Congressional Opposition to WISeR Model Demands Performance Data From CMS
A congressional coalition sent a letter on June 22 to Centers for Medicare and Medicaid Services (CMS) Administrator Mehmet Oz, M.D., expressing...
Virginia Gov. Abigail Spanberger signed Senate Bill 745 on April 6, prohibiting health plans from imposing unnecessary restrictions on referrals to in-network laboratories.
Known as the Practitioner Self-Referral Act, the bill stipulates that health plans cannot impose restrictions on an exclusive set of a few in-network laboratories, thereby denying referrals to other in-network providers. This bill does not apply to state-regulated HMOs.
The College of American Pathologists has been an outspoken critic of steering practices, previously writing in a letter to Spanberger on March 2 that “[t]his business practice of funneling pathology/laboratory referrals undermines the optimal practice of medicine and can harm Virginia patients without their knowledge.”
The law becomes effective July 1, 2026.
Sources:
https://www.cap.org/advocacy/latest-news-and-practice-data/april-14-2026#story2
https://documents.cap.org/documents/Senate-Bill-745-CAP-03-02-26.pdf
A congressional coalition sent a letter on June 22 to Centers for Medicare and Medicaid Services (CMS) Administrator Mehmet Oz, M.D., expressing...
July marks the final month of the 2026 PAMA reporting period. Laboratories that meet the definition of an applicable laboratory, which most do, have...
Effective July 1, 2026, Humana will charge a $5.00 administrative fee for Medicare Advantage paper claim submissions.