Exact Sciences Completes Genomic Health Acquisition

Exact Sciences Completes Genomic Health Acquisition

Exact Sciences Completes Genomic Health Acquisition

Exact Sciences (Madison, WI) finalized its purchase of Genomic Health (Redwood City, CA) on November 8. The deal was initially valued at $2.8 billion when first announced on July 29. However, a subsequent 30% drop in Exact’s shares lowered the deal value to $2.5 billion. Each share of Genomic Health was exchanged for $27.50 in cash (worth $1.1 billion) plus 0.45 shares
of Exact Health (worth $1.4 billion). The net deal worth was approximately $2.2 billion after adjusting for $275 million of cash held by Genomic Health at the time of the close. Thus the deal valued Genomic Health at 4.9 times its projected revenue of $452 million for 2019.

Kim Popovits, 60, Chairman and CEO of Genomic Health, resigned from her positions after the transaction closed. She received a severance package of cash and vested stock and options worth $13.4 million.

Meanwhile, Genomic Health’s Chief Operating Officer Brad Cole has been hired by Exact as General Manager of the company’s newly acquired Oncotype DX franchise.

More Executive Changes At Labcorp’s Diagnostic Division

More Executive Changes At Labcorp’s Diagnostic Division

More Executive Changes At Labcorp’s Diagnostic Division

After only a few days in the position, LabCorp Diagnostics’ CEO John Ratliff has resigned to take a top executive position at an unnamed company. Ratliff, age 59, had become head of LabCorp’s diagnostic testing business effective November 1. He had formerly been CEO of Covance, LabCorp’s drug development business.

Former LabCorp President and CEO Dave King, 62, had been serving as interim head of LabCorp’s diagnostic testing business since January 1, 2019. King retired from his day-to-day executive positions at LabCorp on November 1, but is staying on as Chairman through at least the end
of next year.

LabCorp says that its diagnostics division will now be led by two individuals. Brian Caveney, MD, 46, has been named Executive Vice President and President of Diagnostics. Caveney was formerly Chief Medical Officer at LabCorp. In addition, Mark Schroeder, 58, has become Executive Vice President and President of Laboratory Operations and Global Supply Chain. Schroeder was formerly LabCorp’s Chief Supply Chain Officer.

The EKRA Law Banning Commission-Based Lab Sales Reps Remains In Effect

The EKRA Law Banning Commission-Based Lab Sales Reps Remains In Effect

The EKRA Law Banning Commission-Based Lab Sales Reps Remains In Effect

On October 24, 2018, The Eliminating Kickbacks in Recovery Act of 2018 (EKRA) became law (see LE, December 2018). EKRA was part of broader legislation (The SUPPORT Act) intended to address the national opioid crisis.

The EKRA law prohibits commission payments based on the number of patients referred to a laboratory, the number of tests performed, or the amount billed to or received from a “health care benefit program” (which includes commercial insurance plans as well as Medicare and Medicaid). EKRA applies to all laboratories (toxicology, molecular, routine clinical, anatomic pathology, et al.), not merely labs that perform testing for recovery homes and clinical treatment facilities. Violation of EKRA is punishable by a fine of up to $200,000 and/ or imprisonment of up to 10 years for each occurrence.

The American Clinical Laboratory Association and its largest member labs have lobbied to have EKRA narrowed so that it applies only to laboratories associated with substance abuse services. However, to date, no changes have been made to the EKRA law.

McDonald Hopkins’ attorney Rick Cooper says that although there are no changes to EKRA expected in the near term, there may eventually be some narrowing of the law made in the long horizon.

Top 25 Independent Nursing Home Labs

Top 25 Independent Nursing Home Labs

Top 25 Independent Nursing Home Labs

There are approximately 75 independent lab companies across the United States that are focused on the nursing home market. The table below lists the top 25 companies as measured by their volume of Part B services for G0471 in 2017 (the latest year of available data). G0471 is the billing code used exclusively for blood draws taken from nursing home and home health patients.

On a consolidated basis, TridentUSA Health Services is the largest nursing home lab with combined volume of 956,153 for G0471 at five lab subsidiaries in 2017. Its total Part B payments for all testing services was $50 million in 2017.

American Health Associates (Miramar, FL) is next with volume of 851,305 for G0471 and total Part B payments of $38 million in 2017.

Gamma Healthcare (Poplar Bluff, MO) is third largest with G0471 volume of 291,566 and total Part B payments of almost $18 million in 2017. In addition, Gamma acquired the nursing home lab business of Boyce and Bynum Pathology Laboratories (Columbia, MO) in late 2018. 

Top 25 Fastest-Growing Labs by Medicare Part B Volume of Services

Quest Diagnostics Buys Assets From Bankrupt True Health

Quest Diagnostics Buys Assets From Bankrupt True Health

Quest Diagnostics Buys Assets From Bankrupt True Health

True Health and its parent company THG Holdings have finalized a bankruptcy court-approved sale of their assets to Cleveland HeartLab, a subsidiary of Quest Diagnostics, for $8.5 million.

The deal did not include True Health’s 100,000-square-foot lab in Richmond or its hundreds of employees. True Health acquired the Richmond lab when it purchased the assets of bankrupt Health Diagnostic Laboratory (HDL) for $37 million in late 2015.

HDL went bankrupt in 2015 after agreeing to pay $47 million to settle allegations that it defrauded Medicare and Medicaid by paying kickbacks to doctors in exchange for ordering its lipid test panels.

True Health filed for bankruptcy in July (see LE, August 2019) after CMS suspended all Medicare payments to the company based on “credible allegations of fraud.” According to an ongoing investigation by the OIG, True Health had set up labs inside rural hospitals that receive higher rates of
reimbursement from Medicare. From there, OIG investigators claim that True Health engaged in a kickback scheme by enlisting doctors into Management Service Organizations (MSOs) that incentivized them to send patient samples to the rural hospital labs. The OIG investigators say that
these physicians never had privileges with or visited the rural hospitals, and never provided their patients with a choice as to where to send their lab tests.

A Quest spokesman says that Quest chose not to acquire True Health’s facilities, staff, or accounts receivable “nor will we adopt its policies and business practices.” Essentially, Quest has purchased True Health’s client list and some instruments and supplies.

In the seven-month period January 1 through July 31, 2018, True Health recorded revenue of $38.5 million, equal to an annual rate of $66 million, according to its bankruptcy filings. If Quest’s Cleveland HeartLab can retain a fraction of True Health’s clients and revenue, then the $8.5 million purchase price will be a huge bargain, observes Laboratory Economics.

True Health is majority-owned by the private-equity firm The Riverside Company (New York City), while Founder and CEO Chris Grottenthaler has a 6% stake. True Health has $173 million in total liabilities. Its largest secured creditors are Monroe Capital Management (owed $123 million) and Riverside Strategic Capital (owed $34 million). True Health had initially filed for Chapter 11 bankruptcy reorganization in July, and is now likely headed for Chapter 7 liquidation.