HIGHMARK IMPLEMENTING LAB MANAGEMENT PROGRAM JULY 1, 2016

Highmark has contracted with eviCore to manage molecular and genomic testing within a new Lab Management Program. eviCore’s Lab Management Program utilizes evidence-based policies, developed with trained genetic experts, to ensure that the genetic lab services provided to Highmark’s members support clinically appropriate care and are medically necessary, in accordance with their benefit policy. Effective with dates of service on or after July 1, 2016, Highmark will require prior authorization for several molecular and genomic tests when performed in an outpatient setting for fully insured Commercial, Affordable Care Act and Medicare Advantage members. Please note that services performed without a prior authorization may be denied, and you may not seek reimbursement from members.