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Meeting Reformatted to Virtual EventDetails >
August 2020Including:
• Multiple MolDX Policy Changes, Addition of Reblozyl, Immune Globulins Updated 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:• Medicare 3 Day/1 Day Payment Window • Medicare Advantage - Understanding the Plan Types •
PLUS many additional on-demand educational opportunities including E & M training opportunities! Details >
Recent Oncology Related Articles• Electronic Prescribing of Controlled Substances in Medicare Part D: Request for Information • MACs Resume Medical Review on a Post-Payment Basis • Renewed ABN: Deadline Extended to January 1 • CMS and CDC Announce Provider Reimbursement Available for Counseling Patients to Self-Isolate at Time of COVID-19 Testing • Quarterly Provider Compliance Newsletter, Volume 10, Issue 4 • Physician Compare Preview Period Open through August 20 • ICD-10-CM Diagnosis Codes: FY 2021 • Recent LearnResource & MedLearn Matters Articles Details >Region 1 - Performant Recovery, Inc.No New Oncology Related Issues Since March: • Latest under review at that time included: - Bone Marrow Transplants, ESAs for Cancer Patients, and Therapeutic Injections Details >This edition includes an article on:• CMS Opens Door to G0463 Billing for Remote Physician Visits • A View into Proposed Medicare PFS and Policy Changes for 2021 Details >
Recent Oncology Related News• IVIG dosing strategy is changing for the Medicare Part B medical specialty drug program, starting Dec. 7 • Some providers are being invited to participate in an online research community • Commercial payer claims edit • TecartusTM will require authorization for commercial members effective August and September 2020 • Blue Cross and BCN further extend authorization end dates on select medical and pharmacy benefit. • During the COVID-19 emergency, we're extending global referrals through at least Dec. 31 for BCN HMOSM members • Review August Edition of the BCBSM Record for the Second Quarter HCPCS Changes! • Review August Edition of the BCBSM Record for MANY Oncology Specific Medical Benefit Policy Changes! • Medicare Plus Blue expands prior authorization program to include genetic and molecular testing • Medical specialty drug prior authorization lists are changing in September for BCN HMO, Medicare Plus Blue PPO and BCN Advantage members • Effective Oct. 1, Nivestym® and Zarxio® are the preferred filgrastim products for all Blue Cross and BCN commercial and Medicare Advantage members • Medicare Part B medical specialty drug prior authorization list is changing Aug. 21 and Sept. 28 Details >Publications• The Record • BCN Provider News • Newly Released Blues Brief! Details >Monthly Status ReportMany updates/corrections. Listed below is a sampling of what you will find: • 835 Recoupment isn't reflected on voucher • 835 CARC 210 sanction amount is incorrect • System is applying denied authorization to claim in error • RHC claim issues • And more Details >
Last Reviewed/Updated 8/18/2020Review the reported payer reimbursement issues including BCBSM UMBRT denials and Mvasi additional coverage request approved. Details >Recent Oncology Related NewsMedicaid Updates Include: • COA Files Comments on Medicaid Drug Rebate Rule • MSA Bulletin Updates • Biller "B" Aware Notices Details >• Aetna OfficeLink Updates
• Cigna
• HAP
• Humana YourPractice
• UHC Network Bulletin
• UHC Medical Policy Update
Details >• Non-Medicare outpatient services moving to 90-day window for retro authorizations • Coming August 31: ePA for pharmacy • Register today for our new authorization tool webinar training • Billing reminders for providers treating Qualified Medicare Beneficiaries • Medicaid Health plans transitioning to Preferred Drug List (PDL) Details >
August 2020, Frequently Asked Questions• PHE was extended, how long can we bill Medicare for telehealth for patients at home? • Administration code hierarchy • Aetna POS requirement for telehealth • MUE Denials Details >
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