California Oncology Weekly
"Where California Oncologists Go For Answers!"
A publication of the
Medical Oncology Association of Southern California, Inc.
August 4, 2020
Click anywhere on picture to view the past 30 years
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- Urge your state senator to vote YES on AB2100 California News
- ABN After Hours Webinar - August 5 Noridian News
- CMS released the proposed 2021 Medicare physician fee schedule CMS News
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- It's still moving on in Sacramento! You are encouraged to contact your State Senator to urge them to support AB2100 (Wood) to fix Medi-Cal drug reimbursement. AB2100 (Wood) has unanimously passed the Assembly and is now headed to the Senate Health Committee. AB2100 will make the necessary changes to Medi-Cal's administration of the pharmacy benefit to its beneficiaries by moving the pharmacy benefit from Medi-Cal Managed Care and into fee-for-service (FFS) without causing undue harm or burden to patients. AB2100 also corrects the "below-acquisition cost" reimbursement issue caused by the newly adopted methodology mandated by the Affordable Care Act in 2016. MOASC is urging you to reach out to your elected Senator to vote YES on AB 2100.
- The California departments of Health Care Services and Insurance extended a special enrollment period to Aug. 31 for Medicaid and health plans on Covered California, the state's health insurance exchange. More than 230,000 residents gained coverage through the marketplace from March 20 through the end of July, and some are eligible for new state subsidies. READ MORE>>>
- Upcoming Webinars from the California Medical Association
AUGUST 13, 2020 | 12 PM - 1:30 PM
This webinar series will include 12 presentations over the next six months, and will cover all aspects of implementing telehealth in a medical practice - selecting a platform, reimbursement rules, and patient interactions. The webinar series will have an emphasis on the use of telehealth in Medi-Cal. The first webinar in the series will provide a general overview of telehealth, including changes that have been implemented by federal and state regulators in response to the COVID-19 pandemic. Register TODAY
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- Upcoming Educational Events - July 2020: Providers are encouraged to attend the many educational events offered by Noridian. Read the complete update. The schedules of region-specific events, webinars and training are JEA, JEB, JAF, and JFB
- Advance Beneficiary Notice of Noncoverage (ABN) After Hours Webinar - August 5, 2020. This event includes: The New Advance Beneficiary Notice of Noncoverage (ABN) Form, ABN Basics, ABN Completion, ABN Tips, ABN Resources, and Noteworthy Information. Read the complete update.
- Revision vs Appeals - Telehealth Place of Service 02. Noridian appeals department has been receiving hundreds of redeterminations requesting a change to their claims from Place of Service (POS) 02 (Telehealth) to 11 (office). Read the complete update
- Part B Provider Responsibility for Prior Authorization (PA) for Certain Hospital Outpatient Department (OPD) Services. This program is for outpatient hospital services billed on a UB-04 form, with type of bill 13X. Read the complete update
- COVID-19 Modifiers and Condition Code. Helpful tools and resources for deciding use of modifiers and condition code. Read the complete update
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- MOASC has signed on to a letter to The President asking for the White House team to push the Office of Management and Budget (OMB) to quickly review and release the Centers for Medicare & Medicaid Services (CMS) and Office of Inspector General (OIG) proposed reforms to the Stark Law and Anti-Kickback Statute regulations. Please click on the letters to read more. Letter to Trump Administration Final Stark-AKS
- SAVE-THE-DATE for MOASC's LunchTime Series Virtual Presentation of, "The 2021 Evaluation and Management Changes," Wednesday, August 26, 2020 at 12:30pm-PDT. Presented by: Allison Hirschorn, Senior Coding and Reimbursement Specialist, ASCO. As of January 1, 2021, there will be significant changes to the office and outpatient Evaluation and Management (E&M) services for both new and established patients. Practices, physicians, and staff must be aware of the modifications to ensure a successful transition next year and avoid any disruption in reimbursement. Register with the MOASC Office at moasc@moasc.org.
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- Congratulations to Drs. Bridget Keenan, Nancy Nguyen, and Mohana Roy, recipients of ANCO's Travel Awards for 2020. Dr. Keenan is a fellow at the University of California, San Francisco. Dr. Nguyen is a fellow at University of California, Davis, and Dr. Roy is a fellow at Stanford University.
- The Association of Northern California Oncologists (ANCO) continues to monitor the novel coronavirus (COVID-19) pandemic and is committed to providing the membership the best possible information with which to make clinical and personal well-being decisions. https://anco.org/anco-covid-19-updates-resources/
We encourage member practices to let ANCO know of COVID-19 resources they are depending upon and found useful and how they are responding to COVID-19 and serving their patients and staff at director@anco.org (Use Subject: COVID-19: RESPONSE). Thanks!
- ANCO physician members, their practice staff, and representatives from ANCO's corporate members must register to access password-protected content (e.g., The ANCO Directory, ANCO meeting materials) on the ANCO website www.anco.org.
ANCO's ASCO20 Virtual Highlights will take place on Saturday, August 22nd. The meeting will summarize the major research and treatment advancements presented at this year's ASCO20 Virtual Meeting. The program will focus on breast, gastrointestinal, genitourinary, head and neck, and lung cancers as well as a panel on cancer care during the time of COVID-19. The faculty will place these developments in context as to their immediate clinical utility.
- Use ANCO's job board to post or search for employment opportunities at ANCO member practices.
- Follow ANCO on Twitter at @ANCO News.
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National News
- Besides the US House of Representatives approval of the FY2021 minibus package that allocated a $3.2 billion budget for the FDA, as mentioned last week in this publication, the package also includes an amendment revoking a rule that prohibits federal expenditures on the promulgation or adoption of a unique patient identifier system. If the language passes the Senate, HHS would be able to develop a nationwide patient-matching strategy, which could improve continuity of care and reduce medical errors, advocates say. Healthcare Finance.
- The coronavirus pandemic has worsened problems caused by health illiteracy in the US, experts say. Nearly 30% of patients in a study found health care providers' instructions difficult to understand, numerous studies have linked low health literacy to negative health outcomes and higher health care usage, and a disproportionate share of patients from groups with notoriously low health literacy are dying of COVID-19. READ MORE >>>
- The coronavirus pandemic is particularly difficult for people with cancer, many of whom must go to hospitals for treatment, have lost their jobs and employer-sponsored health insurance and have lost access to social supports. READ MORE >>>
- A high volume of patient messages in EHR inboxes is the leading cause of EHR-related burnout among health care providers, reducing the utility of tools meant to reduce burnout, according to a study published in the Journal of the American Medical Informatics Association. The researchers recommended delegating inbox management to non-physician staff where appropriate and improving EHR usability. EHR Intelligence
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CMS News
- CMS released the proposed 2021 Medicare physician fee schedule (PFS) rule, which includes proposed changes to MIPS and APM participation options and requirements for 2021. Key proposals include:
* Setting 2021 Medicare payment rates for physician services
* Generally confirming E/M documentation guidelines and payment changes finalized in the 2020 PFS
* Expanding telehealth coverage
* Establishing MIPS reporting requirements for 2021.
Review the MGMA PFS fact sheet. Comments are due now. The final 2021 PFS rule is expected by Nov. 1, 2020.
- Due to COVID-19 concerns, CMS is going to expand the deadline for use of the renewed ABN, Form CMS-R-131 (exp. 6/30/2023). At this time, the renewed ABN will be mandatory for use on 1/1/2021. The renewed form may be implemented prior to the mandatory deadline. The ABN form and instructions may be found at https://www.cms.gov/Medicare/Medicare-General-Information/BNI/ABN
- President Donald Trump has signed an executive order directing the HHS to issue rules within 60 days ensuring that certain telehealth regulatory changes made during the COVID-19 pandemic will remain in place once the public health emergency ends. The order directs the HHS to develop a payment model that permits rural health care providers to waive some existing Medicare policies and ensure more predictable financial payments, and also directs the HHS, the USDA and the Federal Communications Commission to establish a task force focused on developing broadband infrastructure to support rural telehealth services. The Hill
- CMS has said it will use existing evaluation and management codes to reimburse eligible health care providers for counseling patients about the importance of self-isolation after they are tested for COVID-19. The agency also released new payment codes effective Aug. 1st for remdesivir and convalescent plasma that will allow real-time tracking of their use and effectiveness.Healthcare Finance
- The US Court of Appeals for the District of Columbia has overturned a lower court ruling and upheld HHS' 28.5% reimbursement cut for certain outpatient drugs under the 340B drug discount program. According to the ruling, the payment cut is a "reasonable interpretation of the Medicare statute." Healthcare Dive
- On July 29, CMS announced the average basic premium for Medicare Part D prescription drug plans, which cover prescription drugs that beneficiaries pick up at a pharmacy. Under the leadership of President Trump, for the first time seniors that use insulin will be able to choose a prescription drug plan in their area that offers a broad set of insulins for no more than $35 per month per prescription.
For More Information:
Ratebooks & Supporting Data webpage: View the 2021 Part D base beneficiary premium, the Part D national average monthly bid amount, the Part D regional low-income premium subsidy amounts, the de minimis amount, the Medicare Advantage employer group waiver plan regional payment rates, and the Medicare Advantage regional PPO benchmarks.
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Affiliate Association News
- ASH has announced not to hold their live 62nd Annual Meeting in San Diego. The planned program will be offered as a virtual experience, so please continue to hold December 5-8 on your calendar. Because this change of venue may affect your plans to submit an abstract, ASH has extended the abstract submission deadline through next Monday, August 10, 11:59 p.m. Pacific time. Visit the abstract site to learn more. Registration has been paused. The on-line registration site for the virtual meeting will be available on August 31st. Those who have already registered will be contacted before August 31st. Hotel reservations made through ASH housing site will be automatically cancelled with no charge to your credit card. Please check the annual meeting webpage for the latest updates and answers to frequently asked questions.
- ASCO has opened their search for the position of Chief Medical Officer and Executive Vice President. ASCO has exclusively retained Bridge Partners to conduct a search. Interested candidates please submit your CV and cover letter to: Debbie Tang and Toya Lawson by August 21, 2020. READ MORE>>>
- The ASCO Foundation's, Conquer Cancer, has awarded more than $126 million through nearly 2,100 grants and awards to medical students, trainees, young scientists, and oncologists at all stages of their careers, and around the world. A comprehensive portfolio of funding opportunities is available for various career stages. READ MORE>>>
- Conquer Cancer, seeks nominations for an Extraordinary Woman Mentor for their Women Who Conquer Cancer Mentorship Award. Please submit your nomination by October 30, 2020. READ MORE>>>
- The ASH Consultative Hematology Course (CHC) is an interactive, half-day program led by faculty familiar with consultative practice issues and commonly encountered clinical problems that require the expertise of a hematologist. Program participants engage in case-based presentations and discussions focusing on non-malignant hematology topics, such as thrombosis, thrombocytopenia, and aplastic anemia. The ASH Consultative Hematology Course (CHC) will be held twice in 2020. The first course will be a virtual experience on Thursday, September 10, in conjunction with the 2020 ASH Meeting on Hematologic Malignancies: A Virtual Experience. The second course will be held on Monday, December 10, in San Diego, California, in conjunction with the 62nd ASH Annual Meeting and Exposition. View the program.
- The NCCN has published updates to the NCCN Clinical Practice Guidelines in Oncology for Genetic/Familial High-Risk Assessment: Colorectal Version 1.2020. For the complete updated versions of the NCCN Guidelines, please visit NCCN.org.
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Industry News
- Genentech announced the FDA granted approval to Tecentriq plus Zelboraf and Cotellic for the treatment of BRAF V600 mutation-positive advanced melanoma. About half of advanced melanoma patients have an abnormal BRAF gene and patients who are BRAF-mutation positive often have poor prognosis. This approval is based on the results from the IMspire150 study, which demonstrated that the Tecentriq combination helped patients with BRAF V600 mutation-positive advanced melanoma live more than 15 months without their disease worsening, compared to the control group (placebo plus Cotellic and Zelboraf). The Genentech Press release including Important Safety Information is linked here and the FDA release is linked here.
- Innovatix encourages you to ACT NOW AND SAVE! Contract pricing for Octagam® (immune globulin [human]) and Wilate® (antihemophilic factor/VWF [human]) has increased under Octapharma USA Inc. effective August 1, 2020. CLICK HERE for detailed product and pricing information. For more information about Innovatix's agreement with Octapharma USA Inc., please contact your Innovatix representative at (888) 258-3273.
- Immunomedics cordially invites MOASC Members to their multiple virtual programs to introduce TRODELVYTM (sacituzumab govitecan-hziy) for adult patients with metastatic triple-negative breast cancer who received at least two prior therapies for metastatic disease on Friday, August 7, 2020 at 9:30am-PDT, presented by: Rebecca L Moroose, MD, Director of Cancer Research and Genetics, Orlando Health UF Health Cancer Center. To attend, this please use the Program ID 10498 and register at: www.pharmethodportal.com/Immunomedics/Register
- SAVE-THE-DATE - Clinical Webinar entitled, "Beyond Being Biosimilar: A Closer Look at Extrapolation of Biosimilarity"scheduled for Thursday, August 13, 2020 at 5:30pm-PDT. Presented by: Jim Koeller, RPH. Please RSVP to your Pfizer Representative. Ilana Rosenblatt: (619) 838-3658 or ilana.rosenblatt@pfizer.com; Ashlie Davis: (323) 992-7211 or ashlie.davis@pfizer.com; Marc Peart: marc.peart@pfizer.com.
- Puma Biotechnology, Inc. cordially invites MOASC Members to their virtual program Protecting Patients with NERLYNX the only HER2-directed small molecule approved by the FDA in both eBC and mBC. These topics will be covered: Current unmet need in HER2+ Breast Cancer; Review of clinical outcomes; Tolerability management and support tools. Presented by: Francis Arena, MD, NYU Langone Arena Oncology, Lake Success, New York, on August 13, 2020 at 6:00pm-PDT. To register go to http://pumareg.tsgmeded.com/RegisterForEvent?LSC=51448
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(Huntington Beach, July 23-25)
(August 22)
(Virtual, Various Dates)
(Davis, New Dates:
March 11-12, 2021)
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The Medical Oncology Association of Southern California (MOASC) is a leading oncology society that advances and protects the ability of cancer patients to obtain, and the ability of the oncology physicians to provide, optimal cancer care.
The material contained in the California Oncology Weekly is intended as general information for MOASC members. Because diagnostic, treatment, contracting, coding, and billing decisions should be made on a case-by-case basis, any such information contained in the California Oncology Weekly may not apply in any given situation. Members are encouraged to contact their own consultants or advisors to obtain specific advice on matters relating to contracting, coding, and billing. The information contained in California Oncology Weekly should not be used as a substitute for such advice. This publication provides a summary of regulations affecting oncology and its business practices. Reading this newsletter does not substitute for understanding regulations and verifying the validity of every claim. This information is time-sensitive and is subject to change. MOASC accepts no liability for any statements or articles herein. CPT codes are owned and trademarked by the American Medical Association. All Rights Reserved.
MOASC: P.O. Box 161, Upland, CA 91785 | P (909) 985-9061 | F (909) 804-5006| www.moasc.org
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