Vachette Pathology

On Saturday April 25, 2009, Cynthia Hegg Krueger, M.D., for the Michigan Society of Pathologists (MSP) presented the following Resolution #72-09 to the Michigan State Medical Society (MSMS) proposing the validity of the practice of professional component clinical pathology billing:

RESOLUTION 72-09A

Title: Pathologist Professional Component Billing for Laboratory Testing

Introduced by:  Cynthia Hegg Krueger, MD, Washtenaw County

                       Ed P. Fody, MD, Ottawa County

Original Authors:  Cynthia Hegg Krueger, MD, Washtenaw County

                        Ed P. Fody, MD, Ottawa County

                        Mick Raich, Vachette Pathology Svcs.

From:  MI Society of Pathologists (MSP)

  Whereas board certified (BC) clinical pathologists overseeing labs hold the title of medical directors of these labs, thus assuming professional liability for the integrity of all test results produced by such labs, and

  Whereas laboratory medical directors assume responsibility for the education and discussion with medical staff physician users and other professional personnel as to the appropriate uses and interpretation of all laboratory tests, and

  Whereas the laws set forth by the US Department of Health and Human Services (HHS) provide for professional component billing for 300 specified laboratory tests by BC clinical pathologists through the MEDICARE program, and

  Whereas BC clinical pathologists in 41 of 50 states, including AK, AL,AZ, CA, CO, CT, DE, FL, GA, IA, ID, IL, IN, KS, KY, LA, MD, MO, MS, MT, NB, NC,ND, NJ, NM, NV, NY, OH, OK, OR, PA, SC, TN, TX, UT, VA, VT, WA, WI, WV, and WY, already routinely bill and are compensated for these services, and

  Whereas BC clinical pathologists in the states of CA, FL, and IL bill and are compensated by their MEDICAID programs for these services, and

  Whereas BC clinical pathologists in the state of FL and IL recently won lawsuits against insurers, awarding them the right to bill for these services, and there are currently lawsuits ongoing against many national payers that have denied these services/payments, therefore be it

RESOLVED:  That MSMS support the efforts of the MSP to seek professional component compensation from Blue Cross/Blue Shield of Michigan (BCBSM) and other Michigan insurers for 300 specified clinical laboratory tests as set forth in law by the U.S. Department of Health and Human Services.