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Welcome to the Reimbursement Bulletin!

In order to more easily view the new format of this Bulletin, we recommend you view it in your web browser. At the very top it says, "To view this bulletin in a web browser, click here." By viewing it this way, you eliminate the need to go back and forth between your email and web browser, making it much easier to navigate. We hope this helps you enjoy our updated Bulletin!

This Bulletin will be published semi-monthly.  As always, any comments, suggestions, stories or questions can be sent to billing@msho.org. We hope you enjoy this issue!

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Important Oncology Related News

~ The Omnibus Spending Bill: Winners & Losers
~ ASCO Commends Congress for Passing Largest NIH Funding Increase in 15 Years
~ Evaluating Clinical Pathway Programs for Your Practice? New ASCO Checklist Can Help

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MSHO's Spring Reimbursement Meeting

Wednesday, April 25, 2018, 8:00 am - 3:30 pm

Lansing Community College - West Campus
~ Early Bird Registration Ends April 13th - REGISTER TODAY!

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BAYER

REACH - Nexavar (sorafenib) tablets

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WPS Oncology Related LCD Updates

April 2018

Including...
~April 2, 2018 MSHO Update on the National Coverage Determination for ESAs
-WPS LCD changes related to biosimilars (within "Drugs and Biologics (Non-Chemotherapy and Human Granulocyte/Macrophage Colony Stimulating Factor), and more...

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WPS Recent Oncology Related News

Part A, Part B and Part A/B News

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Join WPS for a Teleconference, Webinar or Seminar!

Check out these upcoming training events....

Including....
~ Teleconferences on 5/1 and 6/1 on MSP Overview and Appeals, In-person Seminar on 5/15 in Saginaw, "Medicare Day of Learning"

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Michigan RAC Information

Region 1 - Performant Recovery, Inc.

April 2018

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Recent RAC Monitor Articles

This edition includes articles on......

~ New Medicare Cards: Challenges and Opportunities
~ 340B Drug Update: Good News for Some in the Program

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CMS-Medicare

Recent Oncology Related Articles

~ New Q-Code for Yescarta
~ HIMSS18 Presentations
~ E/M Services Listening Session: Audio Recording and Transcript
~ Billing for Stem Cell Transplants
~ Billing Requirements for OPPS Providers with Multiple Service Locations MLN Matters Article
~ Medicare Parts A and B Appeals Process Booklet
~ Provider Compliance Tips for Oral Anticancer Drugs and Antiemetic Drugs Used In Conjunction
~ Early Data Show Positive Trend in Oncology Care ModelCost Savings

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BCBSM/BCN

Recent Oncology Related News

~ April 26, 2018 ICT Webinar: You’ve submitted a few claims; now what?
~ Delayed Medicare Advantage 835 remittance files
~ Earn continuing education credit by attending a provider forum
~ Blue Cross to update ClaimsXten with additional professional and outpatient facility edits in June

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Payer Issue Tracking Page

Last Updated 04/3/18

Review the reported payer reimbursement issues MSHO is currently addressing...

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Medicaid

Recent Oncology Related Issues and News

Medicaid Advantage Pending Issues; stay tuned, MSA Bulletins, Biller "B" Aware Notices

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Newsletters of Interest

~ Aetna OfficeLink Updates
~ BCN Provider News
~ Cigna
~ HAP/HealthPlus ProviderPlus
~ Humana YourPractice
~ UHC NetworkBulletin
~ UHC Medical Policy Update

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Managed Care Committee Reimbursement "TIDBITS"

Featuring this month: Priority Health

Update on Priority Health Advantage and coverage of ESA's!

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Recent Oncology Related Drug News

~ NCCN Guide for Immunotherapy Adverse Events
~ House Subcommittee Urged to Consider Solution to Step Therapy
~ The Uncertain State of the 340B Program: Where Are We Now?

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Recent Oncology Related News

~ Genomic Health launched a new assay on February 26th for mCRPC patients called Oncotype Dx AR-V7 Nucleus Detect

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"Ask MSHO"

April 2018, Frequently Asked Questions

Topics Include: Modifiers for Biosimilar Products, New Medicare Card Release, New Medicare Card Required Timing of Use, the new TPE program by CMS, Office Visit and Injection Same Day, E & M Guidelines

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