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...

Federal Government Agrees to Open Access to Medicare Data about Individual Doctors

Experts predict employers will use this data to create “report cards” on individual physicians In a big step forward for public access to data about provider outcomes, the Department of Health and Human Services (HHS) will make its enormous Medicare claims database more broadly available to the public. Both the press and the public will be able to search for information about individual physicians. It is likely that information about pathologists will be searchable in this manner....

Update on United HealthCare’s Plan to Fine Physicians for Using Out-of-Network Labs

Apparently physicians in several states besides New Jersey are catching the attention of their insurance regulators over UnitedHealthcare’s effort to fine doctors who continue to use out-of-network laboratories. Now, state authorities in Texas, Connecticut, Iowa, Florida, and California have joined New Jersey state regulators by announcing plans to review the legality of the $50 fine announced by United Healthcare for doctor’s who refer their patients to out-of-network laboratories. In March,...
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