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J&J Innovative Medicine

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Save the Date for MSHO's Fall Payer Update!

Wednesday, November 12 at Schoolcraft College in Livonia

Registration opens soon!

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[Duplicate] MSHO Featured Corporate Sponsor Assistance Programs

• Coherus Solutions
• Immunocore's Kimmtrak Connect
• Lilly Oncology Support Center

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WPS Oncology Related LCD Updates

• Retired Policies / Articles
• Revised Policies / Articles

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WPS Recent Oncology Related News

• Hospital & Practitioner PTP Edits
New Medicare Hot Links

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WPS Educational Offerings

New training opportunities available

• Live Trainings
• Encore Presentations
• YouTube Videos

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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

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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

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[Duplicate] BCBSM/BCN

Recent Oncology Related News

• Aug 1: Updated Fees for Some Codes
• Sept 1: Changes to Managing Self-Administered Hemophilia Products
• Sept 1: Changes to How We Pay for Certain Medications
• Oct. 6: Submission Changes for FEP Members' Prior Auth Requests
• Billing for Non-Covered Services

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[Duplicate] BCBSM/BCN

Publications

• The Record
• BCN Provider News

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Current Payer Issue Tracking Page

New update! Retacrit and Procrit Maintenance Dose Billing

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Resolved Payer Issues

• BCBSM Below Cost Reimbursement

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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

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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

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Medicaid

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

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Molina

Recent Oncology Related News

• Preferred Drug List 

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United Healthcare

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

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Recent Oncology Related FDA Approvals and Expanded Indications

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

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ASK MSHO

September 2025 Frequently Asked Questions

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

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