New geographic rule

So just got off a sales call with my current lab. What the hell is this new geographic rule for lab tests? They are stating that starting late 2017, patients will be restricted to labs within a certain geographic distance from the ordering physicians office! They received a letter from BCBS indicating the above! But no start date nothing! Did anyone else get a letter like this!

 

If true I am certain this is related to the problem caused by the HOPD model as I am 100% certain Quest and LabCorp are NOT going to switch to putting little labs in every part of every state and they are the two largest labs in the world. THere is and always will be testing that can only be done by specilty labs who cannot afford to have multiple locations all over the US. If I was working with a lab that was in any way relying on HOPD I would be worried as the insurance carriers are targeting YOU!!!

 

We got the same letter. Going nationwide. Nothing to do with hospital billing. Shutting down all labs that unbundled billing codes. All independtly owned labs are shutting down or are in the process of shutting down.

 

All labs shutting down. You are a moron. This is for OON labs and hospital scheming labs. I am in network with over 30 BC/BS plans and have not received this letter. CROOKS!

 

I think we work for the same lab. They are stating that unbundled billing codes is the reason.

 

Our lab got one as well. And we do not do any hospital billing. Not certain what it means. Optum rx did something similar with pharmacies. I am presuming labs are next. We will wait and see what happens over the next few months. I am diversified enough, I minimized Pgx about a year ago. Anytime I get Pgx paid, it is like a surprising bonus! Labs are dead unfortunately. I remember the hey day where Medicare was even paying for it. Now it's just one in a blue moon.

 

Same letter. But we only market to instate clients. We will be okay.

 

We had a meeting about this last week. And we certainly don't use hospital billing. Our CEO spoke to Our attorney and they assured us that this was a tactic to go after labs that 1099 employees. As we are W2, we are okay. Apparently they are going after reps and labs that carve out tests (whatever that means). I remember people laughing at me since I took an employeed job, but at least I still have a job.

 

Get off your high horse. Nothing to do with w2 or 1099. They are coming for over billing. Every lab is going through this. These tests were so high priced due to overbilling. And the insurance companies want there money back. Like the compounding jerk offs, they will go to jail.

I remember those compounding jerk offs said the same thing. It's legal, they don't come after reps... all are shut down and being tried.

 

Got an overbilling call from united healthcare. Nothing from bcbs yet, however, I can see the writing on the wall. Need to find another gig quickly!

 

My lab is in network with United and 18 BC/BS. We have not received this letter. It must have gone out to all the Out of Network criminal labs out there. Stop running a drug screen and then automatically setting up the screen to bill the 80481 code and maybe the insurances will leave you alone. Greed is what killed this industry and your labs are at fault!

 

Actually they are NOT going after the reps IF the business was obtained legally. The only time the government has targeted reps is when they were illegally paying patients or physicians. I have not heard or read of any cases where any rep has had their money taken away because they were 1099 and you can't give me a single example.

Sure there are cases of reps getting into trouble but it was ALWAYS because they were doing something else illegal. Loads of pharmacies are still in business that paid 1099 reps and are not at risk of anything happening in the future IF they obtained the busines legally.

The problem was too many scripts were written by physicians getting a kickback by either the rep or the pharmacy and or the patient was being compensated in some way to get a script. Some groups were really stupid and had these people get drug tests to really jack up the profits being produced by each patient. In fact, some were doing a PGx test and a toxicology test!!!

Some companies were claiming there were doing studies which was a total joke and rip off all in order to try and make people feel good about taking the bribe money.