Some doctors are complaining about a recent UnitedHealthcare letter that says that they may fine providers $50, reduce their fees, or kick them out of the UnitedHealthcare network if they regularly refer patients to out-of-network labs. UnitedHealthcare says they will use the penalty only for the worst offenders after first speaking with the physicians.

UnitedHealthcare wants doctors to use LabCorp, its national in-network laboratory. Some physicians prefer Quest Diagnostics - previously contracted with UnitedHealthcare nationally. UHC says they want to prevent members from paying higher out-of-network costs. Indeed, consumers are often blindsided with big out-of-pocket expenses (as much as seven times more than in-network costs) if their doctor refers them to an out-of-network lab - whether by inattention, habit, or his or her own agenda. Most health plan members won't know what happened when they get the bill.