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Participating states to test outcomes-based payments for sickle cell disease treatments, improving care while lowering long-term costsDetails >
Join an MSHO listserv and get advice from your peers.Details >
• Adaptive Assist
• Natera Signatera
• PharmaEssentia Source Details >
• Revised Policies / Articles
• Proposed LCD Open Meeting Details >• Process Change for Customer Service
• Steps to Take if You Get a CERT Documentation Request
• Medicare Hot Links Details >New training opportunities available• New! Live Training
• Prior Authorization Education Videos
• Training Indicators
• New! YouTube Video Details >
Recent Oncology Related Articles• PC-Print July 2025 DP1 Updated CARC & RARC Now Available
• CMS Proposed 2026 Rule Changes
• 2.8 Million Potentially Enrolled in Two+ Medicaid/ACA Exchange Plans
• MLN Matters
• And More Details >• New 2023 Participation & Performance Data Available
• CMS Proposes Policy Changes for Quality Payment Program Details >This edition includes articles on• Unpacking the RUC Time Study
• Abe Sutton & MA Reform
• More Prior Authorizations Coming & Correcting Errors
• Navigating Conflicting Guidance on Incident-to Services Details >
Recent Oncology Related News• July 30: Additional Drugs Require Prior Auth for URMBT Members
• Aug 1: Changes to How we Cover Revlimid
• Aug 20: Requirements for More Oncology Drugs for Most Members Details >Publications• The Record
• BCN Provider News Details >
• New Update! Retacrit and Procrit Maintenance Dose Billing
• BCBSM Below Cost Reimbursement Details >• July 2025 OfficeLink Update
• 2025 Formulary Exclusions Drug List Details >• Medical Record Review Projects
• HAP CareSource Monthly Updates
• Aug 1: Preferred Provider for Home Infusion of Specialty Medications Details >Recent Oncology Related News• July 1: Changes to NCQA Credentialing Requirements
• July 1: Molina Has Moved
• General Provider Orientations Details >• Aug 23: IMRT Added to Post-Pay Audit Program
• July 2025 Billing Policy Updates
• Medicaid Audit Underway
• New In-Home Health Assessment Vendor
• And More Details >• Advantage 3-Tier & 3-Tier PDL Updates
• Q3 Preferred Drug List
• Medical Benefit Specialty Medication Update
• And More Details >
• Regeneron Lynozyfic (linvoseltamab-gcpt)
• AstraZeneca & Daiichi Sankyo Datroway (datopotamab deruxtecan or Dato-DXd)
• Incyte Monjuvi (tafasitamab-cxix) Details > • New Dosing Regimen for Pfizer's Elrexfio (elranatamab-bcmm)
• Takeda Oncology's Fruzaqla® (fruquintinib) is Covered on CVS Caremark National Template Formularies
• Streamlined Patient Monitoring Requirements & Removal of REMS Programs within Bristol Myers Squibb’s Cell Therapy Labels
• Tablet Formulation Approved for BeOne’s Brukinsa® for All Approved Indications Details >
July 2025 Frequently Asked Questions• Code 96367 Assignment & Documentation
• Documentation Issues for Certain IV Infusions
• Charging Sequential Administration Lasting Longer Than 15 Minutes Details > |
