Genetic testing is rapidly growing, with over 180,000 registered tests available today and more being added daily. This expansion offers promising treatments but also poses challenges for health plans, which struggle to manage the complexity, cost, and quality of testing.

Health plans face increasing pressure due to state biomarker legislation and new electronic prior authorization (PA) requirements anticipated in 2026. This creates complications around test validity, cost management, and potential abuse, as seen in recent fraud cases.

To navigate these challenges, a comprehensive, science-based approach to genetic testing management is essential. In this Health Payer Specialist article, Mike Snyder, Avalon Executive Vice President of Network Solutions, and Mike Lemieux, Medical Policy Manager, reveal how a lab benefits manager (LBM) with expertise in laboratory testing can help health plans enforce standards, provide a network of accredited labs , and manage the complexities of genetic testing networks.

Read the full article at Health Payer Specialist.