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Lumakras
To learn more about Amgen's Lumakras, CLICK HERE.

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MSHO Featured Corporate Sponsor Assistance Programs

• ServierONE
• Daiichi Sankyo Access Central
• Boehringer Ingelheim Cares Foundation

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WPS Oncology Related LCD Updates

January 2023

Stay current on retired and revised policies/articles

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WPS Recent Oncology Related News

• Discarded Drugs and Biologicals
• Fee Schedules
• Medicare Hot Links

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CMS-Medicare

Recent Oncology Related Articles

• Telehealth Indicator
• MVP Candidate Feedback Process
• QPP Timeline and Important Deadline
• Recent Learn Resource & MedLearn Matters Articles
• And more

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OIG Active Work Plan Items

Active Work Plan Items reflect OIG audits, evaluations, and inspections that are underway or planned.

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Recent RAC Monitor Article

This edition includes articles on

• CMS: Medicare Advantage Plans Must Abide by the Two-Midnight Rule
• Rising Prescription Drug Prices Yields to Drug Importation Proposals
• The Evolution of the Medicare Program Integrity Manual

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BCBSM/BCN

Recent Oncology Related News

• Checking Claim Status & Viewing Remittance Advices & Vouchers in Availity
• Additional Drugs to Require Prior Authorization 
• Generic Pemetrexed to Require Prior Authorization

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BCBSM/BCN

Publications

• The Record
• BCN Provider News

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Current Payer Issue Tracking Page

Last Reviewed/Updated 1/17/23

• 10/11 Update on BCBSM Denials for Auth Exceeds Allowed

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Aetna

• National Precertification List
• Medicare Part B Preferred Drug List
• Clinical Policy Bulletins and Precertification Forms

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Health Alliance Plan

• HAP & MSU Medicare Advantage Plan
• Introducing Dx Gap Advisor

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Medicaid

Recent Oncology Related News

Medicaid Updates Include
• Interprofessional Consultation Coverage
• Key Dates - Medicaid Continuous Enrollment Condition Provisions
• MSA Bulletin Updates
• Biller "B" Aware Notices
• And More

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Priority Health Update

• Update to Secondary Claims Process
• 340B-Aquired Drugs Ruling
• Edits Checker Tool

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United Healthcare

• Medical Policy Updates
• Radiation Medical Policy Updates
• Removal of Cost Sharing on Adult Vaccines
• 2023 Medicare Advantage Michigan PPO Plans

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ASK MSHO

January 2023 Frequently Asked Questions

• Periodic Monitoring Related to Code 96365
• BCBSM Denials for Auth Limits

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