Health Insurers Balk at Paying for Multigene Panels While Clinical Pathology Laboratories and Physicians Pursue Evidence of Clinical Utility

Sep 2, 2015 | Coding, Billing, and Collections, Compliance, Legal, and Malpractice, Laboratory Management and Operations, Laboratory News, Laboratory Operations, Laboratory Pathology

News reports state that Anthem and Cigna have denied payment for some multigene panel tests, saying that the tests are unproven. Other insurers, such as UnitedHealthcare and Priority Health, pay for such tests but only for certain patients A conflict is building between patients and health insurers over the reluctance among health plans to pay for new, expensive molecular diagnostic assays and genetic tests that clinical laboratory companies offer. This conflict has caught the attention of the...

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

Mar 2, 2015 | Compliance, Legal, and Malpractice, Laboratory Instruments & Laboratory Equipment, Laboratory Management and Operations, Laboratory News, Laboratory Operations, Laboratory Pathology, Management & Operations

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...

Medical Laboratories at Hospitals Urged to Improve Newborn Screening Procedures After Wisconsin Report Uncovers Shocking Testing Delays

Feb 19, 2014 | Compliance, Legal, and Malpractice, Instruments & Equipment, Laboratory Management and Operations, Laboratory News, Laboratory Operations, Laboratory Pathology, Management & Operations

Analysis of almost 3 million newborn blood samples found that tens of thousands of specimens were not screened promptly for rare but deadly disorders, leading to patient harm in some cases State-mandated newborn testing has come under increased media scrutiny following the discovery that delays in reporting the clinical laboratory test results had resulted in harm to some children with genetic diseases. One source of problems is some hospitals fail to promptly submit specimens from babies to...

Generational Differences Now Reshaping Physician Attitudes and Will Likely Affect Private Pathology Group Practices

Jul 24, 2013 | Laboratory Hiring & Human Resources, Laboratory Management and Operations, Laboratory News, Laboratory Operations, Laboratory Pathology, Management & Operations

One consequence of the difference in intergenerational attitudes of physicians is the trend to more employee physicians For the dominant generation working in healthcare today—the Baby Boomers—retirement looms. At the same time, however, the younger generation—particularly Generation X—is acquiring the experience and maturity needed to assume leadership roles. As these individuals move into senior executive and administrative positions, healthcare experts are predicting growing conflict over...

Physician Business Leader Predicts Healthcare’s Winners and Losers as More Organizations Take Steps to Become Patient-Centered Medical Homes

Jun 19, 2013 | Laboratory Hiring & Human Resources, Laboratory News, Laboratory Operations, Laboratory Pathology, Management & Operations

Growth in the number of medical homes could make winners of those pathology groups and medical laboratories that learn how to best meet the needs of these providers Physician executives at TransforMED, a wholly-owned subsidiary of the American Academy of Family Physicians, are blogging with their opinions about which providers will be winners and losers in healthcare. Although most pathologists may not agree with these opinions, there are useful insights to be gleaned from the reasoning behind...