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Senate Passes Bill to Extend Medicare Sequester Fix Through 2021

House is unlikely to take up the legislation until next month as the chamber is in recess until the middle of April

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MLN Connects Special Edition – Tuesday, March 30, 2021

Temporary Claims Hold Pending Congressional Action to Extend 2% Sequester Reduction Suspension

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American Red Cross Blood Drive Co-Sponsored by MSHO

Thursday, April 15, 2021 / 10:00 am to 4:00 pm

Your Blood can save lives. Come to give and get a $10 Gift Card by email thanks to Amazon

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MSHO Virtual Spring Reimbursement Meeting

Wednesday, April 21, 2021 - REGISTER BY APRIL 14th!

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Changes to E & M Guidelines: It Really is Easier! Let Me Show You!

Webinar presented on February 16, 2021

The recording has just been released! Be sure to share with your physicians and staff!

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WPS Oncology Related LCD Updates

April 2021

Updates that may be of interest to oncology including these updates/revisions:
• Many MolDX Policy Changes/Updates

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WPS Recent Oncology Related News

Part A, Part B and Part A/B News

Includes 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

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Join WPS for a Teleconference, Webinar or Seminar

Check out these upcoming training events:

• Ask-the-Contractor Teleconferences (ACT)
• Patient Status
• On Demand Training -What's New for 2021 Session 2
• On Demand Training for E & M Services
• YouTube Training Available

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Recent Oncology Related Articles

• Repayment of COVID-19 Accelerated and Advance Payments Began on March 30, 2021
• Quarterly Provider Update
• Update to the Manual for Telephone Services, Physician Assistant (PA) Supervision, and Medical Record Documentation for Part B Services
• Non-Physician Outpatient Services Provided Before or During Inpatient Stays: Bill Correctly
• Average Sales Price Files: April 2021
• April 2021 HCPCS Code Update
• Intravenous Immune Globulin Demonstration
• Recent LearnResource & MedLearn Matters Articles

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Michigan RAC Information

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

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Recent RAC Monitor Articles

This edition includes articles on:

• Are you with the FBI, or the F-I-B?
• The Physician Advisor as a Quarterback in Managing Silos
• Washington Week in Review: The Public Option, Sequester, and a New HHS Secretary

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Recent Oncology Related News

• CMS expected to release April 2021 quarterly Medicare pricer update
• Reminder: There's a new information bubble icon in Benefit Explainer related to diagnosis
• 2% sequestration suspension extended to April 30, 2021
• NEW Last Trans files now available in TM
• AbecmaTM to require prior authorization for Medicare Advantage members starting April 5
• 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
• CMS first-quarter 2021 HCPCS codes are delayed
• Additional medications will require prior authorization for Medicare Advantage members, starting June 22
• Easier access to RC Claim Assist
• Starting in June, we'll use clinical information to validate providers' answers to some questionnaires in the e-referral system
• Starting in May, additional medical benefit drugs will require prior authorization for some Blue Cross commercial members
• Medical benefit specialty drug prior authorization list changing in April for most members

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• The Record
• BCN Provider News

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Medicare Plus Blue

Monthly Status Report

Many 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

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Payer Issue Tracking Page

Last Reviewed/Updated 4/6/21

Review the reported payer reimbursement issues including clarifications and issues with BCBSM and BCN Advantage

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Recent Oncology Related News

Medicaid Updates Include:
• MSA Bulletin Updates
• Biller "B" Aware Notices

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Newsletters of Interest

• Aetna OfficeLink Updates
• Cigna
• Humana YourPractice
• UHC Network Bulletin
• UHC Medical Policy Update

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UnitedHealthcare Update

• Oncology supportive care medication sourcing requirement

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Managed Care Committee Reimbursement TIDBITS

Featuring this month: Priority Health

Tidbits regarding:
• Alliance with Cigna
• Changes to Preferred Biosimilars
• New Portal Coming Soon

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April 2021, Frequently Asked Questions

• Prolonged visits - 99417 vs G2212
• ICD10 History Of Cancer Adjuvant Breast Cancer Therapy
• Counting CBC in E & M MDM
• Billing "Chemo Teaches" as E & M Visit

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