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 doctors who regularly order genetic tests had not been trained
Tag: medical management
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 benefits management program and the requirement to use the BeaconLBS system before they can order any of 80 designated lab tests.
The response of the Florida
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 report, the state Office of Insurance Regulation said that restricting the use
CEO SUMMARY: Physician residents at the UCSF School of Medicine set a target of reducing unnecessary blood draws. By eliminating needless needle sticks, the residents are focusing on patient experience while also encouraging physicians to pay more attention to the need to decrease unnecessary clinical lab testing. The goal is a 5% reduction in phlebotomy procedures for the aca- demic year 2014 to 2015, compared with the previous academic year. Early results show a decrease in phlebotomy procedures.
CEO SUMMARY: In response to the steep ramp-up in the utilization of genetic and molecular testing, the nation’s largest health insurers are preparing to institute new guidelines for coverage and reimbursement. These will include pre-authorization by physicians, a more effective genetic test coding arrangement for claims submission by laboratories, and implementation of evidence-based medicine (EBM)
It’s a sign of the times for managed healthcare. Pacificare Health System, Inc. will offer its first preferred provider organization (PPO) health plan. the PPO is being marketed in California, Oklahoma, and Texas. Enrollment starts this month. Until now Pacificare’s business model was solely built around a fully-capitated, provider-assumes-all-risk arrangement. But during the past 24
Medical Management Programs, Inc. (MMP) of Southfield, Michigan is the new owner of the TPA (third party administrator) business formerly held by Universal Standard Medical Laboratories. MMP purchased the TPA business involving lab testing and home health services from USML’s Chapter 7 bankruptcy case last fall. During the 1990s, USML was unique among the nation’s
CLINICAL LABORATORY DATA will play a big role at iMcKesson, the new Internet healthcare business unit of McKesson HBOC, Inc., based in San Francisco.
McKesson HBOC is putting existing business assets representing annual sales of $300 million into this new division. They include Abaton.com, Physician Office Manager, and Acess Health, among others.
Real-Time Web Services
iMcKesson intends to
BIO-REFERENCE LABS MOVES TO START PATIENT-DOCTOR MESSAGING
ONE OF THE NATION’S MORE AGGRESSIVE efforts to refocus the clinical laboratory organization can be found at Bio-Reference Laboratories, Inc., located in Elmwood Park, New Jersey.
Bio-Reference wants to use its basic lab testing relationship with physicians as the foundation for a business relationship that involves a host of other
CEO SUMMARY: As the pathology profession’s only publicly-traded physician practice management company, AmeriPath is the spear point of far-reaching changes now transforming pathology. With an annual revenue run rate of $270 million and an ample war chest of growth capital, AmeriPath intends to continue its steady expansion. In the 28 months since its initial public