Picking up a 2014 5.7 in a few days...

Yes, absolutely would need a new cam. The mds engines have two types of lifters. 1/2 are made to operate the mods and the other half are the standard style. Just put standard style throughout and special plugs to replace the mds solenoids and you're good to go. The vvt timing setup takes a special lock out kit to eliminate the vvt. There were some bad timing sets out there in certain years, but they've corrected that. If that engine were part of the recall, it's probably been fixed or wouldn't have made to that high of mileage.

Personally, I think that engine would just be a good core (hopefully) to rebuild or build a stroker. A more simple gen3 to start with is a 6.1 They've been coming down in price and are a great and simple engine.