IN A MAJOR STORY LAST WEEK, the Houston Chronicle reported that the rate of Texas physicians who are dropping the Medicare programhas increased 30-fold in 2010 compared to 2006. These findings indicate the level of "no confidence" that growing numbers of physicians have about the Medicare program.

The Houston Chronicle wrote that 50 physicians had opted out of Medicare in the first three months of 2010 and that more than 300 Texas physicians dropped the program in the previous two years. The Chronicle used data from Trailblazer Health Enterprises, the Medicare carrier for Texas, that included the number of physicians who had notified Trailblazer that they would no longer participate in the Medicare program. As recently as 2006, the Chronicle determined that only seven Texas doctors had opted out of providing for the Medicare program. The opt-out numbers were 70 in 2007, 151 in 2008, and 135 in 2009. Opt-out numbers between 1999 and 2002 were no more than three physicians opting out per year.

The Texas Medical Association (TMA) said that the Chronicle's surprising numbers "far exceeded their assumptions." In 2008, TMA had surveyed Texas physicians and learned that 42% of those doctors participating in the survey were no longer accepting new Medicare patients. The more disturbing finding was that, among primary-care doctors surveyed, the percentage of physicians no longer acceptingMedicare patients was a stunning 62%!

Susan Bailey, M.D., President of the Texas Medical Association, told the Chronicle that "This new data shows the Medicare system is beginning to implode." She attributed the growing number of physicians opting out to years of inadequate Medicare reimbursement, combined with the scheduled 21% cut in physician reimbursement that has yet to be fully resolved by Congress.

For pathologists and laboratory administrators, these numbers are an ominous portent. It is an early indication that greater numbers of physicians are prepared to cease serving Medicare patients in coming years, should Congress fail to maintain adequate levels of reimbursement. Of course, that begs the bigger point: where can Congress get the money needed to fund physician reimbursement at more generous levels? Confronted by physicians willing to cease serving Medicare patients, could that motivate lawmakers to possibly shift some of the future funding for Part A lab testing services over to physician services?

ISO 15189 Accreditation Earned by Spectra Labs

Adoption of ISO 15189 and its QMS directly improves lab test quality for Spectra's renal patients

CEO SUMMARY: Spectra Laboratories Inc., recently announced that it had earned accreditation to the ISO 15189:2007 standard, following an assessment by a team from the Association for Laboratory Accreditation (A2LA). Spectra is a high-volume laboratory that serves renal patients. It also provides clinical trial testing for pharmaceutical companies. Spectra officials stated that the laboratory wanted to adopt the quality management system (QMS) that is the foundation of ISO 15189.

Genetic Testing Genie Is Now Out of the Bottle

Walgreens backs off on plan to sell consumers genetic test kits in 6,000 of its retail pharmacies

CEO SUMMARY: There's been an uneasy standoff between companies that want to sell genetic tests directly to consumers over the Internet and both state and federal regulators. But now it appears that the FDA is ready to take off the gloves and assert greater control over genetic testing. The agency moved swiftly to challenge six genetic testing companies that offer genetic testing directly to consumers. One consequence might be more regulation of laboratory-developed tests (LDTs).

Medicare Update: Pathologists Not Enrolled In PECOS By July 6 Risk Denial of Medicare Claims

Using Performance-Based Part A Hospital Path Contracts

Creating a Win-Win Outcome for Pathologists Creating a Win-Win Outcome for Pathologists and tthe Hospital

CEO SUMMARY: One of pathology's greatest challenges is adequate reimbursement for hospital Part A Pathology Services. Over the past two decades, ever more hospitals took steps to reduce or eliminate payment to pathologists for these services. Now several innovative pathology groups are using a performance-based strategy to negotiate win-win Part A Pathology Service contracts with their hospitals and health systems. Properly structured, these Part A agreements do increase reimbursement to pathologists.

ORDER LIVE AUDIO RECORDINGS NOW!
Negotiating Pathology Part A Reimbursement with Hospitals: Why the Performance-Based Approach Opens the Door to Increased Value

LAB MERGERS: Halfpenny Technologies Buys Laboratory Management Services

Acquisition gives Halfpenny added capabilities to provide lab test data to HIEs and payers

LAB BRIEFS: CLARIENT, Inc INKS PACT WITH GENERATION HEALTH FOR GENETIC TESTING

GENMARK'S IPO MAKES IT NEWEST PUBLICLY-TRADED IVD FIRM

INTELLIGENCE: Late & Latent

RED CROSS FINED $16 MILLION BY FDA FOR BLOOD ISSUES

GEN-PROBE INVESTS $50 MIL IN PACBIO

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