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brca test
Two Largest Payers Start Lab Test Pre-Authorization
By Joseph Burns | From the Volume XXIV No. 12 – August 28, 2017 Issue
CEO SUMMARY: Once Anthem and UnitedHealthcare establish their respective genetic test prior-authorization programs, a new era for genetic testing will commence. The 80 million beneficiaries served by these two payers make up half of the individuals who have private health insurance. It is…
UnitedHealth to Start Gene Test Pre-Approval
By Joseph Burns | From the Volume XXIV No. 12 – August 28, 2017 Issue
CEO SUMMARY: With programs now at the nation’s two largest insurers, is it possible to argue that prior-authorization is going mainstream? Some observers say, yes, as THE DARK REPORT predicted. What is certain is that starting Nov. 1, UnitedHealthcare is requiring prior authorization fo…
Lab’s Low Gene Test Price Gets Insurers’ Attention
By Joseph Burns | From the Volume XXIV No. 8 – June 5, 2017 Issue
CEO SUMMARY: At a time when most molecular and genetic testing companies are struggling to gain coverage for their tests, this Silicon Valley-based lab company has become an in-network lab provider for a number of health insurers—including three of the nation’s largest payers. It did …
California company shows labs the way with low genetic testing cost
By Mary Van Doren | From the Volume XXIV No. 8 – June 5, 2017 Issue
This is an excerpt from a 1,485-word article in the June 5, 2017 issue of THE DARK REPORT. The complete article is available for a limited time to all readers, and available at all times to paid members of the Dark Intelligence Group. CEO SUMMARY: At a time when most molecular and gene…
Health Insurers Want More Data On Clinical Utility of Molecular, Genetic Tests
By Joseph Burns | From the Volume XXIV No. 4 – March 13, 2017 Issue
CEO SUMMARY: Genetic tests that lack two essentials are troublesome for the nation’s health insurers. Those essentials are clinical validity and clinical utility. During a recent webinar, two executives from major health insurers stressed the need for genetic testing labs to provide acc…
How to Cover Genetic Tests Confounds Health Insurers
By Joseph Burns | From the Volume XXIII No. 5 – April 11, 2016 Issue
CEO SUMMARY: Managed care experts say health insurers are being overwhelmed by the number of new genetic tests and that many labs find it tough to get paid for these tests. UnitedHealthcare just announced it will require pre-authorization of molecular and genetic tests during 2016. Me…
Hit by Many New Genetic Tests, Health Insurers Just Say ‘No’
By Joseph Burns | From the Volume XXII No. 10 – July 13, 2015 Issue
OVERWHELMED WITH REQUESTS TO PAY for new genetic tests, health insurers, particularly smaller and regional insurers, find it easier to simply deny payment for such tests. This is one of the insights shared during a panel discussion involving several managed care executives at the 20th annual Exe…
More Genetic Counseling Leads to Fewer Lab Tests
By Joseph Burns | From the Volume XXI No. 17 – December 15, 2014 Issue
CEO SUMMARY: Cigna was the first national health insurer to require independent board-certified genetic counseling before approving coverage for certain genetic tests. Since launching this program in September 2013, the insurer has seen a 450% increase in genetic counseling for Cigna …
July 21, 2014 “Intelligence: Late Breaking Lab News”
By Robert Michel | From the Volume XXI No. 10 – July 21, 2014 Issue
Consolidation of private pathology group practices continues. On July 8, NeoGenomics of Fort Myers, Florida, announced that it had acquired Path Logic of Sacramento. Then, one day later, Incyte Diagnostics of Spokane, Washington, disclosed that it wa…
CMS Cuts BRCA Price by 49% in Response to Competition
By Robert Michel | From the Volume XXI No. 1 – January 13, 2014 Issue
IN THE FINAL WEEKS OF 2013, the federal Centers for Medicare & Medicaid Services (CMS) announced that it would reduce the price it pays for the BRCA genetic test by 49%, to $1,438, effective on January 1, 2014. For Myriad Genetics, Inc., this wa…
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Volume XXXI, No. 5 – April 8, 2024
The fragmentation of consumer markets is reflected in clinical lab services, and The Dark Report examines this trend and how it will impact labs in the coming years. Also, The Dark Report notes that the FDA has issued a controversial memo to reclassify many high-risk IVD assays.
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