As Medical Laboratory Test Utilization Grows, Health Insurers Develop Programs to Manage Rising Costs

After seeing a rise in the volume of clinical lab tests physicians order, managed care plans are develop a variety of strategies to manage utilization and costs Health insurers are taking more aggressive actions to control the cost of clinical laboratory testing. For many years, clinical laboratories and pathology groups have been concerned about the strategies used by Medicare to control the utilization and costs of medical laboratory tests. Private health insurers usually follow the actions...

Florida Rheumatologist Says UnitedHealthcare’s Management Program for Clinical Laboratory Tests Could Jeopardize Patient Care

Miami physician asks why UnitedHealthcare requires use of the BeaconLBS system for authorization for recommended medical laboratory tests that may help identify lymphoma early In Florida, the confrontation between one of the nation’s largest health insurance corporations and physicians, clinical laboratory managers, and pathologists continues. The source of this confrontation are the restrictive and burdensome requirements for medical laboratory test ordering imposed last fall by...

UnitedHealthcare Pushes Back Start Date for Making Claims-Payment Decisions Based on its Florida Pilot Management Program for Medical Laboratory Tests

Health plan sets no new date for BeaconLBS claims-payment decisions but promises 30-days’ notice before making decisions on claims payment Physicians, pathologists, and clinical laboratories in Florida got a late Christmas present last week. UnitedHealthcare (UHC) (NYSE:UNH) postponed the date when its medical laboratory benefit-management pilot program in Florida, administered by BeaconLBS, would affect claims payments. This was welcome news, because, beginning January 1, if physicians...

In Florida, UnitedHealthcare’s New Clinical Laboratory Benefit Management Program Triggers Objections from Physicians and Excludes Most Medical Laboratories

College of American Pathologists and associations for family physicians and ob-gyns in Florida have asked UnitedHealthcare to discontinue implementation of BeaconLBS system Medical laboratory testing is at the center of a contest of wills in Florida. On one side is a health insurer that wants to require physicians to obtain pre-notification or preauthorization for a list of clinical laboratory tests. On the other side are the physicians who question the clinical basis for these requirements...