UHC Archives

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Labs Should Prepare for Arrival of ‘Perfect Storm’

By Robert Michel | From the Volume XXXI, No. 3 – February 26, 2024 Issue

CEO SUMMARY: In the near future, clinical labs and pathology groups will need to address three major developments. One involves the FDA proposed LDT rule. A second is the adoption by payers of guidelines that require genetic test claims to have Z-Codes. The third centers around coming ref…

Year’s Top 10 Lab Stories Contain Surprises & Twists

By Robert Michel | From the Volume XXX, Number 18 – December 26, 2023 Issue

CEO SUMMARY: With the SARS-CoV-2 pandemic now in the rearview mirror of the nation’s clinical labs and pathology groups, the important news stories of 2023 were mostly about developments where the consequences will influence laboratory operations in coming years. Artificial intelligence…

Why Payers Bristle as Labs Submit Inpatient Fees for Outreach Tests

By Virchow | From the Volume XXX, Number 18 – December 26, 2023 Issue

EDITOR’S NOTE: Our column, Virchow, is written…

Payers Are Right to Be Wary of Claims for Some LDTs’ Value

By Virchow | From the Volume XXX, Number 17 – December 4, 2023 Issue

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How Certain Labs Can Crack into Health Plans’ Closed Networks

By Virchow | From the Volume XXX, Number 16 – November 13, 2023 Issue

EDITOR’S NOTE: Our column, Virchow, is written by anonymous insiders working within the managed…

UHC Will Delay Enforcement of Z-codes for Genetic Test Claims

By Scott Wallask | From the Volume XXX, No. 13 – September 11, 2023 Issue

IN THE LATEST BACKPEDAL ON ITS NEW POLICY, UNITEDHEALTHCARE (UHC) appears to have dropped its requirement for genetic testing laboratories to use Z-codes for claims under commercial health plans—for now. Earlie…

Smaller Labs Must Verify Z-code Arrangement with Lab Companies

By Virchow | From the Volume XXX, No. 12 – August 21, 2023 Issue

EDITOR’S NO…

With Z-codes, Will Other Payers Follow UnitedHealthcare’s Lead?

By Virchow | From the Volume XXX, No. 11 – July 31, 2023 Issue

EDITOR’S NOT…

HCCI Reports Higher Prices for Hospital Outreach Tests

By Robert Michel | From the Volume XXX, No. 10 – July 10, 2023 Issue

CEO SUMMARY: It’s another shot across the bows to hospital and health systems that use inpatient test prices when billing health insurers for outpatient/outreach lab tests. In its report, the Health Care Cost Institute documents how these hospital l…

Technical Assessment Challenges for Z-Code Applications

By Scott Wallask | From the Volume XXX, No. 10 – July 10, 2023 Issue

CEO SUMMARY: Effective on Aug. 1, UnitedHealthcare will require Z-code submissions for many genetic tests. During a recent webinar, experts tackled a topic that may prove troublesome for labs seeking Z-codes: technical assessments. Key advice is to provide specific data about clin…

Volume XXXI, No. 5 – April 8, 2024

The fragmentation of consumer markets is reflected in clinical lab services, and The Dark Report examines this trend and how it will impact labs in the coming years. Also, The Dark Report notes that the FDA has issued a controversial memo to reclassify many high-risk IVD assays.

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