PAMA - Jan 2018 - Protect American medicare Act

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anonymous

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Does any one know about this new PAMA law that is going to cut approx 50 % from the curent medicare rates effective Jan 1 2018 in the Toxicology segment ??
I had a doctor ask me today "if it is going to force all Tox labs out of business "

XIFIN tapped its data base to look at the data that its client labs will report to CMS for 20 high-volume lab tests. It calculated a weighted average price that private payers paid for these four lab sectors when compared with the Medicare lab fee schedule, as follows:


Independent labs are paid 19.6% less.
  • Hospital labs with NPIs are paid 25.6% more.
  • Molecular and genetic testing labs are paid 27.3% more.
  • Pain management and toxicology labs are paid 50.4% more.
If this actually happens are we going to go out of businees!! After looking up PAMA It scared the #%$% out of me!

I am sort of new and any honest feeback will be greatly appreciated??

Thanks,
 








anonymous said:
Does any one know about this new PAMA law that is going to cut approx 50 % from the curent medicare rates effective Jan 1 2018 in the Toxicology segment ??
I had a doctor ask me today "if it is going to force all Tox labs out of business "

XIFIN tapped its data base to look at the data that its client labs will report to CMS for 20 high-volume lab tests. It calculated a weighted average price that private payers paid for these four lab sectors when compared with the Medicare lab fee schedule, as follows:


Independent labs are paid 19.6% less.
  • Hospital labs with NPIs are paid 25.6% more.
  • Molecular and genetic testing labs are paid 27.3% more.
  • Pain management and toxicology labs are paid 50.4% more.
If this actually happens are we going to go out of businees!! After looking up PAMA It scared the #%$% out of me!

I am sort of new and any honest feeback will be greatly appreciated??

Thanks,
Click to expand...

Yes, after this there will not be a sinlge toxicology lab left in the US. I guess since you say there will not be a sinlge tox lab left everyone can go smoke and do as much drugs as they want since there will not b eany labs left to do the testing.
 








None of Xifin clients matter. Quest and Labcorp will be the deciding factor. CMS can only reduce prices by 10% each of the first 3 years and then 15% the next 3 years. In 6 years everyone will be getting Medicaid rates. My lab will be fine as we have lived in the Medicaid sector for years and have always turned a profit. 90% of all tox labs will be out of business in 3 years and no one will buy them Good riddance to the scum of the lab industry!
 
















anonymous said:
If the Medicare rates drop...doesn't that mean the Medicaid rates will drop also? I can assure you a heavy Medicaid business model cannot last.
Click to expand...

A heavy Medicaid business model can last It depends on how you structure your lab. If you have a huge sales department, huge billing department and huge executive structure you will fail. You keep costs low by automating, running LEAN in all departments and have a great management staff that buys into your model. You make less per sample, but run 5 times as many samples as other labs. My lab can average $45 for a drug screen with confirmation and still pull a 35% EBITDA! Most of the labs that came into existence after 2004 when reimbursements were high, don;t know how to function like my lab. Also 1099 sales reps do not work in my model. W-2 reps with salary and 10% commissions for 12 months then 4% for life of account work. They make less per specimen, but the volumes are very high and they all make in the 150k+ range. Labs like mine will survive just like we have for that past 30+ years!
 








anonymous said:
A heavy Medicaid business model can last It depends on how you structure your lab. If you have a huge sales department, huge billing department and huge executive structure you will fail. You keep costs low by automating, running LEAN in all departments and have a great management staff that buys into your model. You make less per sample, but run 5 times as many samples as other labs. My lab can average $45 for a drug screen with confirmation and still pull a 35% EBITDA! Most of the labs that came into existence after 2004 when reimbursements were high, don;t know how to function like my lab. Also 1099 sales reps do not work in my model. W-2 reps with salary and 10% commissions for 12 months then 4% for life of account work. They make less per specimen, but the volumes are very high and they all make in the 150k+ range. Labs like mine will survive just like we have for that past 30+ years!
Click to expand...

Are you hiring ???
 








Yes we are hiring. Post your cell or email and I will have someone reach out. I will not post my number for fear of exposing who my lab is. I like to stay anonymous as we have been flying under most labs radar for 30 years!
 
























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