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Presented on December 8, 2021Handouts, the 2022 Physician Fee Schedule Analyzer, and recording are already available on the MSHO website! Details >Presented on November 10, 2021Handouts are still available. Recordings have been released and are located on the MSHO website! ALSO on the website; responses to the questions submitted to WPS Medicare and a Medicaid Health Plan Key Contact List from DHHS!! Details >
Novartis Patient Assistance FoundationDetails >
December 2021Updates that may be of interest to oncology including:
• Multiple MolDx Revised Policies 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 2022 Proposed Rules, 2021 Final Rules and the WPS Fee Schedules Details >Check out these upcoming training events:• Learning Center: Content Library Enhancements • Teleconference - Evaluation and Management Visits in 2022 • On Demand Training Including; Appeals - Understanding the Basics, E & M Services for 2021, 3 Day/1 Day Payment Window, YouTube Training and more... Details >
Recent Oncology Related Articles• Impossible to Navigate Price Lists at Cancer Hospitals • Checking Medicare Eligibility — Revised • Medicare Provider Compliance Tips • Quality Payment Program: 2020 Doctors & Clinicians Preview Period Open Until December 14 • New/Modifications to the Place of Service (POS) Codes for Telehealth - Effective January 1, 2022 • January 2022 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing Files & Revisions to Prior Quarterly Pricing Files • Recent LearnResource & MedLearn Matters Articles Details >Region 1 - Performant Recovery, Inc.Newest approved issues listed on RAC website: • Positron Emission Tomography for Initial Treatment Strategy in Oncologic Conditions • Next Generation Sequencing Medical Necessity and Documentation Requirements Details >This edition includes articles on:• Medicare Advantage Plans and the Two-Midnight Rule • What are the Costs and Benefits of Medicare Audits? • No Surprises Act Features Some Unpleasant Surprises for Providers Details >
Recent Oncology Related News• We've improved the commercial Blue Cross and BCN utilization management medical drug list • Changes to the prior authorization list for medical benefit drugs for Medicare Advantage members • Blue Cross enhances tools for electronically prescribing medications and submitting prior authorizations • Mark your calendar – 2022 PGIP Quarterly meeting dates • Prior authorization requirements expanding for Medicare Plus Blue, BCN commercial and BCN AdvantageSM members on Jan. 1 • Additional drugs require prior authorization for UAW Retiree Medical Benefits Trust members with Blue Cross non-Medicare plans, starting Jan. 3 • Additional drugs require prior authorization for UAW Retiree Medical Benefits Trust members with Blue Cross non-Medicare plans, starting Jan. 27 • Changes to the medical oncology prior authorization list for URMBT members with Blue Cross non-Medicare plans, starting Feb. 21 • Starting March 1, radiology procedure code *71271 requires prior authorization for most members Details >Publications• The Record • BCN Provider News • Blues Brief for Oncology Providers Details >Monthly Status Report for DecemberMany 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 12/7/21Review the reported payer reimbursement issues including: • Confusion on the rounding of NDC with BCBSM 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
• UHC Reimbursement Policy Update
Details >• Reminder: THC members newly transferred to Priority Health Choice Medicaid may have benefit changes • 2022 Commercial Product Updates Details >Featuring this month: UnitedHealthcare Community PlanTidbits regarding: • Step Therapy • Preferred Drugs for Oncology and Non-Chemo Medications • Denied Drug Codes - Pharmacy Benefit Drugs Details >
December 2021, Frequently Asked Questions• New Code for Neulasta in 2022 • Principal Care Management Coding • Inpatient Hospital E & M Changes for 2022 • How Bad Is the Medicare Cut
MSHO MEMBERS - You can access and search previous FAQs! Scroll to the bottom of the Q & As to find out how!
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