like us on facebook connect with us on linkedin August 21, 2024

Jazz Cares

To learn more about Jazz Cares, click here

Section Header Section Header Section Header

MSHO Featured Corporate Sponsor Assistance Programs

• Eagle CAN
• KaryForward: Patient Support by Karyopharm 
• Natera Signatera

Details >
Section Header

WPS Oncology Related LCD Updates

New, retired, and revised policies/articles

Details >

WPS Recent Oncology Related News

• Expedited Prior Authorization Requests
• Wage Index Pension Cost Worksheet
• Change Request 13413
• Medicare Hot Links
• And More

Details >

WPS Educational Offerings

New training opportunities available

Details >
Section Header

CMS-Medicare

Recent Oncology Related Articles

• Help Protect Consumers from Marketplace Fraud
• CPT/ICD Code Updates
• Negotiating for Lower Drug Prices
• MLN Matters
• And More

Details >

QPP & MIPPS

• Submit Comments for QPP Proposed Changes by Sept. 9
• MIPPS 2023 Targeted Review
• 2023 MIPS Final Score & 2025 MIPS Payment Adjustment Information

Details >

Recent RAC Monitor Article

This edition includes articles on

• Codes G2211 and GIDXX – Continued Uncertainty
• DOJ Launches New Whistleblower Award Program
• Understanding the Compliance Risks
• AI Advancements for Coding and Clinical Documentation Improvement
• Codes, Codes Everywhere

Details >
Section Header

BCBSM/BCN

Recent Oncology Related News

• Change Healthcare Incident & Potential Effect on Patients

Details >

BCBSM/BCN

Publications

• The Record
• BCN Provider News

Details >
Section Header

Current Payer Issue Tracking Page

Last Reviewed/Updated 8-19-24

New BCBSM Below Cost Reimbursement
• 0885 Claims Denied
• Procrit  Denials (693)
• Procrit or Epoetin Class Drugs Maintenance
• And More

Details >

Resolved Payer Issues

Last Reviewed/Updated 8-19-24

• BCBSM Carelon Letter

Details >

Aetna

• Changes to National Precertification List
• Services Billed With a Diagnosis Considered Not Covered
• August 2024 OfficeLink Update

Details >

Health Alliance Plan

• CareSource Medicaid
• Prior Auth Requirements, Policy Updates, & Pharmacy Info
• Submitting Urgent Prior Authorization Requests
• Keep Provider Information Updated in NPPES

Details >

Medicaid

• MDHHS Program Enabling Food Assistance Continues to Expand

Details >

Priority Health Update

• Procedure Codes Impacted by TurningPoint & EviCore Auth Programs
• Resources & Trainings for TurningPoint Authorization Programs
• Genetic Testing & Lab / Pathology Coding Policies
• 2024 InterQual Criteria Transition
• And More

Details >

United Healthcare

• Reimbursement Policy Updates
• Medical Policy Updates
• Pharmacy & Clinical Updates
• New Gold Card Program

Details >
Section Header

Recent Oncology Related FDA Approvals and Expanded Indications

Johnson & Johnson Rybrevant plus Lazcluze
• AstraZeneca Imfinzi
• Syndax & Incyte Niktimvo
Servier Voranigo
Genmab & Pharmacyclics Epkinly

Details >
Section Header Section Header

ASK MSHO

August 2024 Frequently Asked Questions

• Infusion stop time due to negative reaction
• XS modifier with IVP drug administration codes
• Methotrexate injection for rheumatoid arthritis
• IVP be coded with no recorded stop time

Details >