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• Advancing Education on Biosimilars Act of 2021 • Hearing on Drug Pricing • Addressing Anticompetitive Conduct and Consolidation in Health Care • Future of Telehealth • Reduced Prices for Prescription Drugs • Bill to Increase Payments for Biosimilar Drugs • Reimbursement for Pharmacist Services Details >
Live Event November 10, 2021, Schoolcraft College, LivoniaDetails >Handouts are available and the recording will be available by the end of the week!Details >
Education to Enhance Provider Awareness of the Depression Screening Benefit for Medicare PatientsDetails >May 2021Updates that may be of interest to oncology including these updates/revisions:
• Many MolDX Policy Changes/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 2021 Final Rules and the WPS Fee Schedules Details >Check out these upcoming training events:• May 21 - E/M Office Services Questions and Answers • On Demand Training -What's New for 2021 Session 2 • On Demand Training for E & M Services • YouTube Training Available Details >
Recent Oncology Related Articles• Clinical Diagnostic Laboratories: Resources about the Private Payor Rate-Based CLFS • Coordination of Benefits: Parts A & B Crossover Claims Issue • SBIRT Services • Chronic Care Management: Comparative Billing Report in April • Medicare Billing: Form CMS-1450 and the 837 Institutional — Revised • OPPS Part B drug payment and status indicator change for HCPCS code Q5122 • Medicare Pays to Help Patients Plan - Advanced Care Planning • Telehealth Services: Bill Correctly • Diagnosis Coding: Using the ICD-10-CM Web-Based Training — Revised • How to Use the Medicaid NCCI Tools • Recent LearnResource & MedLearn Matters Articles Details >Region 1 - Performant Recovery, Inc.No New Oncology Related Issues Since March, 2020: • Latest under review at that time included: - Bone Marrow Transplants, ESAs for Cancer Patients, and Therapeutic Injections Details >This edition includes an article on:• Biden’s Low-Key Healthcare Agenda Emerges after First 100 Days • Battling the Backlog at the ALJ
• The ALJ Backlog Dissolves – and Supplemental Medical Review Contractor (SMRC) Audits Escalate Details >
Recent Oncology Related News• IMPORTANT - ATTENTION MSHO MEMBERS - Additional Update on the BCBSM/AIM Prior Authorization Denials • Reminder: Using HCPCS code G2212 • Changes to drug coverage on Preferred Drug List starting in July • 2% sequestration moratorium extended to Dec. 31, 2021 • Some Medicare Supplemental claims rejecting in error • Spravato® and Panzyga® to require prior authorization starting July 12 for URMBT PPO non-Medicare members • Additional medications will require prior authorization for most members starting May 24 • Starting in June, additional medical benefit drugs will require prior authorization for some Blue Cross commercial members • Michigan outpatient facilities must bill NDCs with NOCs or commercial claims will reject, starting in August • Additional medications will require prior authorization for Medicare Advantage members, starting June 22 • Starting in June, we'll use clinical information to validate providers' answers to some questionnaires in the e-referral system 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 • 835 CARC 210 sanction amount is incorrect • The system is applying a denied authorization to a claim in error • Multiple RHC Issues Details >
Last Reviewed/Updated 5/4/21Review the reported payer reimbursement issues including clarifications and issues with BCBSM and BCN Advantage Details >Recent Oncology Related NewsMedicaid Updates Include: • 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: Medicare Advantage PlansTidbits regarding: • Medicare and You Booklet • Medicare Advantage Cannot Charge More for Chemo than Traditional Medicare • Reporting Issues to CMS Regional Office Details >
May 2021, Frequently Asked Questions• Documentation requirements for a blood draw • Time based "incident-to" E & M visit • Pharmacist billing of E & M visits • Chemo and CT same day • Telehealth
•MSHO MEMBERS - You can access and search previous FAQs! Scroll to the bottom of the Q & As to find out how! Details >
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