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Fall Payer Update - Save the Date

November 1 - Schoolcraft College, Novi

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Are You Hiring?

Post Your Job Openings on MSHO's Job Board

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MSHO Featured Corporate Sponsor Assistance Programs

• Alnylam Assist®
• Coherus Solutions
• Taiho Oncology Patient Support
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WPS Oncology Related LCD Updates

Stay current on new, retired, and revised policies/articles

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WPS Recent Oncology Related News

• J5 & J8 Contractor Advisory Committee
• SAD List
• Customer Service Training Closure
• Medicare Hot Links

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CMS-Medicare

Recent Oncology Related Articles

• Remedy for the 340B-Acquired Drug Payment Policy
• 2024 Projected Medicare Part D Premium & Bid Info
• Hospital Price Transparency Proposals
• And More

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Recent RAC Monitor Article

This edition includes articles on

• Intrigued by Coding Accuracy?
• CMS Unveils 2024 Medicare PFS, OPPS Proposed Rules
• Summer Catchup with Adding & Updating HCPCS Codes

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BCBSM/BCN

Recent Oncology Related News

• HCPCS 2nd-Quarter Update: New & Deleted Codes
• Billing Chart

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BCBSM/BCN

Publications

• The Record
• BCN Provider News

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Current Payer Issue Tracking Page

Last Reviewed/Updated 8/15/23

• BCBSM Carelon Dismissal Notes
• Medicare Plus Blue Denying J9190
• Optum Denials Preparation & Administration of Drugs

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Resolved Payer Issues

Last Reviewed/Updated 8/15/23

• BSBCM PGIP Program Withholds
• Meridian / Wellcare labs

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Aetna

• Changes to National Precertification List
• Transition to the New Edition of the Milliman Care Guidelines

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Cigna

• Network News, 3rd Quarter Highlights

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Humana

• Commercial Preauthorization & Notification List Changes
• Claims Payment Policy - Modifiers JW & JZ

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Health Alliance Plan

• New JZ Claims Modifier
• Prior Auth Requirement Lists Updated Monthly
• Keep Provider Information Updated in NPPES
• And more

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Medicaid

Recent Oncology Related News

Medicaid Updates Include
• Medicaid Code and Rate Reference
• Medicare/Medicaid Crossover
• MSA Bulletin Updates
• Biller "B" Aware Notices
• And more

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Meridian

• New Provider Relations Intake Form
• Provider Network Monthly Webinar Series
• Help Patients with Transportation Needs
• New Z-Code Provider Incentive Program

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Priority Health Update

• Webinar on Disease Burden Capture
• Medicare Health Fair
• FDA withdrawal of approval for Oxandrin® and generic oxandrolone tablets
• Q3 Physician and Practice News Digest
• And More

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United Healthcare

• Intravenous Iron Replacement Therapy
• MRI & CT Scan - Site of Service
• Implantable Beta-Emitting Microspheres 
• And More

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Recent Oncology Related FDA Approvals and Expanded Indications

• Daiichi Sankyo Vanflyta
• GSK Jemperli
• Taiho Oncology Lonsurf
Janssen Talvey
• Genentech Gavreto
Janssen Akeeg
• Pfizer Elrexfi

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ASK MSHO

August 2023 Frequently Asked Questions

• Concurrent IV Administration

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