The College of American Pathologists and the Florida Society of Pathologists have composed a letter of opposition to the Laboratory Benefit Management Pilot Program (LBMP) created by UnitedHealthCare (UHC) and administered by BeaconLBS that is scheduled to begin on January 1, 2015 in Florida. I recommend all Florida pathologists sign on to the letter to fight against the implementation of this horrible program.
For those who do not know, BeaconLBS describes itself as follows:
BeaconLBS® is a laboratory benefit solutions company that enables health plans, physicians and network labs to connect and deliver high-quality, cost-effective care to patients. BeaconLBS® is distinctive in its approach, offering a fully integrated, solutions-based technology that automates real-time clinical and financial decision-making at the point of care and point of ordering.
UHC partnered with BeaconLBS, a wholly-owned subsidiary of LabCorp, to create the LBMP, which is supposedly designed to “help improve quality of care and manage appropriate utilization for outpatient laboratory services.”
But instead, I believe it will create a huge amount of unnecessary administrative work for referring physicians, laboratories and pathologists that will render them tremendously inefficient and actually harm patient care.
The LBMP will require referring physicians to notify Beacon if they intend to order any tests that appear on an 80-test list that includes molecular and genetic tests, flow cytometry and essentially all anatomic pathology tests, including simple biopsies, cytology (including Pap smears) and immunohistochemistry. Two additional tests, BRCA-1 and BRCA-2, will require permission from BeaconLBS before they can be ordered.
Ridiculously, if a referring physician fails to notify Beacon, but the lab to which the test was sent performs the requested test anyway, it is the lab, and not the physician whose responsibility it was to notify Beacon, that will be penalized and not reimbursed for the test it performed. [Read more…]