Several PHLs believe that MCOs' lack of awareness of and responsiveness to disease reporting requirements are negatively affecting the PHLs' disease reporting efforts. We did not uncover any formal information to support this contention, but it may well be correct – establishing this link is beyond any of the data that we encountered in conducting this study.
Difficulty in obtaining payment for tests with associated fees
A few PHLs reported difficulty in obtaining reimbursement from MCOs for testing services rendered to MCO patients. This result, while not widespread, demonstrates the lack of formal channels of commerce between MCOs and PHLs.