News
TELCOR is excited to share industry news and updates with our stakeholders across the country.
Robinson+Cole: COVID-19 Testing – Additional Considerations
At the start of the COVID-19 pandemic, each state and the federal government announced various states of public health emergencies which enabled them to suspend or modify various laws, [...]
California Senate Bill, SB535, Prohibits Prior Authorization Requirements for Cancer Biomarker Testing
On October 6, 2021, California Governor Gavin Newson signed into law bill SB535. This bill restricts health insurers from requiring prior authorizations to limit advanced cancer patients’ timely access [...]
Cigna Moving Forward to End Reimbursement for Professional Component of Clinical Pathology Beginning Nov 1, 2021
A letter dated September 23, 2021 from Cigna says, “As a result of a recent review, we will deny separate reimbursement for Current Procedural Terminology (CPT®) codes billed with [...]
Medicare FFS Claims: 2% Payment Adjustment (Sequestration) Suspended Through December
The Coronavirus Aid, Relief, and Economic Security (CARES) Act suspended the sequestration payment adjustment percentage of 2% applied to all Medicare Fee-for-Service (FFS) claims from May 1 through December [...]
Quarterly Update for Clinical Laboratory Fee Schedule (CLFS) and Laboratory Services Subject to Reasonable Charge Payment
The quarterly update for clinical laboratory fee schedule (CLFS) and laboratory services subject to reasonable charge payment information is now available. For information on the data reporting period and [...]
HRSA Patient Registration Backlogged
The process for registering patients for billing of COVID-19 testing to the HRSA payer is currently backlogged. The patient registration process was returning ID numbers within a day or [...]
Laboratory Test Registry Protocol is Delayed Until Further Notice
UnitedHealthcare is delaying the implementation of the clinical and pathology Laboratory Test Registry Protocol until further notice. This includes registration of non-genetic tests and placement of test codes on claims [...]
Modifier Decision Trees for Hospice Billing
Knowing when hospice patient services should be covered and which appropriate modifiers, GW or GV, should be used can be confusing. Novitas Solutions created simple decision trees to help [...]
CMS Released a Proposed LCD (DL39063) for Pharmacogenomics Testing
On June 11, the Centers for Medicare & Medicaid Services (CMS) released a proposed Local Coverage Determination (LCD) for Molecular Diagnostic Services Program (MolDX): Pharmacogenomics Testing. The scope of [...]
HHS Dedicating Funds to HRSA
The US Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), announced it is dedicating $4.8 billion from the American Rescue Plan (ARP) [...]