Prior Authorization Legislation Takes Center Stage at Joint Hearing on Health Care Affordability
A joint hearing held on Jan. 22 by the U.S. House of Representatives Energy & Commerce Subcommittee on Health and the Ways and Means Committee hosted...
1 min read
On Oct. 30, the American Hospital Association and other organizations, including the College of American Pathologists, sent a letter to U.S. House and Senate leadership urging them to pass the Reforming and Enhancing Sustainable Updates to Laboratory Testing Services (RESULTS) Act (S.2761/H.R. 5269).
The legislation would modernize the Clinical Laboratory Fee Schedule (CLFS) with current and comprehensive commercial market data, reduce administrative data collection and reporting burdens for clinical laboratories and the Centers for Medicare & Medicaid Services, and promote diagnostic innovation through Medicare payment stability. The organizations also note that passage of the RESULTS Act would prevent pending payment cuts of up to 15 percent for about 800 clinical laboratory services, set to begin on Jan. 1, 2026.
“The CLFS represents less than 1 percent of total Medicare spending, while clinical laboratory services inform 70 percent of clinical decision-making,” the organizations wrote. “Timely access to innovative clinical laboratory tests is critical to the prevention, early detection, therapy selection, and effective management of chronic and life-threatening diseases.”
Both versions of the bill were introduced on Sept. 10 and have been referred to relevant committees for further consideration.
Source:
Payer Update for Blue Cross Blue Shield New Jersey
TELCOR has identified ongoing processing challenges with BCBS New Jersey that laboratories should be aware of. When claims require medical records,...
Payer Update for BCBS Nebraska
TELCOR has identified a recent process change with BCBSNebraska impacting payment timelines. As of November 1, 2025, BCBSNE adjustedits payment...