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Blog Posts by Author: XIFIN

Time Is Running Out to Voice Concern over the SPA 20-0010 Amendment

Important: Public input on this controversial amendment must reach the DHCS no later than Monday, July 27, 2020, to guarantee consideration before SPA 20-0010 is submitted. See various ways to contact the DHCS at the end of this article. The Department of Health Care Services (DHCS) plans to submit its State Planned Amendment (SPA) 20-0010 to the Centers for Medicare & Medicaid Services (CMS...

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XIFIN Data Reveals That COVID-19 Antibody Testing Volumes Are Surprisingly Low

Antibody testing volumes are lower than expected, while lab testing volumes have rebounded since March 2020, according to XIFIN data shared at a recent UBS audio conference. XIFIN’s Executive Chair and CEO Lâle White and Executive VP and General Manager of Diagnostic Services Kyle Fetter were on hand to share updates on nationwide COVID-19 testing and payor behavior. “COVID-19 has impacted...

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CMS Has Largest-Ever Public Meeting – Discusses Pricing Lab Test Codes

On June 22, 2020, CMS held its largest-ever annual public meeting for pricing new laboratory test codes. In addition, it was the first-ever meeting held only virtually. Nearly 30 different organizations offered comments on some 130 new codes. A full transcript of the meeting is available at the blog “Discoveries in Health Policy.” The blog’s author, Bruce Quinn MD PhD, told XIFIN there are...

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The Ugly Truth About Payors and PAMA

Recently CAP Today provided an excellent recap of XIFIN CEO and Executive Chairman, Lâle White's Executive War College presentation "Ugly Truth about Payors & PAMA: What Labs Can Expect and How to Respond." In this blog post, we break down some of the key points: PAMA Is a Price Reduction ProgramContrary to its publicized goal of achieving market-based pricing, the government remains fixed...

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ACLA Wins in Appeals Court Versus HHS

Recently, the DC Court of Appeals determined that federal courts do in fact “have jurisdiction to decide the merits of a challenge to the federal government’s administration of the Protecting Access to Medicare Act (PAMA).”1 This ruling will result in the ACLA vs. Azar case being sent back to the DC District Court to determine if the decision from HHS/CMS to exclude hospital outreach labs from...

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ACLA Issued a Statement to CMS on Automated Chemistry Test Panels

After claims from the Government Accountability Office (GAO) in November of 2018 that labs unbundling automated chemistry test claims will correlate to a drastic increase in Medicare spending, many industry thought leaders are responding. Most recently, ACLA has released a statement claiming that GAO’s assumptions are not backed by Medicare’s public claims data, or by ACLA’s own survey conducted...

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Market Disruption is the New Normal in the Diagnostic Industry

The laboratory and diagnostics industry has experienced tremendous changes in recent years. Top of mind, of course, is PAMA. With cuts totaling up to 30% over the next three years underway, laboratories are operating in one of the most challenging environments seen to date. As had been predicted, labs have had to tighten up their operations to mitigate the lost revenues. Some labs have already...

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The 5 Keys to Minimizing the Impact of PAMA

At this year's Executive War College Conference, XIFIN CEO and Executive Chairman, Lâle White presented on PAMA’s effects on laboratories and gave some thought-provoking ideas on how labs can respond. This blog post will cover many of the topics that Lâle discussed, starting with this timeline of industry events which provides background on the laboratory reimbursement environment...

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