News Update

Salt Lake City Selected as CLMA National Conference Site in 2003

By Susie Adams

Have you heard the news? CLMA has selected Salt Lake City for the
2003 National Convention!! This will be an exciting time to show

off our state and get on the CLMA map. We already have many
innovative programs. I think this will give us the impetus to leap forward.

The President's Report to the Membership from National CLMA has
many points I would like to reiterate. In CLMA's 22-year history

it has been recognized within the laboratory community as well as the
health-care industry, as a credible, authoritative player in relevant

federal legislative circles. As the members' roles have enlarged their
scope, it is time for CLMA to broaden its visions and responsibility

into the realm of clinical systems management. The health-care industry's
view of the laboratory is shifting. Laboratorians are an

integral part of the health-care continuum, influencing decisions from
outcomes and disease management to legislative reimbursement

issues.

Although many clinical sectors have associations, CLMA is the only
organization that is dedicated to management. There is an

opportunity for us now to expand. By being flexible and receptive to
supporting and championing clinical systems management we

continue to provide what is needed, so that our members, in turn, can
provide the highest quality, most effective, and most cost efficient

care for their patients. CLMA is indeed an association with roots and
wings.

I hope we can all embrace this broadened direction. Share with your
counterparts the opportunities available through CLMA. Invite them

to join you at a Power Breakfast or Spring Seminar. As we grow and
diversify our Chapter will strengthen. I look forward to seeing you

and your friends on October 15th to hear the latest from Dr. Madsen with
regards to the University Hospital and Clinics.

Mid Year Conference

By David Young

The Mid-Year Conference scheduled for Nov 12 & 13 in Zion has been
canceled for this year. The Utah Chapter CLMA Board of

Directors decided to postpone the conference after notification that
Intermountain Health Care will not have their Laboratory management

retreat which runs prior to the CLMA conference.

The CLMA mid-year conference had as its theme "What do we do
beyond compliance?" Which is a two day hands-on highly interactive

workshop conducted by Dr. Kimbal Wheatley.

Mark Your Calendar for Upcoming Events

CLMA/USCLS Spring Seminar

This year promises you informational interesting seminars, workshops,
keynote speakers, good food, and free parking.

March 8 & 9, 1999 Ogden Utah - At the new Conference Center

For additional information contact Dave Young (801-621-8136) or

E-mail, young@inconnect.com

Compliance Corner

By Paul Keoppel

OIG Compliance Program Guidance for Clinical Laboratories Published

The Department of Health and Human Services, Office of Inspector
General published the updated laboratory guidance on August 24,

1998. The document is similar to the Model Compliance Plan published
last year. There have been several clarifications, deletions and

a few additions. For a detailed review of the document read Chris
Young's report in the September CLMA Vantage Point. Copies of the

program guidance can be obtained from the CLMA web site, the OIG
web site and from the Federal Register, Vol. 63, No. 163, page

45076-45087. If you don't have access to the Internet or just want a copy
we will have some available at the CLMA Power breakfast on

October 15th.

Health Care Policy

By Paul Keoppel

Negotiated Rulemaking

The Balanced Budget Act of 1997 mandates adoption, beginning
January 1, 1999, of national coverage and administrative policies for

clinical diagnostic laboratory tests using negotiated rulemaking. The
negotiating process is in full session. CLMA has a member on the

negotiating panel with HCFA. The negotiations started in July and must
be done soon in order to meet the January deadline. Because

the task is large, the committee was split into several workgroups. Each
workgroup has a list of tests for which to determine Medicare

coverage policies. They are using as templates the existing limited
coverage policies from local carriers. One pro of the national list will

be that laboratories operating in more than one state will be able to use
the same set of rules no matter which in state the blood sample

is drawn. On the downside, for Utah at least, the limited coverage list will
increase by adding tests previously not on the local carrier's

list. The national list will also make it more difficult to add a diagnosis
which the provider feels should be a covered diagnosis. The

biggest change is that the new chemistry panels; Comprehensive
metabolic panel, Hepatic panel, Basic metabolic panel, and the

electrolyte panel are included as limited coverage tests on the national
list. Other tests that will be on the national list but currently are

not on the Utah list are: pap smear, CK and CK isoforms, cultures, HIV,
hepatitis and urinalysis. Add this to the current high volume

tests of CBC, lipids and protime and we can see that all of the high
volume outpatient tests will be limited coverage. Stay tuned, "You

ain't seen nothin' yet". If you have comments direct them to Tina Tran at
the national CLMA office. Who will pass them on to the

CLMA negotiating team.

Prospective Payment System (PPS) for Hospital Outpatient Services

The proposed rule for PPS for hospital outpatients was published in the
Federal Register on September 8, 1998. The document is over

400 pages in length, about the same size as the Star Report, but not as
much medical detail! In 1983 the hospital Medicare inpatient

payment system was changed to the diagnosis related group (DRG)
system. The outpatient payment system for the most part has remained

fee for service until now. Since many patients that would have been
treated as inpatients ten years ago are now being treated on an

outpatient basis, HCFA decided it was time to start a PPS system for
these patients. HCFA has been working on this system on and off

since 1986. It will become effective as soon as possible after January 1,
2000, barring any HCFA computer meltdowns with the year 2000

problem. The laboratories were placed on a fee schedule back in 1985.
The proposed rule exempts any outpatient service that is on a fee

schedule, so for now laboratories have dodged a bullet. This may all
change before the final rule is published, however.

Prospective Payment System and Consolidated Billing for Skilled
Nursing Facilities

The final rule for nursing home PPS was published in the Federal
Register on May 12, 1998. If your laboratory does business with skilled

nursing facilities (SNF) then you had better become familiar with this
regulation. It is basically a "DRG" type of payment to nursing

homes. The regulation uses Resource Utilization Group (RUG) instead of
DRG. They both work similarly no matter what the name is.

The nursing home will be paid "x" dollars per day for the patient
depending on why the patient is in the facility. From this set amount

the nursing home will pay for almost all outpatient services, including
laboratory. The most confusing part of the program for

laboratories right now is the transition period. All SNFs must convert to
PPS for the Part A patients between July 1998 and January 1999.

For those SNFs on PPS, consolidated billing applies. The Part B
Medicare portion has been put on indefinite hold until HCFA fixes their

computer which will die at midnight December 31, 1999, if not remedied.
That means that laboratories doing business with SNFs must

find out if the home is on Part A PPS, if the patient is covered under Part
A or Part B, and if they are a qualified resident or not. This

information is needed so the laboratory will know whether to bill the
nursing home or Medicare. Are we all totally confused yet?

FDA Withdraws HCV 'Lookback' Policy

According to the latest issue of the CAP STATLINE, the FDA,
responding to public comments, including those of the College of

American Pathologists, has withdrawn its controversial hepatitis C virus
"lookback" policy issued earlier this year and said it will revise

the policy. Refer to the CAP article for further details. (September 16,
1998, Vol. 14, Number 18)

Spring Conference

By Kathy Carlson

1999 Utah CLS/CLMA Spring Meeting

March 8 - 9, 1998

Ogden Conference Center

Ogden, Utah

Share your ideas, expertise and experience with your peers by submitting
a proposal for a workshop or poster presentation at the 1999

Utah CLS/CLMA Spring Meeting.

The following topics have been suggested for the conference.
Presentation topics in other areas will also be considered.

The Internet - healthcare uses, information/education/future

Laboratory information systems- the new systems, quality, selection,
validation

POCT - practical management and inspection

Safety Programs - New issues

CAP - Advanced Inspectors Program

Legislative Updates - State and Federal

Compliance the second year - Updates

Humor

Personal Development

* How to market yourself for that new position

* Basic Self Defense - a novice course

* Baby Boomers Retirement Planning and the decade ahead

Technical Operational issues

Financial management

Submit your proposals to any CLMA board member or contact:

Kathy Carlson

Voice Mail: 582-1493

e-mail: carlsoks@arup-lab.com

Membership

By Maxine Garwood

Have you heard of the new direction that CLMA is taking? CLMA's
focus is on gathering clinical professionals of diverse backgrounds

to help us all address the challenges of health-care leadership in the
constantly evolving health-care system, one that is radically different

from the health-care system we started to work in just a few years ago.

Not long ago the laboratory was placed in the basement of the building.
We really were comfortable there because we were not interactive

persons. We thrived on performing a mighty service in our private corner
without windows and without contact basically with the rest

of the health-care managers. No one but us understood how vital our
results were to the outcome of the patient's recovery. No longer can

we remain in this environment. We need to be networking with other
leaders in the health-care system. I am happy to see CLMA take

a giant step forward to address the changes taking place in health care.
We are on the Health Care team and it is time to be recognized

and work together to provide better quality health-care in today'' rapidly
changing managed care environment. Our local chapter's

membership committee's goals include involving a diverse group of
health-care leaders. Please help us identify those persons in your

organization who need to be included in CLMA. Contact Maxine
Garwood at 965-3520 or E-mail: garmax@upmmso.com.

Philadelphia

By Gloria Zuroff

Benjamin Franklin's home became the place for Laboratory Professionals
to gather and learn more about science and healthcare.

Regarded as one of the most influential diagnostic meetings, CLMA's
1998 annual Conference was held in Philadelphia, Pennsylvania

on August 19 - 23, 1998. Educational seminars ranged from finance and
reimbursement, personal development, laboratory information

systems, outcomes and clinical guidelines, clinical systems management,
marketing laboratory services, and new organizational models

for laboratory services. The fourth annual symposium on laboratory and
clinical systems research was a pre-conference workshop geared

to those interested in gaining knowledge for the clinical system manager.
There were three sessions - general, sunrise, and breakout

sessions - and the exhibition. General sessions, focusing on the human
experience, included topics like "Live Long and Prosper: Working

at a full Potential without Blowing a Fuse". The Sunrise Seminars were a
way for early risers to share experiences with colleagues.

Breakout Sessions were many, varied, and relevant for all managers and
laboratory professionals interested in seeking improvement to

gather information and learn tools of the trade. We all noticed the new
look of the Exhibit Hall. What once stood as single booths for

each vendor now reflected the few conglomerates and companies that
have merged together! One source said there were 993 booths from

269 companies offering state-of-the-art products for the clinical systems
market. Many of these exhibitors support CLMA's efforts

throughout the year and sponsored many of the breakout sessions,
special events, seminars, and conference materials. We would like to

thank the vendors for their support and for the dinners.

October 1998 Newsletter