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Cigna Sues HDL, Alleges Unlawful Fee Scheme

CEO SUMMARY: In court papers, Cigna alleged that HDL misrepresented patients’ responsibilities by promising not to collect co-payments, co-insurance, or deductibles. Also, HDL promised not to seek reimbursement from patients for any portion of its bills that the health insurer did not c…

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Public Comment Started on FDA LDT Regulations

CEO SUMMARY: On October 3, the FDA published draft guidelines to regulate laboratory-developed tests (LDTs). Pathologists and lab executives now have 120 days to comment on the guidelines. Several prominent national lab associations have expressed concerns about this additional bureaucrat…

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FL Docs Say: ‘No Thanks’ to UHC and BeaconLBS

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 b…

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Physicians and Labs Wary of United’s Lab Test Program

CEO SUMMARY: Providers seem to have a natural distrust of health insurers, particularly when payers introduce new programs with the stated purpose of improving quality and ensuring that physicians deliver evidence-based medicine. Doctors serving members of UHC’s HMO plans in Florida are…

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Defining a Path to Clinical Laboratory Best-in-Class via Benchmarks

CEO SUMMARY: With the American healthcare system undergoing a major transformation, it is essential that all clinical laboratories and pathology groups recognize this transformation and effect the right strategies to meet the needs of physicians, patients, and payers. A g…

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To Be Paid More, Labs Must Deliver More Value

GETTING PAID FOR LAB TESTS IS BECOMING A MORE URGENT PRIORITY for both clinical laboratories and anatomic pathology groups this year. Multiple factors are responsible for lengthening the collection cycle and reducing overall reimbursement for lab testing. Clients of THE DARK REPORT have followed our…

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Did Labs Rip Off Medicare? Feds Are Investigating

CEO SUMMARY: One reason why there is not a level playing field in lab industry compliance with laws governing kickbacks and anti-business behavior is that government officials do not act quickly against the lab industry’s worst offenders—if they take any action at all. News of a feder…

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UnitedHealthcare, BeaconLBS Respond with Statements

IN FLORIDA, BOTH CLINICAL LABS and physicians have expressed concerns UnitedHealthcare’s Laboratory presented in full on this page and the following page. about Benefit Management Program that formally becomes effective on October 1. From that date forward, physicians will be requi…

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Florida Doctor Questions Lab Test Pre-notification

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 pract…

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Ignoring Lab Industry, Theranos Goes Its Way

CEO SUMMARY: With each passing month, Theranos pulls open the curtain a bit more on its business structure and its market growth plans. Its clinical lab tests are now offered in Walgreens pharmacies in Palo Alto, California, and Phoenix, Arizona. Recent news coverage in Fortune and USATod…

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