News
TELCOR is excited to share industry news and updates with our stakeholders across the country.
CMS, MACs to Issue New Proposed LCD for Blood Tests Monitoring Organ Transplant Rejection
The Centers for Medicare & Medicaid Services (CMS) and Medicare Administrative Contractors (MACs) are not finalizing the proposed MolDx: Molecular Testing for Solid Organ Allograft Rejection local coverage determination (LCD) [...]
CMS Reminds Providers of Next Private Payer Data Reporting Period for CDLTs
In a quarterly update for the Clinical Laboratory Fee Schedule (CLFS) and laboratory services, the Centers for Medicare & Medicaid Services (CMS) reminds providers billing Medicare Administrative Contractors (MACs) that [...]
Circuit Court Upholds Ruling in Texas Medical Association et al. v. HHS
Judges in the Fifth Circuit Court of Appeals upheld a 2023 ruling that the federal government’s regulations implementing the independent dispute resolution (IDR) process under the No Surprises Act improperly [...]
L.A. Care Health Plan Announces Removal of 50 Percent of Laboratory and Radiology Codes From Prior Authorization List
In an update to its list of codes requiring prior authorization, L.A. Care Health Plan has removed 24 percent of medical codes, including more than 50 percent of all laboratory [...]
House Appropriations Committee Calls on FDA to Suspend LDT Final Rule
The House Appropriations Committee approved a measure on July 10 that requests the U.S. Food and Drug Administration suspend implementation of the final rule regarding laboratory-developed tests (LDTs). The request [...]
ONC Releases HTI-2 Proposed Rule
The Office of the National Coordinator for Health Information Technology (ONC) released the Health Data, Technology, and Interoperability: Patient Engagement, Information Sharing, and Public Health Interoperability (HTI-2) proposed rule on [...]
CMS Releases Proposed 2025 Medicare Physician Fee Schedule
The proposed 2025 Medicare Physician Fee Schedule was released on July 10 and includes provisions increasing relative values of certain services, coverage for new chimeric antigen receptor (CAR) T-cell services, [...]
Senate HELP Committee Ranking Member Cassidy Calls on FDA to Respond to Loper Bright Decision
On June 30, Sen. Bill Cassidy, M.D. (R-La.) sent a letter to U.S. Food and Drug Administration Commissioner Robert Califf, M.D., regarding the applicability of the Supreme Court Loper Bright [...]
Congress Reintroduces Legislation to Streamline Prior Authorization for Medicare Advantage
On June 12, a bipartisan group of congressional leaders reintroduced the Improving Seniors’ Timely Access to Care Act, which would streamline the prior authorization process under Medicare Advantage. U.S. Sens. [...]
UHC Implemented Molecular Pathology Reimbursement Policy Requiring Z-Codes
On June 1, United Healthcare (UHC) implemented the Molecular Pathology Reimbursement Policy, which requires DEX Z-codes on genetic test claims to receive payment. In accordance with Phase 1 of the [...]