like us on facebook connect with us on linkedin connect with us on instagram October 24, 2025

AstraZeneca

To learn more about AstraZeneca's Access 360, click here.

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Registration Now Open for MSHO's Fall Payer Update!

Wednesday, November 12 at Schoolcraft College in Livonia

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MSHO Featured Corporate Sponsor Assistance Programs

• Alnylam Assist
• Deciphera AccessPoint
• Ipsen Cares

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WPS Oncology Related LCD Updates

Billing and Coding Articles for October 2025

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WPS Recent Oncology Related News

• Hospital & Practitioner PTP Edits
New Medicare Hot Links

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WPS Educational Offerings

• Live Trainings
• Encore Presentations
• YouTube Videos

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CMS-Medicare

Recent Oncology Related Articles

•Medicare Advantage and Medicare Prescription Drug Programs
•Telehealth
• MLN Matters

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Recent RAC Monitor Article

This edition includes articles on

• All Eyes on Telehealth as Federal Shutdown Continues
• What HIM Professional Can Expect from Government Shutdown

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BCBSM/BCN

Recent Oncology Related News

• Oct 6: Submit FEP Members Prior Auths Through E-Referral System
• New Provider Prior Authorizations Beginning Oct 22
• Documentation & Coding Webinars for Physicians & Coders
• And More

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BCBSM/BCN

Publications

• The Record
• BCN Provider News

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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

• CMS Telehealth Services Expired
• Process Change When Providers Appeal On Member Behalf
• HFHI is Preferred Provider for Home Infusion of Specialty Medications
• And More

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Medicaid

• MMP Bulletins 
• Biller Be Aware

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Molina

Recent Oncology Related News

• Preferred Drug List 

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Priority Health Update

• Preliminary 2026 PIP Manual Now Available
• Complete D-SNP Model of Care Training by December 31, 2025
• And More

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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

Regeneron Libtayo® (cemiplimab-rwlc)
Jazz Pharmaceutical Zepzelca® (lurbinectedin) and Atezolizumab (Tecentriq®)
Lilly Inluriyo (imlunestrant)

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Drug Updates

• BeOne's Brukinsa Changing from Capsules to Tablets

• Takeda's FRUZAQLA® (fruquintinib) and ALUNBRIG® (brigatinib) Covered at Cigna Healthcare

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ASK MSHO

October 2025 Frequently Asked Questions

• Reporting two drugs administered at same time
• Unrecorded stop time and IVP code

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