Independent and physician-owned laboratories across the country are sounding the alarm as payer networks continue to exclude them, blocking patient access to essential diagnostics and threatening the future of innovation. That urgency was front and center during Lighthouse Lab Services’ recent webinar, How Independent Labs Can Gain Payer Network Access, featuring Dr. Sherry Dadgar (CEO, PMCDx), Ann Lambrix (Executive Director of RCM Consulting), and Lighthouse Founder Jon Harol.
Despite producing 70% of data used for medical decisions, many independent labs are denied in-network status with the simple phrase: “The network is closed.” The result? Delayed diagnoses, care disparities, and financial strain for labs built to serve local communities.
Patients Outcomes & Care Disparities
Speakers emphasized that payer exclusions hurt patients first — especially those on Medicaid, those living in rural regions, and those navigating complex or rare diseases. Limited testing access increases avoidable hospitalizations, extends diagnostic odysseys, and drives up healthcare costs.
“Independent labs exist to innovate and improve patient outcomes,” Dr. Dadgar said. “But many can’t provide those services because payers simply refuse to let them in.”
States with high managed-care penetration — like Maryland, where 80% of Medicaid beneficiaries are under MCOs — face significant diagnostic inequities. Rare disease patients, in particular, may wait years longer for answers when advanced tests remain out-of-network.
There Are Solutions — And They’re Working
Two states offer promising models based on common sense solutions:
- Tennessee: “Any willing provider” legislation ensures qualified labs can join networks.
- Kentucky: Labs are defined as healthcare providers, not vendors, giving them legitimate contracting paths.
These approaches are now shaping a national push for change. Both of these approaches can be achieved with relatively minor adjustments to the current State legislation.
The Fair Healthcare Access Coalition
To unify these efforts, Dr. Dadgar introduced the Fair Healthcare Access Coalition (FHAC) — a new initiative mobilizing labs, clinicians, and patients to advocate for federal reforms, network transparency, and equitable access to diagnostics. The nonprofit advocacy group is building momentum with grass roots efforts in Maryland, seeking to present legislation in the upcoming general session this January.
At the center of this campaign is a petition calling for widespread support and gathering the data needed to advocate for change. If successful, the group hopes to make a national push to help drive change all across the country.
Lighthouse’s Jon Harol put it plainly: “We need representation from all 50 states to make this case nationally.”
Why Labs Should Sign On
FHAC is collecting valuable data for to help make their case to legislators; including:
- Stories of patient impact
- Examples of payer denials
- Clinician endorsements
- Lab signatures from across the country
These collective experiences give advocates the leverage needed to challenge unfair network closures and push for policy change.
The Path Forward
Independent labs play a critical role in community health, precision medicine, and the biotech workforce. But without equitable network access, more labs will close — and patients will pay the price.
The industry’s message is clear: The time to act is now.
Labs can learn more and sign the Fair Healthcare Access Coalition petition today.
Learn more here: https://fairhealthcareaccess.org/
