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Welcome to the Reimbursement Bulletin
BeiGeneIntroducing my BeiGene, a personalized and comprehensive program designed to help guide and assist patients, caregivers, and practices with the support of experienced Oncology Nurse Advocates. Details >
March 11, 2020 - 12:00-1:00 PMRegister Today! Details >March 30 - 31, 2020 - Walsh College, TroyRegister 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:• 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• Open Payments Registration
• Quality Payment Program: Updated Explore Measures Tool
• Medicare Part B Immunization Billing: Seasonal Influenza Virus, Pneumococcal, and Hepatitis B
• Quality Payment Program: 2019 Data Submission Videos
• Quality Payment Program: 2020 Resources
• Recent LearnResource & MedLearn Matters Articles 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 >This edition includes an article on:• Artificial Intelligence in Medicare Audits: Part II Details >
Recent Oncology Related News• January 2020 pricer implementation delayed
• Updates made to procedure codes for online visits
• Register for the March PGIP quarterly meeting today
• Clarification: Prolia and Xgeva drug 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
• AvsolaTM and GivlaariTM will have authorization and site of care requirements for commercial members effective February and March 2020 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 2/18/2020Review the reported payer reimbursement issues MSHO is currently addressing including the response from BCBSM regarding 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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