Florida Lab Story Has National Implications

Pathology groups should be particularly concerned about what happens to BeaconLBS in Florida

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PLEASE ALLOW ME TO THANK ALL OF YOU READERS who have contacted us with information, rumors, and useful intelligence about UnitedHealthcare’s laboratory benefit management program in Florida that is administered by BeaconLBS, a division of Laboratory Corporation of America.

Your input, along with that from physicians in different specialties in Florida and their respective state and national medical associations, has helped THE DARK REPORT tell the remarkable story about how a huge national insurance company wants to cram a poorly-designed system for ordering lab tests down the throats of thousands of very unhappy doctors in the Sunshine State.

UnitedHealthcare has yet to provide data to physicians to justify why it believes that many well-established clinical lab tests must be pre-notified or pre-authorized.

That failure rankles many of these clinicians. In addition, these physicians have legitimate concerns about the negative effect that the UHC program will have on patient care-particularly because it could disrupt an accurate and timely diagnosis what would otherwise occur when these physicians are ordering lab tests consistent with established evidence-based medicine guidelines.

For pathologists and laboratory administrators outside of Florida, this story is directly relevant. It is known that representatives from BeaconLBS are attempting to recruit labs in eight or 10 other states in order to replicate the laboratory benefit management program.

In fact, pathology groups should be particularly concerned about what happens to BeaconLBS in Florida. That’s because the requirements for pre-notification and pre-authorization, if implemented in other states, would exclude about 40% of the pathology groups from providing services in their respective states!

The clinical reasons to support these restrictive requirements have never been documented by UHC or BeaconLBS. Of course, it goes without saying that LabCorp, as owner of BeaconLBS, has the anatomic pathology resources to fully meet the requirements of UHC’s laboratory benefit management program.

Might some labs challenge this as anti-competitive business behavior? These concerns show why the events unfolding in Florida with UnitedHealthcare and BeaconLBS have national implications-not just for pathologists and clinical lab managers-but for primary care and specialist physicians as well!

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