09/18/2018

Important Oncology Related News

ATTENTION ALL MSHO MEMBERS - Managed Medicare Audits on Waste!

Make sure you are purchasing and utilizing the smallest vial when wasting drugs!

BRAND NEW AND VERY IMPORTANT – NEW AUDITS – Medicare Plus Blue recently began auditing drug waste – Priority Advantage to begin soon!  Some of the take backs have been incorrect and MSHO is working with our members' offices to have their money refunded. Some member offices have received take backs because they did not purchase the smallest available vial and therefore the waste they received reimbursement on was more than allowed and the monies are being taken back!

Medicare policy states:  

If the provider must discard the remainder of a single-use vial or other package after administering the prescribed dosage of any given drug, Medicare may cover the amount of the drug discarded along with the amount administered. The following elements must be followed in order for the discarded amount to be covered. 

1. The vial must be a single-use vial. Multi-use vials are not subject to payment for any discarded amounts of the drug. 

2. The units billed must correspond with the smallest dose (vial) available for purchase from the manufacturer(s) that could provide the appropriate dose for the patient. 

3. The left-over amount must actually be discarded and may not be used for another patient regardless of whether or not that other patient has Medicare. 

CMS Urged to Drop Proposal That Would Further Reduce Medicare Resources for Most Complex Beneficiaries, Including Those with Cancer

(ASCO) Sept 11, 2018 - The American Society of Clinical Oncology (ASCO) warns that certain provisions of the 2019 Medicare Physician Fee Schedule (MPFS) proposed rule will undermine access to cancer care for Medicare beneficiaries through a combination of payment reductions under the MPFS.  READ PRESS RELEASE 

MSMS and WCMS Host Roundtable Discussion on MOC

TUESDAY, SEPTEMBER 11, 2018

Addressing some of the challenges that have arisen from the insurance industry's de facto dependence on the flawed Maintenance of Certification (MOC) process is one of the major strategic priorities of the Michigan State Medical Society (MSMS). On Monday, September 10, MSMS -- in partnership with Washtenaw County Medical Society (WCMS) -- hosted the second in a series of MOC roundtable discussions between physician members and legislators intended to foster discussion on legislation -- House Bills 4134 and 4135 -- and continue to raise awareness around the issue.   READ MORE

Mon, Sep 17, 2018 - Another Proposed Rule Released by CMS

CMS Proposes to Lift Unnecessary Regulations and Ease Burden on Providers

Proposed rule driven by agency’s Patients Over Paperwork initiative, expected to save U.S. healthcare facilities $1.12 billion per year

Today, the Centers for Medicare and Medicaid Services (CMS) announced a proposed rule to relieve burden on healthcare providers by removing unnecessary, obsolete or excessively burdensome Medicare compliance requirements for healthcare facilities. Collectively, these updates would save healthcare providers an estimated $1.12 billion annually. Taking into account policies across rules finalized in 2017 and 2018 as well as this and other proposed rules, savings are estimated at $5.2 billion. READ MORE