Two U.S. senators are scrutinizing a practice in which health insurance companies get discounts from labs in exchange for referrals, including testing for Medicare beneficiaries.
Sen. Chuck Grassley, R-Iowa, and Sen. Max Baucus, D-Montana, are asking leaders of three health insurance companies and two leading clinical laboratory companies for information about the practice.
In Nov. 8 letters to the companies, the senators noted that the U.S. Department of Health and Human Services Office of the Inspector General has called such discount arrangements "particularly suspect." They asked Cigna, Laboratory Corp. of America, Aetna Inc., UnitedHealth Group Inc. and Quest Diagnostics Inc. for copies of lab service agreements, correspondence related to negotiation of contracts, presentations to boards about contracts, presentations to clinical laboratory testing providers and other documents related to "pull-through" practices. The senators requested the documents by Dec. 1.
"Pull-through" involves a lab testing company offering discounts in exchange for health insurance companies directing their in-network providers to refer business to the lab.
"We take seriously our responsibility to protect the interests of our nation's Medicare and Medicaid beneficiaries and the federal health care programs from waste, fraud, and abuse," the senators wrote.