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Michigan Patient Assistance Programs

• Angels of Hope
• Hot Pink Helpers
• New Day Foundation

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WPS Oncology Related LCD Updates

Billing and Coding Articles for November 2025

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WPS Recent Oncology Related News

• Hospital & Practitioner PTP Edits
Targeted Probe and Educate Problem Error Rates
Quarterly Average Sales Price (ASP) Pricing Files

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WPS Educational Offerings

• Live Trainings
• Encore Presentations
• YouTube Videos

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CMS-Medicare

Recent Oncology Related Articles

• 2026 Physician Fee Schedule Final Rule
• Policy Changes QPP
• CMS Negotiates Lower Prescription Drug Costs
• MLN Matters

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Recent RAC Monitor Article

This edition includes articles on

• What Happens Now - Shutdown Ends
• Outpatient E&M Audits in Transition
• Diagnosis Coding for Medicare Advantage
• RADV Audits

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BCBSM/BCN

Recent Oncology Related News

• Change to Copay & Coinsurance for Oral Chemotherapy
• Changes to Coverage on Drug Lists
• Discontinuing Payment to Provider on Certain Items and Services

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BCBSM/BCN

Publications

• The Record
• BCN Provider News

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Aetna

• Claim & Code Review Program (CCRP) Update
• Changes to Commercial Drug List
• Changes to National Precertification List
• And More

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Health Alliance Plan

• Formulary & Prior Authorization Changes
• Plan Changes
• Provider Call Center
• And More

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Medicaid

• MMP Bulletins 
• Biller Be Aware
• CPT Coding Update

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Molina

Recent Oncology Related News

• Provider Bulletin
• Preferred Drug List
• Billing & Reimbursement Policies
• And More

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Priority Health Update

• Recent News
• 2026 Fee Schedule
• Complete D-SNP Model of Care Training by December 31, 2025
• Medical Benefit Drug List

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United Healthcare

• Medical & Reimbursement Policy Updates
• Pharmacy Updates
• Specialty Drugs 
• And More

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Recent Oncology Related FDA Approvals and Expanded Indications

Kura Oncology Inc. Komzifti™ (ziftomenib)
Johnson & Johnson DARZALEX FASPRO® (daratumumab/hyaluronidase-fihj)
Syndax Pharmaceutical Revuforj® (revumenib)
GlaxoSmithKline Blenrep (belantamab mafodotin-blmf)

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ASK MSHO

November 2025 Frequently Asked Questions

• Unrecorded stop time and IVP code
• Billable hydration hours
• Reporting two drugs administered at the same time

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