like us on facebook connect with us on linkedin connect with us on instagram September 17, 2025

J&J Innovative Medicine

To learn more about Johnson & Johnson's J&JwithMe, click here.

Section Header Section Header

Save the Date for MSHO's Fall Payer Update!

Wednesday, November 12 at Schoolcraft College in Livonia

Registration opens soon!

Details >
Section Header

MSHO Featured Corporate Sponsor Assistance Programs

• Boehringer Ingelheim's CareConnect4Me™ Patient Support Program
• myAgios
• Rigel OneCare

Details >
Section Header

WPS Oncology Related LCD Updates

• Retired Policies / Articles
• Revised Policies / Articles

Details >

WPS Recent Oncology Related News

• Hospital & Practitioner PTP Edits
New Medicare Hot Links

Details >

WPS Educational Offerings

New training opportunities available

• Live Trainings
• Encore Presentations
• YouTube Videos

Details >
Section Header

CMS-Medicare

Recent Oncology Related Articles

• Rural Health Transformation (RHT) Program
• CMS Announces Changes to AHEAD Model
• HHS Expands Access to Affordable Health Insurance
• MLN Matters
• And More

Details >

Recent RAC Monitor Article

This edition includes articles on

• AI in Auditing: Are We Auditing the Machines?
• Weighing Privilege for Internal Coding Reviews
• Denials Management in 2025
• More Prior Authorization?
• How NSA is Affecting Providers & Consumers

Details >
Section Header

BCBSM/BCN

Recent Oncology Related News

• Upfront Collection of Applicable Member Deductibles & Copayments
• Oct 6: Submit FEP Members Prior Auths Through E-Referral System
• New Provider Prior Authorizations Website Coming
• Documentation & Coding Webinars for Physicians & Coders
• And More

Details >

BCBSM/BCN

Publications

• The Record
• BCN Provider News

Details >
Section Header

Current Payer Issue Tracking Page

New update! Retacrit and Procrit Maintenance Dose Billing

Details >

Resolved Payer Issues

• BCBSM Below Cost Reimbursement

Details >

Aetna

• Complete Required Medicare Compliance Training & Attest by Oct. 31
• Claim & Code Review Program (CCRP) Update
• Training that Transforms: Meet PatientForward
• Smart Compare is Coming Soon
• And More

Details >

Health Alliance Plan

• Reminder - Claims Appeal Timeframe
• Process Change When Providers Appeal On Member Behalf
• Medicare Fraud Scheme
• HFHI is Preferred Provider for Home Infusion of Specialty Medications

Details >

Medicaid

• CHAMPS Pay Cycle 40: Early Claim Cutoff Dates and Early Payment 
• MMP Bulletins 
• Biller Be Aware

Details >

Molina

Recent Oncology Related News

• Preferred Drug List 

Details >

Priority Health Update

• September 25 Billing & Coding Webinar
• Preliminary 2026 PIP Manual Now Available
• 2024 Quality Award Packets Will be Delivered Soon
• Complete D-SNP Model of Care Training by December 31, 2025
• And More

Details >

United Healthcare

• Medical & Reimbursement Updates
• Changes to Prior Authorization Requirements & Coverage
• Q4 2025 Preferred Drug List Update 
• And More

Details >
Section Header

Recent Oncology Related FDA Approvals and Expanded Indications

AstraZeneca Koselugo (selumetinib)
Johnson & Johnson Nlexzo™ (gemcitabine intravesical system)

Details >

Section Header Section Header

ASK MSHO

September 2025 Frequently Asked Questions

• Oral Hydration VS Intravenous Hydration Therapy
• Documentation for Medically Necessary Fluid Replacement

Details >