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Patient Assistance Programs

• Bristol-Myers Squibb Access Support
• Gilead's Trodelvy Access Support 
• PharmaEssentia Source

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WPS Recent Oncology Related News

• Holiday Closure
• Outstanding Citibank Checks
• Add-On HCPCS Codes Erroneously Rejecting

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WPS Educational Offerings

New Education Tracks - Check Them Out!

• Live Trainings
• Encore Presentations
• YouTube Videos

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CMS-Medicare

Recent Oncology Related Articles

• FY 2027 ICD-10-PCS Procedure Code Files
• FY 2027 ICD-10-CM Diagnosis Code Files
• Fact Sheet: Medicare Drug Price Negotiation Program
• And More

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Quality Payment Program (QPP)

• 2026 MIPS Value Pathway (MVP) Registration Now Open
• 2026 Consumer Assessment of Healthcare Providers Survey Open

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Medically Unlikely Edit (MUE)

• NCCI Add-on Code Edits
• Procedure-to-Procedure Edits
• Medically Unlikely Edits
• Add-on Code Edits

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Recent RAC Monitor Article

This edition includes articles on

• Medical Record a Clinical Tool or an Invoice?
• AI in the Audit and Compliance Industry
• An IPPS Proposed Rule Preview – Body Mass Index (BMI)

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Blue Cross Blue Shield

Recent Oncology Related News

•Changes Coming to Incident-to Billing Policy
• Management Changes to Radiation Oncology and Radiopharmaceuticals
• HelpScript Enrollment Service
• And More!

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Blue Care Network

Publications - Important Articles to Note

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Aetna

• June OfficeLink Updates
• Changes for Certain Radiology Services
• Claim and Code Review Program Updates
• Changes to Commercial Drug Lists

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Health Alliance Plan

• New Enrollment Platform Go Live
• KAA (NDC Invalid) Denials
• New Name. New Look. Same Commitment
• Ensure Your Claim Appeals are Valid

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Medicaid

• MMP Bulletins 
• Expansion of Coverage for Pharmacist-Provided Services
• Reimbursement of Specialty Behavioral Health Services
• CPT & HCPCS Code Updates
• Updates to MDHHS Medicaid Provider Manual

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Molina

• Provider Bulletins
• Preferred Drug List May-July
• Billing & Reimbursement Policies

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Priority Health Update

• New Provider Portal
• GLP-1 Weight Loss Medications Expanded
• Medicare Providers are Required to See Dual Eligible Members

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United Healthcare

• June Medical & Reimbursement Policy Updates
• Pharmacy & Clinical Updates
• Specialty Drugs & Benefit Updates 

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Recent Oncology Related FDA Approvals and Expanded Indications

• Incyte's Jakafi XR™
• AstraZeneca's Imfinzi™
• AbbVie's DECNUPAZ™ 
• AstraZeneca's ENHERTU–THP
• AstraZeneca's ENHERTU

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ASK MSHO

June 2026 Frequently Asked Questions

•Can unused drug in a MDV be reimbursed as waste
•How will the Incident-to policy affect reimbursement with Modifier SA on APP claims billed under the physician's NPI

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