To: PSA Affiliated Pathology Practices
The 10-year exclusive national agreement between United Healthcare (UHC) and Laboratory Corporation of America (LabCorp) have both companies implementing aggressive marketing campaigns designed to encourage referring physicians to refer specimens to an in-network provider.
Network Providers Not Listed In Online Directory
As part of their marketing campaign, UHC sent information to referring physicians and patients informing them to visit UHC's online directory for a list of participating laboratories. However, many referring physicians and pathology practices soon realized that most community-based pathology practices are not listed on the online directory. UHC also reported that referrals to non-participating laboratories will result in higher cost for the patient and a financial penalty for referring physicians.
Outreach To Be Shifted Away from Local Providers
During a recent PSA audio conference with Practice Managers and Marketing Representatives from PSA affiliated practices, Jane Pine Wood, attorney-at-law with McDonald Hopkins, LLC, commented
“It is my understanding based upon conversations with LabCorp representatives that LabCorp is in the process of putting together its national provider network to service its exclusive contract with United Healthcare. It is my understanding that LabCorp hopes to have this national provider network in place by next year, at which time United Healthcare will shift most, if not all, of its outreach (non-hospital) services to the exclusive LabCorp contract.
United Healthcare probably will not renew existing provider agreements with pathologists and pathology laboratories once the transition to LabCorp takes effect, and limit new contracts to only hospital-based services. United Healthcare may also exercise its rights under the existing contracts to enact an across-the-board policy change to limit the participation of pathologists and pathology laboratories to hospital-based services only. I have not heard any specific plans with respect to these options, but these are my assumptions based upon United Healthcare’s legal options.”
Action Needed:
PSA is attempting to work directly with UHC on listing the PSA affiliated practices that are currently participating providers with UHC for anatomic pathology and cytopathology services. PSA has also contacted the College of American Pathologists (CAP) for their support on this issue. PSA encourages your practice to continue informing your referring physicians on the status of this unresolved issue. We also encourage your practice to review the current terms of your UHC contract.
PSA will continue to keep our affiliated pathology practices apprised of any updates and ask that you contact PSA with your specific complaints, comments, unresolved issues and updates. Send your comments to
psa@psapath.com.