Good questions
"If a physician who is an employee of a group that has a contract with a lab e.g quest doesn't have faith in their AP services and wants to send his patients biopsies elsewhere can she / he do this?"
Maybe, it depends. Some groups have financial incentives with the lab through legal kickback backs such as client billing or free phlebotomy in the office to draw blood.
Sometimes these arrangements are exclusive contracts with the laboratory. Often times they will make exceptions for physician preference with respect to AP.
Other groups have no such arrangement and they have unrestricted access to all labs.
You have take it up with the management for the group to see if the referral is restricted for some reason.
"Will insurance cover it ?"
That's totally up to the patient's individual insurance coverage and the lab in question. Quest and Lab Corp have national contracts but they not exclusive.
Many insurance companies try to steer the to the big labs and give that impression to doctors and patients.
"Can punitive steps be taken against them if they do?"
It depends but yes.
If you cause the group to violate a insurance or other contract in major way, this might be possible.
Most of the time the lab or insurance company threatens to cancel first.
Also, if there significant financial loss incurred by the group... then maybe yes.
