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"Where California Oncologists Go For Answers!"
A collaborative publication of the
Medical Oncology Association of Southern California, Inc.
and the
Association of Northern California Oncologists, Inc.
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- CMA wants to hear from you if your practice has received an incorrect payment from Anthem or any other payer related to the new law (AB72). (California News)
- Policymakers in Washington are debating a proposal from the Centers for Medicare & Medicaid Services (CMS) to stop abuses of the 340B program by some hospitals. (National News)
- The Centers for Medicare &Medicaid Services (CMS) is removing Social Security numbers from Medicare cards. (CMS News).
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California News
- The California Medical Association (CMA) has resources available for members as the deadline for the 90-day reporting option for the Medicare Quality Payment Program (QPP) approaches (October 2). Physicians in practices with 15 or fewer can receive free assistance to prepare and participate in the QPP through the California Health Information Partnership & Services Organization (CalHIPSO). Contact CalHIPSO at https://www.hsag.com/calhipso. CMA's MACRA Resource Center (www.cmanet.org/macra) provides an overview of MACRA and a comprehensive list of tools, resources and information from CMA, the American Medical Association, and CMS.
- CMA wants to hear from you if your practice has received an incorrect payment from Anthem or any other payer related to the new law (AB72) limiting out-of-network billing for covered, non-emergent services performed at an in-network facility. Practices can contact CMA ta (888) 401-5911 or via e-mail at economicservices@cmanet.org. CMA is hosting a free members-only webinar on the different options for challenging the interim payment on September 27. For more information, visit www.cmanet.org/ab-72.
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CalPERS Open Enrollment is September 11th through October 6th.
You are encouraged to assist your CalPERS patients as to what to keep in mind when changing their health plan. They have the right to: Continuity of care, determine health benefits, compare plans and change plans during open enrollment. If your patient's treatment is interrupted, they can contact the California Department of Managed Health Care at 888-466-2219.
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- Noridian/JEMAC has posted more updates to its website:
* MLN Connects
Announcements--Hospice Provider Preview Reports Available through September 28; Quality Payment Program: New Resources Available; Transition to New Medicare Numbers and Cards; 2016 PQRS Feedback Reports and Annual QRURs Available; Chronic Care Management: Connected Care Videos; Quality Payment Program: Hardship Exception Application for 2017 Transition Year Available
Claims, Pricers & Codes
--October 2017 Average Sales Price Files Available
Events--Informal Review Process for PY2016 Results Call-September 26; Physician Compare Call-September 28; 2016 Register here; Annual QRURs Webcast-October 19
Publications-
- September Webinars - Register Now
Noridian is hosting free, web-based workshops (webinars). This article includes a listing of this month's webinar topics. Read the complete update.
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- Per the MGMA, 65.6% of practices are NOT prepared for Value Based Payment. ATTEND the 2017 Clinical Staff, Oncology Billing & Administrator Programs! November 8, 2017- Clinical Staff Program (Nurses, pharmacists, NPP's) and November 9, 2017- Administrators Program and Billers Program, at the DoubleTree Suites by Hilton Anaheim Resort, from 8:30am to 12:30pm. Topics to be presented and discussed are: MACRA/MIPS; Pharmacy Standards/USP Regulations; Immunotherapy and Targeted Therapy; Pain Management; A/R & Billing Updates, and more. For more information contact the MOASC office at moasc@moasc.org or 909-985-9061 x1.
- MOASC Member, Cedars-Sinai, invites you to register now for their 6th Annual Experimental Therapeutics in Oncology: The Road to Personalized Medicine. This important educational activity will provide guidance to front-line and oncology clinicians, oncology nurses, physicians, pharmacists, nurse practitioners, physician assistants and pharmacists with current information about new agents in oncology and the translation of the latest research to their patients. The sixth annual Experimental Therapeutics in Oncology: The Road to Personalized Medicine conference will cover drug and treatment updates with a focus on new agents in breast cancer, GI malignancies, and head and neck cancer. The conference will also feature a mini-symposium that will cover various new clinical trials.Click Here for more information & to register.
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To better serve you and your patients, Cedars-Sinai would like to let you know of their clinical trials available to you and your patients.
Please call 310-423-2133 for updates or visit their website at: www.cancertrialinfo.csmc.edu. MOASC Member participating practices are: The Angeles Clinic & Research Institute and Tower Hematology Oncology.
- MOASC Member, City of Hope invites you to their 4th Annual Gayle Brinkenhoff Breast Cancer Symposium on Tuesday, November 4th, 8am - 4pm. Contact cme@coh.org or call 626-218-5622, for more information.
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The UCSF Stephen and Nancy Grand Multiple Myeloma Initiative invites
ANCO members to join them at their annual retreat on October 2 on the UCSF Mission Bay Campus. For more information, contact Cammie Edwards,
Program Director, Grant MMTI
at
cammie.edwards@ucsf.edu
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- Stanford Cancer Center's MDS Center is co-sponsoring the MDS Foundation's Educational Patient-Caregiver Forum on Saturday, October 28. The Forum takes place at 875 Blake Wilbur Drive, Room 2103, Stanford CA 94305 from 9:30AM through 2PM.
- ASCO member, David Gandara, MD, UC Davis, is chairing the one-day CME conference Best of WCLC 2017-San Francisco on November 11 following the 18th WCLC held in Yokohama Japan, October 15-18. The Eventbrite registration URL is https://www.eventbrite.com/e/best-of-the-18th-wclc-san-francisco-tickets-37865231928. ANCO members will receive complimentary registration when they register for an "Early Bird ANCO Member " ticket by October 20. For more information, please visit the Eventbrite website above.
- The 18th Multidisciplinary Management of Cancers: A Case-based Approach returns to the Silverado Resort and Spa in Napa on March 16-18, 2018. The meeting is sponsored by the Association of Northern California Oncologists, Stanford Cancer Institute, UC Davis Comprehensive Cancer Center, and UCSF Helen Diller Family Comprehensive Cancer Center. Go to www.multicancers.org to register your interest in receiving registration and housing information when it becomes available in the Fall.
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- This week, the Senate plans to vote on the Graham-Cassidy-Heller-Johnson Amendment to H.R. 1628, the American Health Care Act. This is the most recent attempt to repeal and replace the Affordable Care Act (ACA). AS it stands now, this piece of legislation will reduce coverage, raise premiums for people with pre-existing conditions, and put at risk thousands of those with hematologic diseases and disorders that rely on Medicaid. As Congress continues to consider legislation to repeal and replace the ACA. Congress has until September 30 to vote on this piece of legislation under the rules of reconciliation, meaning they would only need a majority of the vote to pass the bill rather than the usual 60 votes.
- Policymakers in Washington are debating a proposal from the Centers for Medicare & Medicaid Services (CMS) to stop abuses of the 340B program by some hospitals. The changes will reduce drug costs, help stop hospital abuse of the 340B program, and hopefully reverse the trend of closure and consolidation of our nation's community cancer care system.
- Tempus, a cancer-data company, is getting $70 million. Tempus was launched two years ago, after the founder's wife had been treated for breast cancer. The past year, the company started signing up research centers and other hospitals as partners. Tempus is a big data play on oncology. Hospitals send patients to Tempus for genetic sequencing and analysis. The hospitals provide data, back to Tempus. The company's software platform uses data to provide doctors information about treatment options for individual patients, showing how other patients with similar genetic profiles have responded to particular therapies. One of the big challenges was gathering enough partners to build a critical mass of data. The additional funds will help Tempus build out that database. To date, Tempus has signed up hospitals, including Northwestern University's Lurie Cancer Center, University of Chicago Medicine, Cleveland Clinic, Duke University School of Medicine, Mayo Clinic, University of Pennsylvania's Abramson Cancer Center and University of Michigan, as well as community hospitals.
The investment is one of the largest in Chicago in a year that has seen a healthy uptick in large financings. The biggest so far is Outcome Health, an 11-year-old health-information and media company that raised more than $500 million.
- Fifty-nine percent of 129 White Hat and Black Hat hackers surveyed said phishing is the best way to steal data from organizations, including health care groups, followed by ransomware and malware, a Bitglass report states. Respondents also cited access controls, facial recognition and password protection as the three least effective enterprise security measures, while data at rest in the cloud, mobile devices, outdated applications/programs/systems, traditional on-premises security and unmanaged devices were listed as the top five blind spots in data security.
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- CMS, through the Medicare Administrative Contractors (MACs), recently mailed letters to all Medicare Fee-For-Service providers about CMS' work to assign new numbers (known as Medicare Beneficiary Identifiers or MBIs) and issue new Medicare cards to all people with Medicare beginning in April 2018. CMS' top priorities are to make sure:
Medicare patients have continuous access to care; Providers have the tools and information needed for a smooth transition. Starting in June 2018, providers can look up their patients' new Medicare numbers through the MAC's secure web portal.
- This year, about 171,000 Medicare eligible professionals could be penalized for not meeting meaningful use, according to the CMS. First-time participants in the Medicare
EHR Incentive Program need to act now to avoid a payment penalty. The deadline for filing a hardship exemption is Monday, October 1, 2017.
The exemptions give providers who are transitioning to the new Merit-based Incentive Payment System a way to avoid 2018 payment penalties for not demonstrating meaningful use in the 2016 reporting year because they would have experienced "significant hardship" in meeting the requirements. CMS can help protect
physicians
from penalties through Hardship Exemptions, when it is not feasible for them to participate successfully in federal programs.
In addition to being first-time participants this year, eligible
providers who want to be exempt must also be moving into the MIPS track of MACRA for the 2017 performance period and be reporting data for the MIPS advancing care information performance category in 2017.
- Here is a link to the slides on the Proposed Rule for Quality Payment Program Year 2, as present by CMS Region IX conducted a webinar yesterday. QPPYear2
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Affiliate Association News
- New White Paper Details Bureaucracy, Deadly Delays, and Apathy by Pharmacy Benefit Managers (PBM's). COA has released the 3rd edition of PBM patient horror stories. The link also has all the white papers and letters from COA regarding the PBM's onerous activities. All 3 editions are on this link to share with your patients and staff. https://www.communityoncology.org/home/studies/
- ASCO's Cancer.Net resources is a patient education website www.cancer.net that provides timely, comprehensive, oncologist-approved information to people living with cancer, their caregivers and families to help them make informed health care decisions. The ASCO 2017 Patient Education Materials catalog and Cancer.Net Referral card are available now.
- Year In Review
, moderated by Neil Love, M.D.,
is a multi-tumor regional symposia series focused on the application of emerging research information to the care of patients with common cancers, is scheduled for Saturday, November 18, 2017 at the Fairmont Miramar Hotel in Santa Monica, CA. To register go to www.ResearchToPractice.com/Meetings/YIR2017/CA .
- For the complete updated versions of the NCCN Guidelines, NCCN Guidelines with NCCN Evidence Blocks™, the NCCN Compendium®, the NCCN Biomarkers Compendium®, the NCCN Chemotherapy Order Templates (NCCN Templates®), the NCCN Radiation Therapy Compendium™, and the NCCN Imaging Appropriate Use Criteria (NCCN Imaging AUC™), please visit NCCN.org. Recent updates include:
* multiple myeloma (V1.2018)
* prostate cancer early detection (V2.2017)
- NCCN has announced that it has instituted Categories of Preference for recommendations within the NCCN Clinical Practice Guidelines in Oncology. Initially, Categories of Preference will be published for drugs and biologics within the NCCN Guidelines for Multiple Myeloma. Additional cancer types are forthcoming. The Categories of Preference are preferred intervention, other recommended intervention, and useful in certain circumstances. Learn more about Categories of Preference at
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- Ipsen Biopharmaceuticals informs ANCO and MOASC that the United States Food and Drug Administration has approved a supplemental indication for Somatuline Depot (120mg) for the treatment of carcinoid syndrome.
- Sanofi-Aventis informs ANCO and MOASC that the United States Food and Drug Administration has approved a lower dose of Jevtana (20mg/m2 every 3 weeks) in combination with prednisone for the treatment of patients with metastatic castration-resistant prostate cancer previously treated with a docetaxel-containing treatment regimen.
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MOASC CALENDAR
Professional Educational Series
November 8-9
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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
Association of Northern California Oncologists
(ANCO) is an association of hematologists/oncologists dedicated to promoting high professional standards of cancer care by providing a forum for the exchange of ideas, data, and knowledge.
The material contained in the
California Oncology Weekly
is intended as general information for ANCO and 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 or ANCO 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
ANCO: P.O. Box 151109, San Rafael, CA 94915 | P (415) 472-3960 | F (415) 472-3961 | www.anco-online.org
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