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To learn more, please visit MSHO.org.
Meeting Reformatted to Virtual EventDetails >
July 2020Including:
• Multiple MolDX policy changes 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 CMS Rules Details >Check out these upcoming training events:• Evaluation and Management Office Services for 2021
• Medicare Advantage - Understanding the Plan Types
• Medicare 3 Day/1 Day Payment Window
• Local Coverage Determinations (LCD) - Reconsideration
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PLUS many additional on-demand educational opportunities including E & M training opportunities! Details >
Recent Oncology Related Articles• Reduce Provider Burden: Participate in Medical Documentation Interoperability Pilot.
•ICD-10-CM Diagnosis Codes: FY 2021
• Flexibilities Announced for Quality Payment Program Participants Impacted by COVID-19
• Quarterly Provider Update
• Physician Compare Preview Period Open through August 20
• ABN Form Renewal
• CLIA Program and Medicare Laboratory Services — Revised
• Medicare Secondary Payer — Revised
• Now Available: Fact Sheet for State and Local Governments - CMS Programs & Payment for Care in Hospital Alternate Care Sites
• New COVID-19 FAQs on Medicare Fee-for-Service Billing
• 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:
• Including - Bone Marrow Transplants, ESAs for Cancer Patients, and Therapeutic Injections Details >This edition includes an article on:• RAC Audits Expected During the COVID Pandemic Details >
Recent Oncology Related News• URMBT’s In-Home Visits program includes in-person, virtual, telephone assessments
• For MESSA members, no-cost telehealth services, including behavioral health, which previously had an end date of June 30, have been extended through Dec 31
• BCN extends rate increases for in-person home health care and home infusion nursing visits in response to COVID-19
• Blue Cross is recovering overpayment for telehealth originating site fee
• Effective Oct. 1, Nivestym® and Zarxio® are the preferred filgrastim products for all Blue Cross and BCN commercial and Medicare Advantage members
• Clinical review requirements return July 1 and member cost sharing is again required for telehealth services for commercial members
• We're ending the 90-day extension to claim submission time limits Sept. 30
• Medicare Part B medical specialty drug prior authorization list is changing Aug. 21 and Sept. 28
• Blue Cross isn't changing retrospective audits appeal time frames for Medicare Plus Blue
• Provider Training and Learning opportunities pages updated with new eLearning and webinar recordings Details >Publications• The Record
• BCN Provider News Details >Monthly Status ReportMany updates/corrections. Listed below is a sampling of what you will find:
• 835 Recoupment isn't reflected on voucher
• CVS/Novologix authorizations are not passing through to Care Advance incorrectly
• RHC claim issues
• And more Details >
Last Reviewed/Updated 7/22/2020Review the reported payer reimbursement issues including BCBSM UMBRT denials and Mvasi additional coverage request approved. Details >Recent Oncology Related NewsMedicaid Updates Include:
• CMS’s Proposed Medicaid Best Price Loophole for Value-Based Purchasing Of Drugs
• Medicaid Best Price' Changes Aimed At Value-based Gene Therapy Contracts: U.S. Agency
• MSA Bulletin Updates
• Biller "B" Aware Notices Details >• Aetna OfficeLink Updates
• Cigna
• HAP
• Humana YourPractice
• UHC Network Bulletin
• UHC Medical Policy Update
Details >• We've extended coverage of COVID-19 testing and treatment through Dec. 31, 2020
• We've expanded coverage of virtual care and telehealth services for our members through Dec. 31, 2020
• Other telehealth updates and extensions
• Financial relief for members and employers in response to COVID-19 - Expanded
• Collecting copays from Medicare Advantage members - Expanded Details >Featuring this month: Meridian Health Plan of MITidbits regarding:
• Mvasi Reimbursement Issues Addressed
• Telehealth
• Monthly MHP Provider Bulletin Details >
July 2020, Frequently Asked Questions• PHE ending and now telehealth?
• Rebill or not when paid position 2 facility rate for telehealth
• When to use new HCPCS codes
• New patient or established? Details > |
