like us on facebook connect with us on linkedin follow us on twitter October 18, 2023

Pfizer
Pfizer


To learn more about Pfizer's Oncology Together, click here
To learn more about My Healthcare Finances, click here.

Section Header Section Header Section Header

MSHO Featured Corporate Sponsor Assistance Programs

• Lilly Oncology Support Center 
• Natera Signatera
• Rigel OneCare 

Details >

Section Header

WPS Oncology Related LCD Updates

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

Details >

WPS Recent Oncology Related News

• HOPD Prior Authorization Requests
• New CMS 855I Released
• Website Redesign
• Medicare Hot Links

Details >
Section Header

CMS-Medicare

Recent Oncology Related Articles

• CY 2024 Part A Premiums
• Oral Anticancer & Antiemetic Drugs
• Infusion Pumps & Related Drugs
• 12 Months of Mandatory Continuous Coverage for Children
• And More

Details >

Quality

• Scoring for CY 2023
• Promoting Interoperability Programs
• Changes to 2023 Submission Experience
• Relevant Resources

Details >

Recent RAC Monitor Article

This edition includes articles on

• Staying Current with Medical Necessity
• The Benefits of Revenue Cycle Operational Assessment Times of Financial Crisis
• A Suggestion for Addressing Medicare Advantage Plans that Refuse to Do What They’re Told
• Transfers and Medicare Payment – Who Knew it Could Be So Complex?

Details >
Section Header

BCBSM/BCN

Recent Oncology Related News

IMPORTANT - PLEASE READ!
• Changes to preferred drug designations and prior authorization requirements
• Changes to preferred drug designations under the medical benefit for most commercial member
• Auto-assign a primary care provider
• Additional fee schedules added to our provider portal
• And More

Details >

BCBSM/BCN

Publications

• The Record
• BCN Provider News

Details >
Section Header

Current Payer Issue Tracking Page

Last Reviewed/Updated 10/17/23

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

Details >

Humana

• Commercial Preauthorization and Notification List
• Medicare Advantage and Dual Medicare-Medicaid Plans Preauthorization and Notification List

Details >

Health Alliance Plan

• HAP CareSource exclusive EDI gateway service

Details >

Medicaid

Recent Oncology Related News

Medicaid Updates Include
• MSA Bulletin Updates
• Biller "B" Aware Notices

Details >

Priority Health Update

• New clinical edit goes into effect Dec 5
• Claims temporarily denying incorrectly
• New clinical edits for professional claims go into effect Nov 26
• Provider enrollments error occurring in prism
• And More

Details >

United Healthcare

• Specialty Medical Injectable Drug Program Updates
• Medicare Part B Step Therapy Prior Authorization Requirements
• Submit Oral Chemotherapeutic Prior Authorizations to CGP
• And More

Details >
Section Header

Recent Oncology Related FDA Approvals and Expanded Indications

• Bristol Myers Squibb Reblozyl
• Pfizer Bosulif
• Bristol Myers Squibb Opdivo
• Merck Keytruda

Details >
Section Header Section Header

ASK MSHO

October 2023 Frequently Asked Questions

• Medicare JZ and JW modifiers

Details >