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In This Issue:
- New webinar on the future of molecular test reimbursement.
- CMS updates tied to the federal government shutdown.
- Interview with Lighthouse Founder Jon Harol on what sets thriving labs apart.
- New tax advantages for lab equipment purchases.
- UHC policy changes and risk strategy for opioid testing.
- Conference appearances and more lab industry insights.
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Upcoming Webinar: The Future of Molecular Testing Reimbursement - MolDx, Prior Auth, and Payer Reforms
Join us at noon EDT, Wednesday, Oct. 29, for a timely webinar exploring the latest developments shaping reimbursement for molecular and genetic testing.
With payer guidelines, MolDx requirements, and prior authorization programs continually evolving, staying compliant while securing fair payment can be a serious challenge. Lighthouse's Ann Lambrix will be joined by Tara Cepull of Quadax to break down what laboratories need to know to stay ahead.
You’ll gain clarity on:
- The current reimbursement environment for molecular and genetic testing.
- How MolDx and payer policies affect your billing and compliance strategy.
- Legislative and payer reforms that could ease prior authorization burdens in the months ahead.
Don’t miss this opportunity to hear from two of the most knowledgeable voices in lab reimbursement and compliance.
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How the Government Shutdown Is Impacting Claims and Reimbursements
CMS issued an update on October 15 clarifying how claims are being processed amid the U.S. government shutdown. Here’s what labs and providers need to know, and what you should be watching for if you see delays.
CMS directed all MACs to temporarily hold certain claims with dates of service on or after October 1, 2025. However, the hold only affects services billed under the Medicare Physician Fee Schedule (MPFS), not services billed under the Clinical Laboratory Fee Schedule (CLFS). Even within MPFS, the hold is limited: it only applies to claims tied to expired legislative payment provisions that lapsed October 1.
These include:
- Telehealth flexibilities and geographic waivers
- Some hospice face-to-face encounter waivers
- Other “extender” rules that have not been renewed
In short: if your lab is seeing payment delays for services under CLFS, it’s not due to this CMS hold; something else is likely at play!
What this means in practice:
- Labs billing under CLFS should continue to see normal processing (unless there are unrelated adjudication issues).
- Providers billing MPFS services should flag any claims tied to lapsed rules and monitor those specifically for delays.
- If you're encountering delays beyond what this hold would predict, it may indicate other issues that warrant closer review.
- The hold is not blanket; CMS emphasized that the scope is narrower than the agency's initial notices suggested.
If you’re worried about claim lag, need a second look at your adjudication flow, or just want to validate whether a delay is “expected or not,” feel free to follow up with us directly. Our team is here to help you navigate this period of uncertainty.
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How Medical Labs Can Thrive in a Changing Healthcare Environment
In a recent interview with Life Sciences Decoded, Lighthouse Lab Services Founder Jon Harol sat down to share his perspective on what separates the labs that are struggling from those that are thriving. He discusses how preparedness, strong leadership, and a healthy workplace culture can turn today’s challenges into tomorrow’s competitive advantages.
Watch or read the full interview HERE>
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Recent Tax Changes Create Upgrade Opportunities for Labs
Don't forget, a recent change in law has reinstated a unique financial opportunity for laboratories. You can fully write off the cost of new and used equipment placed in service before Dec. 31, 2025.
If you haven't read the details of the change, here’s what it means for your lab:
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Permanent 100% Bonus Depreciation: Deduct the full purchase price of eligible equipment in the same tax year, rather than spreading it over multiple years.
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Expanded Section 179 Limits: Deduct up to $2.5 million in equipment purchases, with phase-outs not kicking in until $4 million.
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Flexible Financing: You can finance equipment and still deduct the full amount, helping preserve cash flow while reducing tax obligations.
If you would like to learn more, Lighthouse can help your lab take advantage of this opportunity by providing new and refurbished instrumentation with service support from our nationwide team of engineers. We will also ensure delivery and installation timing comply with IRS “placed-in-service" rules.
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Lighthouse Lab Services Celebrates 22 Years
This month marks 22 years since Lighthouse Lab Services was founded with a simple mission: to make laboratory testing more accessible.
Over the past two decades, we’ve grown from a small startup into a leading provider of medical laboratory consulting, recruiting, and operational solutions, all thanks to the trust and partnership of our incredible clients, employees, and strategic partners.
As we celebrate this milestone, we remain committed to lighting the way forward for laboratories of all sizes and specialties. Here’s to the next chapter of innovation, service, and patient support!
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The Lighthouse "Candidate Corner" is a recurring monthly spotlight featuring some of the great lab professionals our recruiters work with each day. Check out a quick preview of one individual below, then click over to our blog to see all five candidates for October.
If you'd like to learn more about anyone listed in this section or inquire about their ability to relocate, email us directly here!
Candidate: Toxicology Supervisor
- Education:
- Master's in Biology
- Bachelor's in Chemistry
- Certification:
- Louisiana state license in Clinical Chemistry
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Preferred Location:
- Near Baton Rouge, LA.
View all candidates HERE>
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New UHC Lab Test Policy Takes Effect December 1
UHC has announced a new Routine Laboratory Testing Policy update that will take effect for dates of service on or after Dec. 1, 2025 (all states except AR, CO, KY, NC, NE, OH, and RI, where changes will come later).
✅ Policies apply to lab services performed in office, hospital outpatient, and independent lab settings.
❌ They do not apply to emergency room, hospital observation, or inpatient services.
What to know:
- Claims for routine testing will undergo automated post-service, pre-payment policy enforcement.
- New guidelines will set circumstances and frequency for when certain tests are eligible for reimbursement.
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Tests impacted include: Flow Cytometry, A1c, Iron Metabolism Testing, Prostate Biopsy Analysis, Lyme Disease Testing, Bone Turnover Markers, Fecal Calprotectin, Inflammatory Bowel Disease Panels, and more.
Policies are available for review on the UHC website in the comments below. Now is the time for labs and billers to prepare for how these changes could affect reimbursement workflows and appeals!
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Managing Risk Assessment in Opioid Testing
Clinical laboratories and physician-owned labs are under growing pressure to deliver high-quality opioid testing while staying compliant with payer rules and avoiding costly audits. Too often, overreliance on risk screening tools or incomplete documentation leads to denials, lost revenue, and heightened regulatory exposure.
In this new on-demand webinar, our revenue compliance and legal panel outline how labs can protect themselves by strengthening documentation, educating providers, and adopting more comprehensive risk assessment strategies.
Watch now HERE>
| | | October Employee Spotlight: Dionne Blount, Account Management Specialist | | |
Have you heard? Dionne Blount, a Specialist with our Account Management Team, is our Lighth Award recipient for October!
She brings an infectious attitude to our Account Management Team that strengthens our connections and furthers our company's mission to make laboratory testing more accessible.
Thanks for everything you do, Dionne!
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Texas Pain Society Annual Scientific Conference
Society of Forensic Toxicologists Annual Meeting
AAPS PharmSci 360
| | This email is brought to you as a service from Lighthouse Lab Services to provide quality and timely information that can improve your laboratory operations. We strive to maintain our position as the country’s premier lab consulting firm and support your success. | |
The Lab Insighter is a monthly publication for Lab Owners and Decision Makers.
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Contact us at:
(919) 443-6553
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