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To learn more about Together with GSK Oncology, CLICK HERE.

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MSHO Featured Corporate Sponsor Assistance Programs

• ADC's Advancing Patient Support 
• Eisai Assistance Program 
• Meijer Specialty Pharmacy
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WPS Oncology Related LCD Updates

Stay current on new, retired, and revised policies/articles

There are no new, retired, or revised policies/articles for May 2023.

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WPS Recent Oncology Related News

• May 2023 Dark Days for CMS Data Center Migration
• Fee Schedules
• Medicare Hot Links

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CMS-Medicare

Recent Oncology Related Articles

• Hospital Price Transparency Enforcement Updates
• Medicare Drug Price Negotiation Program - Next Steps, Timelines, Initial Guidance Fact Sheet

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Quality

• ASCO EOM Fact Sheet
• EOM Payment Methodology Changes
• 2023 MIPS MVPs Registration Now Open
• MIPS EUC Exception Application Now Open

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Michigan RAC Information

Region 1 - Performant Recovery, Inc.

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Recent RAC Monitor Article

This edition includes articles on

• Medicare Poised to Expand List of Medications Excluded from Consolidated Billing
• Medical Necessity: Realities and Hypotheticals
• Non-compliant Payers: “Hello, CMS, Are You Listening?”

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BCBSM/BCN

Recent Oncology Related News

• Prior Authorization Changes Coming in June
• BlueCard Processes
• Medical, Benefit Policy Changes
• Prior Authorization Requirements for Patients with Non-Michigan Blue Plans

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BCBSM/BCN

Publications

• The Record
• BCN Provider News

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Current Payer Issue Tracking Page

Last Reviewed/Updated 5/16/23

• BCBSM Withhold on Drugs Related to the PGIP Program
• Meridian Paying for Labs

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Resolved Payer Issues

Last Reviewed/Updated 5/16/23

• BCBSM AIM Auth Limit

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Humana

• COVID-19 Public Health Emergency
• Changes to Preauthorization Requirements for Medical Services

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Health Alliance Plan

• AP Medicare Complete Duals Annual Required Training
• Appointment Time Standards
• Prior Authorization Requirement Lists Updated Monthly

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Medicaid

Recent Oncology Related News

Medicaid Updates Include
• PHE Unwind Policy Crosswalk
• MSA Bulletin Updates
• Biller "B" Aware Notices

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Priority Health Update

• Formulary Changes Coming July 1
• Two Midnight Rule
• GuidingCare was Recently Updated
• And more

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United Healthcare

• Proton Beam Radiation Therapy 
• Immune Globulin (IVIG and SCIG)  
• Provider Administered Drugs – Site of Care  
• And more

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ASK MSHO

May 2023 Frequently Asked Questions

• Code 96521

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