Healthcare Blog
New U.S. Health Care Fraud Law Spells Trouble For Labs
In enacting the Eliminating Kickbacks in Recovery Act of 2018 (EKRA) late last year, the U.S. Congress approved an unprecedented expansion of federal anti-kickback authority. EKRA adds an all payor anti-kickback rule to the health care fraud law concerning improper...
PAMA Data Collection Starts This January But Most Hospitals Are Clueless
Hospital outreach laboratories which escaped providing private payor data to Uncle Sam under The Protecting Access to Medicare Act (PAMA) during the first round of reporting in 2016 have now run out of luck as the next collection period starts this January and runs...
How the Shifting U.S. Political Climate Will Impact Drug Pricing in 2019
Far more aggressive than anything they expected to see from a Republican Administration, the pharmaceutical industry was blindsided by a proposal by the Trump White House to import some of the price controls imposed by Europe’s single-payer healthcare systems. But...
Big Change Ahead for U.S. Labs in 2019
Starting next year, U.S. clinical laboratories including hospital outreach labs are facing a number of significant challenges now that the Centers for Medicare & Medicaid Services has made a significant change in its new market-based pricing system (PAMA)...
Turning the Tables On The ACA in 2018 Election Cycle
Don't look now but the upcoming 2018 U.S. midterm elections are shaping up as virtually the exact inverse of 2010 when widespread opposition to the Affordable Care Act (ACA) helped sweep Republicans into power from the local courthouse all the way up the political...
Healthcare Forecast: Look to the Cloud for Industry Disruption
With many tech giants looking for openings to disrupt the healthcare industry, a recent survey of health professionals point to Amazon as the one tech player likely to have the biggest future impact on the healthcare sector. Yet it would foolish to discount the...
ACA Won’t Die
Just like the Zombie in popular folklore, the Affordable Care Act (ACA) refuses to die despite the best efforts of the Trump Administration to kill it off. Despite GOP-led congressional action to axe the ACA’s individual mandate coupled with White House moves to...
Big Losers Under the White House Blueprint to Lower Prescription Costs
So whose ox is being gored under the Trump Administration's blueprint to lower prescription drug prices? Well, if you guessed the powerful and politically well-connected multinational pharmaceutical companies -- surprise -- you're wrong! A close look at the myriad...
Its A Dog-Eat-Dog World for Hospital Laboratories
Hospital laboratories nationwide are facing a challenging financial climate in the wake of sharp cuts in Medicare payment which became effective this year under the Protecting Access to Medicare Access (PAMA) of 2014 combined with ongoing market uncertainty in...
Pull and Tug of the Health Insurance Market
Despite various actions by the Trump Administration to undermine the Affordable Care Act, nearly 11.8 million people ended up enrolled in coverage through the ACA’s health insurance exchanges for 2018, down only slightly from the 12.2 million who...