Pathology, Managed Care Contracts & Payer Reimbursement, Management & Operations
Many clinical laboratory directors are unaware that CLIA officials have proposed heavy sanctions against the medical laboratory of the Ohio State University Wexner Medical Center, located in Columbus, Ohio. The enforcement actions include possible revocation of the lab’s CLIA license because of the inadvertent referral of proficiency testing specimens by the OSUWMC lab.
This is a significant event for the clinical laboratory profession. It will certainly catch the attention of those pathologists who serve as laboratory directors in labs holding Clinical Laboratory Improvement Amendments (CLIA) certification. It is extremely rare for any first-rank medical laboratory organization to face the possibility of having its CLIA license revoked by CLIA officials. (more…)
