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lab benefit management

UnitedHealthcare Forming Network of Preferred Labs

NEW CLINICAL LABORATORY CONTRACTING INITIATIVES are planned at UnitedHealthcare (UHC), including the launch of a preferred laboratory network this summer. The nation’s largest health insurer with 49 million beneficiaries, UHC announced in May that it would add Quest Diagno…

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Two Largest Payers Start Lab Test Pre-Authorization

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…

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Labs Report Problems with Anthem’s Pre-Approval

CEO SUMMARY: Since the July 1 launch of its prior-authorization program for genetic tests, Anthem and its subsidiary, AIM Specialty Health, have authorized few genetic tests, said a national lab. Lab directors say they have been unable to communicate with Anthem/AIM when client physicians…

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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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Florida Pathology Group Lost Volume After BeaconLBS Started

CEO SUMMARY: A 22-physician pathology group in Tampa has complied with rules for lab test ordering that UnitedHealthcare and BeaconLBS established, yet has experienced a steep decline in the volume of specimens it receives. Physicians told the pathologists that other labs were not using t…

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Florida bill to restrict BeaconLBS advances in state Senate

THE DARK REPORT is first to report on the latest development as part of its ongoing coverage of how Florida physicians are reacting to the implementation of the UnitedHealthCare laboratory be…

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Lab Benefit Management Bill Advances in FL Senate

CEO SUMMARY: To date, a bill to restrict how health insurers use lab benefit management systems such as UnitedHealthcare’s BeaconLBS, has been favorably received in the Florida Senate. But the bill may face opposition when presented to the Senate’s Appropriations Committee. In a repor…

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2015’s Top 10 Lab Stories Show Significant Changes

CEO SUMMARY: During 2015, two stories captured the full attention of most pathologists and clinical lab managers. One was how CMS intends to gather lab price market data as mandated by PAMA. The other was the continued efforts by the FDA to move ahead on proposed guidance for regulation o…

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New Company Targets Lab Benefit Management

CEO SUMMARY: Soon, the nation’s newest laboratory benefit management company will begin working for Blue Cross Blue Shield of South Carolina. Avalon Healthcare Solutions committed to BCBSSC that it can save money off what the health plan has been spending on clinical lab testing. It wil…

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Florida Docs Seek to Cut Ties with UnitedHealthcare

CEO SUMMARY: Physicians in Florida continue to express significant concerns about UnitedHealthcare’s pilot program requiring pre-notification for 80 clinical laboratory tests, including many routine tests, and pre-authorization for two genetic tests. The program i…

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