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Welcome to the Reimbursement Bulletin
AMGENDownload the newly released Resource Guides for KANJINTI (trastuzumab-anns) and MVASI (bevacizumab-awwb) which includes information on preparation, administration, coding, patient support, and so much more! Details >
Senate Health & Human Services Committee Hears Testimony on SB 612, Prior Authorization/Step Therapy ReformSecond Hearing Scheduled for February 6th Details >March 11, 2020 - 12:00-1:00 PMRegister Today! Details >Now That the Dust Has Settled: Billing & Coding Changes in 2020The recording and handouts will be available on the MSHO website right after the program scheduled on February 5, 2020 at noon! Details >
February 2020Including;
• Multiple MolDX Updates Details >Part A, Part B and Part A/B NewsIncludes articles that may be of interest to oncology released in the past 2 weeks
• Also, Medicare Hot Links to Fee Schedules and 2020 Final and Proposed CMS Rules Details >Check out these upcoming training events....Including....
• Webinars: New to Medicare - Getting Started with the Medicare Program
• Medicare Advantage - How Does It Affect You?
• Care Management Services
• PLUS many additional on demand educational opportunities including E & M training opportunities! Details >
Recent Oncology Related Articles• Medicare Part B Immunization Billing: Seasonal Influenza Virus, Pneumococcal, and Hepatitis B — Revised
• Quality Payment Program: 2019 Data Submission Videos
• Quality Payment Program: 2020 Resources Details >Region 1 - Performant Recovery, Inc.Latest Issues Under Review That May be Significant to Oncology...
• BE READY - NEW ISSUES including - ESAs for Cancer Patients and Therapeutic Injections! Details >Are you at risk?Are you utilizing the smallest available vial size for all drugs? Details >This edition includes an article on......• To Sign or Not to Sign: A Provider’s Responsibility
• 340B Health President Notes “Cautious Optimism” in Moving Forward in 2020 Details >
Recent Oncology Related News• Clarification: Prolia and Xgeva drug authorization
• Reminder: Check for authorization requirements, not all Blue Cross patients require AIM authorization
• We're adding site-of-care requirements for Lemtrada and Tysabri for commercial members, starting May 1
• Reblozyl® will have authorization and site-of-care requirements for commercial members effective February and April 2020
• We're removing zoledronic acid drugs from the Medicare Part B medical specialty drug prior authorization list in March
• February 13, 2020 ICT Webinar: You've submitted a few claims; now what?
• AvsolaTM and GivlaariTM will have authorization and site of care requirements for commercial members effective February and March 2020
• Radiation therapy services for A9590 require authorization starting April 1 for all Blue Cross and BCN members
• We're adding two medical drugs to the site-of-care program for Blue Cross and Blue Care Network commercial members starting April 1, 2020
• Medicare Part B medical specialty drug prior authorization list is changing in March Details >Publications• The Record
• BCN Provider News
• Blues Brief for Oncology Providers Details >February Monthly Status ReportMany updates/corrections. Listed below is a sampling of what you will find...
• 835 Recoupment isn't reflected on voucher
• J0881 and J0885 claims are being denied incorrectly
• RHC claim issues
• and more... Details >
Last Updated 2/4/2020Review the reported payer reimbursement issues MSHO is currently addressing including BCBSM reimbursement by NDC and problems with payments below the minimum fee schedule Details >Recent Oncology Related NewsMedicaid Updates Include:
• Understanding the Interplay Between State Medicaid Programs and 340B
• Best Practices for Avoiding 340B Duplicate Discounts in Medicaid
• Michigan Medicaid Health Plan Common Formulary - Comment by February 21!
• MSA Bulletin Updates
• Biller "B" Aware Notices Details >• Aetna OfficeLink Updates
• Cigna
• HAP
• Humana YourPractice
• UHC Network Bulletin
• UHC Medical Policy Update
Details >Featuring this month: CignaTidbits regarding;
• Changes in Drug Formulary & Management effective: 01/01/2020
• Accredo Specialty Pharmacy, is the Specialty Pharmacy for Cigna
• Breast & Prostate Tumor Profiling Details >
February 2020, Frequently Asked Questions• Discharge and Chemotherapy on the Same Day
• Medicare IMM Requirements
• Chemotherapy and CT Scan Same Day
• Billing for a Port Draw
• Reciprocal Billing (Locum Tenens) Details > |
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