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Read the MSHO update about the 2% sequestration delay, increase to physician fee schedule payments, no G2211, additional Radiation Oncology Model delay, increased clinical trial access and more... Details >
January 2021Updates that may be of interest to oncology including:
• Billing and Coding: Radiopharmaceutical Agents and MolDX Changes Details >Part A, Part B and Part A/B NewsIncludes articles that may be of interest to oncology released in the past 2 weeks
• Also, Medicare Hot Links to 2021 Final Rules and 2021 Proposed CMS Rules Details >Check out these upcoming training events:• What's New for 2021
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PLUS new on-demand educational opportunities Details >
Recent Oncology Related Articles• Non-Physician Outpatient Services Provided Before or During Inpatient Stays: Bill Correctly
• 2020 MIPS Extreme and Uncontrollable Circumstances Exception Application: Deadline February 1
• Telehealth Services: Bill Correctly
• Advance Care Planning — Revised
• Recent LearnResource & MedLearn Matters Articles Details >Region 1 - Performant Recovery, Inc.No New Oncology Related Issues Since March:
• Latest under review at that time included: - Bone Marrow Transplants, ESAs for Cancer Patients, and Therapeutic Injections Details >This edition includes articles on:• Credible Allegations of Fraud Yield Immediate Medicare Payment Suspension Details >
Recent Oncology Related News• Provider 1099s to be mailed by Jan. 31, 2021
• Some temporary changes due to the COVID-19 pandemic conclude Dec. 31, 2020
• CMS expected to release January 2021 quarterly Medicare pricer update
• Some drugs not payable when administered by a health care professional to Blue Cross and BCN commercial members, starting April 1, 2021
• For nonpreferred filgrastim products, submit prior authorization requests using NovoLogix® for all members, starting April 1, 2021
• Changes coming to preferred products for drugs covered under the medical benefit for most members, starting April 1, 2021
• EDI Clearinghouse Connection Changes – Meridian Health Plan of Michigan
• CMS 2021 HCPCS codes delayed
• Telehealth codes remain billable through the end of the PHE for Medicare Advantage members
• CMS approves Next Generation Sequencing for certain cancer patients covered by Medicare Advantage plans
• Update: Oncology management program for Blue Cross commercial members will not include use of S codes (S0353 and S0354)
• We're expanding High Technology Radiology Prior Authorization program with AIM to Michigan FEP members
• Medical specialty drug prior authorization list will change in January for Blue Cross commercial fully insured groups
• BCBSM/BCN: New, Secure Provider Website in 2021 Details >Publications• The Record
• BCN Provider News
• Blues Brief for Oncology Providers Details >Monthly Status ReportMany updates/corrections. Listed below is a sampling of what you will find:
• 835 Recoupment isn't reflected on voucher
• 835 CARC 210 sanction amount is incorrect
• System is applying denied authorization to claim in error
• Authorizations coming through are causing claim denials, multiple RHC Issues Details >
Last Reviewed/Updated 1/6/21Review the reported payer reimbursement issues including clarifications and issues with WPS Medicare, BCBSM, BCN, Medicare Plus Blue, Priority Health and UHC. Details >Recent Oncology Related NewsMedicaid Updates Include:
• MSA Bulletin Updates
• Biller "B" Aware Notices Details >• Aetna OfficeLink Updates
• Cigna
• HAP
• Humana YourPractice
• UHC Network Bulletin
• UHC Medical Policy Update
Details >Featuring this month: Molina Healthcare of MichiganTidbits regarding:
• Use of Biosimilars
• Car-T Coverage
• Telehealth Details >
January, 2021, Frequently Asked Questions• Status of MFN Interim Final Rule
• Sequestration
• Fee Schedule Disappearance
• No Specialist Code G2211
• Audio/Video Supervision Details > |
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