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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…
Labs: Watch for Whistleblowers! You Can’t Predict Who’s Filing
NEWS STORIES ABOUT TWO DIFFERENT FEDERAL WHISTLEBLOWER CASES against lab companies provide a reminder that managers of every clinical laboratory and pathology group must be vigilant about compliance, because potential whistleblowers can emerge from the unlikeliest of places. The first example involv…
Health System Lab Is Genotyping To Identify Best Drugs for Patients
CEO SUMMARY: One essential element of precision medicine will be the regular use of pharmacogenomic testing to provide additional guidance to physicians when selecting the most appropriate therapeutics and optimal dose for each individual patient. Despite the reluctance of private payers …
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…
Pharmacogenomic testing a success at South Dakota health system
This is an excerpt from a 2,700-word article in the January 30 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: One es…
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…
Some Florida Docs Are Not Using BeaconLBS System
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…
What Labs Need to Do as Payers Audit More Claims
CEO SUMMARY: Attorneys who advise pathologists and clinical laboratories on compliance issues say the number of audits from the government and third-party payers has increased sharply in recent years. In those audits, payers are looking for recoupment of overpayments. A lab’s fai…
Florida Doc Says Questions Go Unanswered by UHC
CEO SUMMARY: One common complaint about the efforts of UnitedHealthcare to introduce its unpopular laboratory benefit management program in Florida is that the insurer-and its agent, BeaconLBS, a division of Laboratory Corporation of America-don’t respond to physicians when they …
Florida Doctors Refuse to Use UHC’s Lab Ordering System
CEO SUMMARY: It may not yet be open rebellion, but UnitedHealthcare faces strong opposition in Florida from physicians- and their medical societies-over the requirement that they obtain pre-notification and pre-authorization when ordering tests listed in UHC’s laboratory benefit …
CURRENT ISSUE
Volume XXXII, No. 6 – April 21, 2025
Now that a federal judge has vacated the FDA’s LDT rule, The Dark Report analyzes the judgement and notes the various steps the FDA could take in response. Also, lab testing at pharmacies is proving to be less successful than was once anticipated.
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