Sep 16, 2013 | Coding, Billing, and Collections, Laboratory Management and Operations, Laboratory News, Laboratory Operations, Laboratory Pathology, Laboratory Sales and Marketing, Management & Operations, News From Dark Daily
Clinical laboratories and pathology groups serving Cigna beneficiaries can expect to see new requirements for genetic tests used to diagnose breast cancer, colon cancer and long QT syndrome
Effective this week, Cigna (NYSE: CI) in Bloomfield, Connecticut, is implementing a new program that requires genetic counseling and pre-authorization for certain genetic tests. This is an important development and clinical laboratory executives can expect to see other health insurers take similar steps.
Cigna wants to control costs and improve the appropriateness of ordering expensive genetic tests. It will start with tests for three conditions and may require counseling for other types of genetic tests if this program is successful. Industry observers expect other health insurers will follow Cigna’s example and also require genetic counseling for a compelling reason: all insurers recognize that more than 50% of all genetic tests may be ordered inappropriately, experts say.
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Jun 29, 2012 | Coding, Billing, and Collections, Compliance, Legal, and Malpractice, Digital Pathology, Instruments & Equipment, Laboratory Hiring & Human Resources, Laboratory Management and Operations, Laboratory News, Laboratory Operations, Laboratory Pathology, Laboratory Sales and Marketing, Management & Operations
Price transparency expected to encourage competition among healthcare providers, including medical laboratories
Before consumers visit a clinical laboratory, they can now check the “fair” price of medical laboratory tests. New websites have sprung up that make it easy for consumers to find what experts consider to be fair market prices for each type of lab test, as well as for other medical procedures and healthcare services.
Pathologists should think of the well-known “Kelly Blue Book” that has been the price authority for prices of new and used automobiles for decades. These new medical price websites are easy to use and make it quick for a consumer to find “fair” prices for common clinical laboratory test and medical procedure.
These new web-based companies are organized to serve the needs of consumers who are enrolled in high-deductible health plans (HDHP). For an individual, an annual deductible can be as high as $2,500—and as much as $5,000 for a family. Thus, clinical laboratory managers should not be surprised that consumers are actively price-shopping before they visit their laboratory to have a specimen collected.
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Nov 14, 2011 | Compliance, Legal, and Malpractice, Laboratory News, Laboratory Pathology, Laboratory Sales and Marketing
Two Senate committees seem interested in how certain medical laboratories offer discounted laboratory test prices to selected health insurers
Is it a coincidence that discounted medical laboratory test pricing offered by the nation’s two largest clinical laboratory companies appears to now be the subject of interest for the Senate Judiciary and Senate Finance Committees? Last Tuesday, Senator Max Baucus (D-Montana) and Senator Chuck Grassley (R-Iowa) issued a press release titled “Grassley, Baucus Scrutinize Practice by Health Insurers and Testing Labs.”
Baucus is Chairman of the Senate Finance Committee and Grassley is the Ranking Member of the Senate Judiciary Committee. Together, these two Senators sent letters last week to two clinical laboratory companies and three big health insurance firms: (more…)