like us on facebook connect with us on linkedin July 17, 2024

Merck's Keytruda

To learn more about Merck's Keytruda, click here

Section Header Section Header

Have You Been Stumped on a Reimbursement Issue and Need Help?

Join an MSHO listserv and get advice from your peers.

Details >
Section Header

MSHO Featured Corporate Sponsor Assistance Programs

• Adaptive Assist
• Eisai Assistance Program 
• TerSera SupportSource

Details >
Section Header

WPS Oncology Related LCD Updates

New, retired, and revised policies/articles

Details >

WPS Recent Oncology Related News

• Physician Fee Schedule Proposed Rule and Fact Sheets
• Outpatient and ASC Proposed Rule and Fact Sheets
• Medicare Hot Links

Details >

WPS Educational Offerings

New training opportunities available

Details >
Section Header

CMS-Medicare

Recent Oncology Related Articles

• APM Incentive Payments for 2024
• 2023 Open Payments Data
• CARC and RARC Updates 
• MLN Matters
• And More

Details >

QPP & MIPPS

• CMS Proposes Policy Changes to PFS Proposed Rule
• Upcoming MIPS Important Dates and Deadlines

Details >

Recent RAC Monitor Article

This edition includes articles on

• Will OIG’s Latest Report Lead to More Administrative Harm?
• Are You Ready for the New Diagnosis Codes?
• UH Subsidiary Reports Major Data Breach Affecting Millions
• Release of 2025 OPPS Proposed Rule

Details >
Section Header

BCBSM/BCN

Recent Oncology Related News

• New President & CEO Appointed
• Updated Clinical Editing Billing Tips
• Changes Coming to Prior Authorization Process
• Requirements, Codes Changed for Some Medical Benefit Drugs

Details >

BCBSM/BCN

Publications

• The Record
• BCN Provider News

Details >
Section Header

Current Payer Issue Tracking Page

Last Reviewed/Updated 7-16-24

• 0885 Claims Denied
• Procrit  Denials (693)
• Procrit or Epoetin Class Drugs Maintenance
• And More

Details >

Resolved Payer Issues

Last Reviewed/Updated 7-16-24

• BCBSM Carelon Letter

Details >

Aetna

• G2211 and E/M With Modifier 25
• July 2024 OfficeLink Update

Details >

Health Alliance Plan

• Online Claims Appeals – New Status Reasons
• Inpatient Admissions Criteria
• Keep Provider Information Updated in NPPES

Details >

Medicaid

• DHHS Updates on Change Healthcare
• MMP Bulletins
• Biller "B" Aware Notices

Details >

Meridian

• Clinical & Payment Policies
• Provider Education
• Ongoing Reminders

Details >

Priority Health Update

• Teladoc Health Mental Health Wellness Tool
• You Must Refer Members to In-Network Providers, Including Labs

Details >

United Healthcare

• Reimbursement Policy Updates
• Medical Policy Updates
• Clinical Requirements
• Drug Step Therapy
• Prior Auth Update

Details >
Section Header

Recent Oncology Related FDA Approvals and Expanded Indications

• Bristol Myers Squibb & Mirati Krazati
• Genmab & Pharmacyclics Epkinly
Details >

Drug Updates

• Coherus' Loqtorzi Granted Permanent, Product-Specific J Code

Details >
Section Header Section Header

ASK MSHO

July 2024 Frequently Asked Questions

• IV push charge when no stop time in MAR
• Stop time when adverse reaction occurs
• Documentation requirements for hydration

Details >