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ANTHEM LAUNCHES PROGRAM TO MANAGE GENETIC TESTS

Nation’s largest health insurer to require pre-authorization

CEO SUMMARY: Pre-authorization of genetic tests is coming to physicians serving patients insured by Anthem, Inc. Its specialty benefits management company, AIM Specialty Health, will manage the program. AIM will work with InformedDNA, a company that specializes in genetic testing clinical decision support and genetic counseling for health insurers. Anthem has about 40 million members in

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June 26, 2017 Intelligence: Late Breaking Lab News

Intelligence Late & Latent News

Theranos is back in the news again. The Wall Street Journal reported earlier this month that the troubled lab company is close to negotiating a settlement with Walgreens after being sued for $140 million in a breach of contract lawsuit filed by the national pharmacy chain. According to the journal, the settlement amount may be as

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Mass Spec Tests Struggle To Gain Insurers’ Attention

Why are payers, providers missing the opportunity to make this low-cost testing technology available?

CEO SUMMARY: Since 2014, a toxicology lab at the University of Colorado has used mass spectrometry to offer low-cost, accurate multi-analyte test panels that can detect hundreds of therapeutic drugs and drugs of abuse. However, CU Toxicology’s chief medical officer says health insurers are slow to accept this diagnostic technology, despite its demonstrated clinical benefit

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Lab Fraud Update Labs: Watch for Whistleblowers! You Can’t Predict Who’s Filing

Whistleblowers aren’t just lab employees or insiders, but include physicians and even HMO med directors

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 involves Piedmont Pathology in Hickory, N.C. In May, it agreed to pay the federal government

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Anthem Launches Program to Manage Genetic Tests

Nation’s largest health insurer to require pre-authorization

CEO SUMMARY: Pre-authorization of genetic tests is coming to physicians serving patients insured by Anthem, Inc. Its specialty benefits management company, AIM Specialty Health, will manage the program. AIM will work with InformedDNA, a company that specializes in genetic testing clinical decision support and genetic counseling for health insurers. Anthem has about 40 million members

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Digital Pathology Can Be Transformative for Labs

Pathologists have opportunity to innovate with this technology to improve patient care

CEO SUMMARY: Across the nation, pathologists are at a crossroads. Now that the FDA has cleared a digital pathology and whole slide imaging (WSI) system for use in primary diagnosis, should they adopt this technology sooner or wait until later? One pathologist who has worked with WSI for many years shared the lessons learned in

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Six Years after Launch, Med Fusion Sold to Quest

For the second time in 13 years, an effort to create a reference lab in Dallas fails to deliver

CEO SUMMARY: In Dallas, the relatively short-lived lab company known as Med Fusion has a new owner. After seven years, the lab partnership of Baylor Scott and White, US Oncology Network, Texas Oncology, and Pathologists Bio-Medical Laboratories decided to sell their ownership stakes to Quest Diagnostics. The sale comes despite $100 million of capital and

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Quest Diagnostics Exits 31-Year-Old Lab Venture

Partners in this laboratory joint venture were hospital, pathology group, and Quest Diagnostics

CEO SUMMARY: News that Quest Diagnostics had exited the long-running CompuNet Clinical Laboratory joint venture in Dayton, Ohio, caught many observers by surprise. The only clues as to possible problems and the motivation of Premier Health, the 51% owner, to buy out Quest’s ownership share are contained in an announcement the health system issued. The

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Genetic Test Pre-Authorization Goes Mainstream

IT IS ALWAYS A BIG DEAL WHEN ONE OF THE NATION’S LARGEST HEALTH INSURERS TAKES A MAJOR STEP. That is certainly true of Anthem’s decision to launch a new program that requires physicians to obtain pre-authorization when ordering genetic tests for its members.

THE DARK REPORT is first to report this news to the clinical laboratory

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