AFTER SEVERAL LABS SPOKE about the difficulties in working with the new Anthem/AIM Specialty Heath prior-authorization program for genetic tests, THE DARK REPORT sent questions to Anthem. Responses from Anthem/AIM were lengthy and have been edited to fit the available space:
Q: Is it true that labs cannot assist physicians in ordering tests through the Anthem/AIM program?
ACROSS THE NATION, the hundreds of pathology groups and clinical labs that use McKesson Technology Solutions for their billing and collections, along with labs that use the Advanced Diagnostics Solutions group, should pay attention to a major corporate deal announced June 28.
On June 28, McKesson Corporation of New York and Change Healthcare (formerly Emdeon) of
CEO SUMMARY: Once again, entrepreneur and pathologist David G. Bostwick, MD, is starting up a new lab company. Granger Diagnostics is now open and is located in North Chesterfield, Virginia. It is designed to be an anatomic, clinical, and molecular pathology reference laboratory. In an exclusive interview, Bostwick identified three substantial changes that have happened
CEO SUMMARY: Some physicians in Florida are not complying with UnitedHealthcare’s laboratory benefit management program since the claims impact took effect on April 15. Although officials from UnitedHealthcare and BeaconLBS, a business division of LabCorp, state publicly that the program is going well, physicians and several state medical associations continue to voice serious objections to several key elements of UnitedHealthcare’s lab test utilization management program.
CEO SUMMARY: Over the past 18 months, Theranos has taken steps to enter the clinical lab marketplace. Across Greater Phoenix, Theranos now has specimen collection centers in about 40 Walgreens pharmacies. It is opening a CLIA lab facility in Scottsdale. Now that it is delivering clinical laboratory testing services on a regular basis, the quality of its laboratory test results and the service it provides to physicians and patients will get close scrutiny from both investors and competing labs.
CEO SUMMARY: EHR system vendors must now comply with the federal government’s Meaningful Use Stage 2 requirements. Well-established EHR vendors will survive. But smaller EHR companies may struggle to provide the enhancements to their first generation EHR products that are required to certify as MU Stage 2 compliant. These developments mean many physicians may need to find new EHR vendors. In turn, that will require clinical labs to build new interfaces to these physicians’ EHRs.
CEO SUMMARY: In Florida, obstetricians and gynecologists are complaining about the burdensome nature of the new lab test management system introduced by UnitedHealthcare. In addition to calling for an end to the program, some ob-gyns plan not to use the system, a process that could lead UHC to deny payment to clinical labs. In a
CEO SUMMARY: Since its big public debut in late 2013, Theranos has been the subject of keen interest and much skepticism among pathologists and clinical laboratory professionals. Theranos is expanding its presence in Phoenix, Arizona. However, as it does, it looks more like a conventional clinical laboratory—with all the associated costs—than a disruptive lab testing
CEO SUMMARY: Some Florida physicians are declaring their intent to leave UnitedHealthcare’s network because they find the insurer’s new BeaconLBS laboratory benefit management system to be time consuming and onerous. The defections come as the program goes through a soft launch that began on October 1. Apparently in response to physician complaints, UHC announced a
CEO SUMMARY: An interesting tug-of-war may develop in Florida between a major health insurer and physicians. UnitedHealthcare will require physicians to obtain a pre-notification number for 81 lab tests by using the BeaconLBS system (developed by a subsidiary of LabCorp). One family practice physician is speaking out about his concerns that the new UHC requirement