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Johnson & Johnson Innovative Medicine
To learn more about Janssen Oncology, click here
To learn more about Janssen Oncology Care Path, click here
To learn more about Janssen Oncology Patient Assistance Programs, click here.

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MSHO Featured Corporate Sponsor Assistance Programs

• Immunocore's Kimmtrak Connect 
• Novartis Patient Assistance Foundation
• Sanofi CareASSIST 

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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

• CMS Finalizes Physician Payment Rule
• CMS Makes Hospital Prices More Transparent
• Accelerated Payments Eligibility
• Updated Medicare Hot Links
• And More

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CMS-Medicare

Recent Oncology Related Articles

• HCPCS Application Summaries & Coding Recommendations
• Remedy for the 340B-Acquired Drug Payment Policy
• Medicare Pays for 3 Behavioral Health Services
• Executive Order: Increasing Access to High-Quality Care
• And More

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Recent RAC Monitor Article

This edition includes articles on

• United Healthcare’s Medicare Advantage & the 2-Midnight Rule
• SDoH Z Codes: How it Took a Village to Cleared the Confusion
• When the NSA & Price Transparency Collide

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BCBSM/BCN

Recent Oncology Related News

• Delayed WPS Medicare Part B 277CA Reports
• New and Updated Questionnaires
• Additional Fee Change Schedules
• Southeast, East & Mid-Michigan Provider Consultant Team
• And More

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BCBSM/BCN

Publications

• The Record
• BCN Provider News

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Current Payer Issue Tracking Page

Last Reviewed/Updated 11/14/23

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

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Aetna

• Changes to our National Precertification List (NPL)
• Appropriate Use of Separate and Distinct Modifiers
• Assistant Therapy Services Billing Reductions

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Health Alliance Plan

• Payer ID Changes for Medicaid and MI Health Link Claims
• New Process to Verify Payments to Contracted Facilities
• Keep Provider Information Updated in NPPES

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Medicaid

Recent Oncology Related News

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

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Priority Health Update

• New Audit Program for Duplicate Claims
• PCMH Designations are Now in Find A Doctor
• HCC coding Shifting to the V28 Model
• Updates on Priority Health Narrow Networks for 2024
• And More

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United Healthcare

• Specialty Medical Injectable Drug Program Updates
• Prior Authorization Reduction
• Reconsideration & Appeal Submissions Going Digital
• And More

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Recent Oncology Related FDA Approvals and Expanded Indications

• Genentech Rozlytrek
• Servier Tibsovo
• Coherus Loqtorzi
• Merck Keytruda
• Takeda Fruzaqla

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ASK MSHO

November 2023 Frequently Asked Questions

• Questions from MSHO Fall Payer Update

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