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In Florida, More Tests Added to UHC’s Decision-Support Program

IN THE FIRST BROAD EXPANSION OF ITS pilot decision-support program for clinical lab testing in Florida, UnitedHealthcare (UHC) will add genetic and molecular tests, drug tests, and pathology procedures, among other assays starting in two months. On March 1, UHC will expand its labor…

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Paths of Hospital Labs, Independent Labs Diverge

CEO SUMMARY: With each passing year, the primary role of hospital and health system labs evolves in a different direction than that of independent lab companies. This trend is a response to the creation of integrated delivery networks paid on value and how they are scored on their ability…

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NYU Langone and Sonic Healthcare Create Laboratory Outreach Joint Venture

CEO SUMMARY: NYU Langone Health recognized the clinical and financial advantages of providing competitive lab outreach testing services to its employed physicians. The laboratory joint venture with Sonic Healthcare USA will allow NYU Langone to increase use of its hospital labs and will f…

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Issues Encountered with Anthem’s Pre-approval

CEO SUMMARY: Since Anthem and AIM Specialty Health began a prior-authorization program for genetic testing July 1, a Northeast lab has not had any genetic tests approved through the new system. Physicians told the lab that the steps required for prior authorization were disruptive. Those …

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Details Emerge About End of 31-Year Lab JV

CEO SUMMARY: Quest Diagnostics is no longer an equity partner in the CompuNet Clinical Laboratory joint venture, which has operated successfully since its founding in 1986. Typical of other lab JVs and inpatient lab management agreements that the hospital or health system partners do not rene…

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Sonic, Western Connecticut Health Network Announce New Laboratory Joint Venture

CEO SUMMARY: To prepare for the transition from fee-for-service to value-based payment, Western Connecticut Health Network, a three-hospital health system, announced a laboratory joint venture with Sonic Healthcare. Benefits will include lower test costs, more competitive prices, and the …

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In Texas, BeaconLBS Start Will Be Delayed

CEO SUMMARY: UnitedHealthcare will not implement the claims impact part of its laboratory benefit management program in Texas on March 1, 2017, as it had previously announced. Opposition to the program and the requirement that physicians use the BeaconLBS system when ordering about 79 lab…

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In Texas, Questions for UnitedHealth, BeaconLBS

CEO SUMMARY: As of January 1, 2017, clinical laboratories and pathology groups in Texas will find it more difficult to serve the 500,000 patients enrolled in UnitedHealthcare’s fully-insured commercial plans in the Lone Star State. That’s because—just as it did in Florida—UnitedHe…

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Patient Safety Expert Says: ‘Tell Patients About Errors’

CEO SUMMARY: As described in a civil lawsuit filed by a whistleblower pathologist in Kansas in July, a chair of pathology allegedly misdiagnosed cancer and the patient’s healthy pancreas was surgically removed. Court documents say that the pathologist then altered records to cover up th…

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Cover-Up Charged After Alleged Surgical Pathology Error

CEO SUMMARY: In an explosive civil case, documents show a pathologist erroneously diagnosed a patient as having cancer of an essential body organ and that the organ was removed unnecessarily, stated an attorney for the whistleblower. The patient has not yet been told of the misdiagnosis o…

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