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brca testing

UnitedHealth to Start Gene Test Pre-Approval

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…

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Lab’s Low Gene Test Price Gets Insurers’ Attention

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 …

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California company shows labs the way with low genetic testing cost

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…

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Health Insurers Want More Data On Clinical Utility of Molecular, Genetic Tests

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…

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How to Cover Genetic Tests Confounds Health Insurers

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…

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CMS Cuts BRCA Price by 49% in Response to Competition

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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Two Blood Brothers Report Declines in Revenue-Per-Req

REIMBURSEMENT FOR CLINICAL laboratory testing has declined, particularly for molecular tests. As a consequence, the nation’s two largest laboratory testing companies are feeling the negative effect of lower lab test prices. Both Quest Diagnostics Incorporated and Laborator…

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