California
Oncology
Weekly
"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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This Weekly's Hot Topics
- Leadership changes in California oncology associations.MOASC News & ANCO News
- U.S House of Representatives released their drug-pricing plan. National News
- CMS introduced Omnibus Burden Reduction final rule.CMS News
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- Consumer Watchdog announced, last week, that it is pursuing a 2020 statewide ballot initiative that challenges MICRA.
While CAPP is still reviewing the details of the initiative, it does include many provisions that would hurt access to health care in California, including increased attorneys' fees. In the meantime, CAPP is prepared to defend the existing law, thanks to the strength and diversity of the CAPP coalition, which is more than 1,000 organizations strong. As you remember, California voters in 2014 recognized that changes to MICRA would ultimately increase costs and decrease access to health care when they resoundingly rejected similar language in Proposition 46 by a 2-1 margin. ALL California Physicians are encouraged to support CAPP to ensure the trial lawyers do not interfere in your ability to care for your patients. Contact Lisa Maas,
Executive Director, Californians Allied for Patient Protection. lmaas@micra.org. Show your support of CAPP by attending the following reception.
- The Coalition to Protect MICRA (CAPP) invites you to join them for an evening reception in honor of Assembly Member Christy Smith on Wednesday, October 23, from 5:30 PM to 6:30 PM. The reception will be held at Oakmont of Valencia (24070 Copper Hill Dr., Valencia, CA 91354). Please click here to view the invitation. If you are not far from Valencia, please share this invitation with your colleagues and staff and encourage them to attend. Please RSVP to Kristina Gelaber kgelabert@micra.org. Thank you for your continued support of CAPP.
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- Noridian/JEMAC has the following updates on their website
Announcements:
New Medicare Card: More Questions about Using the MBI?; Clinical Diagnostic Laboratories: Resources about the Private Payor Rate-Based CLFS; Hospice Quality Reporting Program Quarterly Updates;
Publications:
Quality Payment Program: Resources for Clinicians New to the Program in 2019; Medicare Enrollment for Physicians and Other Part B Suppliers-Reminder; Quality Payment Program: All-Payer Combination Option in 2019 Web-Based Training Course
*
Radiopharmaceutical Fee Schedule Updates-Effective October 15, 2019
* HCPCS Drug/Biological Code Changes-October 2019 Update-Revised CR11422
* Quarterly ASP Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing Files-October 2019-Revised CR11343
Forthcoming Noridian JEMAC meetings/webinars/workshops
* Eligibility Claim Denials and Rejections Webinar (October 3)
* What's New in the Fourth Quarter 2019 Webinar (October 8)
* Common Errors on all Application Types Webinar (October 9)
* Using the Medicare Beneficiary Identifier Webinar (October 16)
* What's New in the Fourth Quarter 2019-After Hours Webinar (October 24)
* Open Enrollment Webinar (November 6)
For more information and to register visit:
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- The following comes from MOASC President, Warren Fong, M.D.
Dear Valued Members of the Medical Oncology Association of Southern California, MOASC;
After serving MOASC as its Executive Director since 1992, Mariana S-B Lamb, M.S. has decided to take a well-earned rest and retire from her job as Executive Director of MOASC. Mariana has shown exceptional leadership, boundless energy, unwavering dedication to our cause, and is a true visionary. MOASC growth and success has been largely due to her. She will be missed. I would like to express the gratitude and appreciation of the Board of Directors and the MOASC membership to Mariana and wish her well on her next adventure.
I am pleased to also announce, that the MOASC Board of Directors, after careful consideration by the Search Committee lead by Dr. Robert Moss, Chairman of the Board, has appointed Nichole East, CAE as MOASC Executive Director. Nichole has been a dependable force at MOASC. Whenever MOASC faced a challenge, Nichole has always been my "clutch hitter." I am confident that she will prove to be an effective and successful Executive Director.
Once again, thank you Mariana and welcome Nichole.
- September was National Preparedness Month (NPM). MOASC's Oncology Patient Emergency Network (OPEN) program with the CDC's Center for Preparedness and Response (CPR) and FEMA partners from the Ready Campaign wish to encourage you to continue to promote family and community disaster and emergency planning now and throughout the year. MOASC would like to remind you to include the MOASC OPEN program in your emergency preparedness procedures. This is information you need to ensure continued access for cancer patients to oncology care in the event of an emergency. It is better to be prepared and not need the precaution than to be unprepared and suffer the consequences. Contact the MOASC Office moasc@moacs.org for more information.
- Mark your calendars for November 14, 2019, to attend the "MOASC Educational Series Program." The day will present: Bobbi Buell bringing the MOST UP-TO-DATE billing changes from across the board with southern California benchmarks and specific California healthplan issues;
Carynne Godfrey,
from
Noridian, addressing specific Medicare changes; Dawn Holcombe & Willis Triplett presenting current USP800 (eff. 12/1/19) and USP797 news and further actions;
Arthur Lurvey, MD, FACP, FACE,
California
Medicare Contractor, Noridian, Medical Director, speaking on new E&M codes for physicians' awareness coming in 2021; and Remedios Turner, from Medi-Cal, reviewing state initiatives of coverage. Presenters will also address new imaging rules; payment changes; classification of physician relationship to patient; off - label coverage, and more. Please RSVP no later than November 1, 2019 to
moasc@moasc.org
- Mark your calendars NOW for the Annual MOASC Oncology Summit, Saturday, March 14, 2020
at the Hyatt Regency Huntington Beach. The MOASC Oncology Summit continues to highlight cutting-edge topics presented by world-renowned physicians. You will not want to miss our 2020 program!
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The Board of Directors of the Association of Northern California Oncologists (ANCO) is pleased to announce the appointment of Courtney G. Flookes as Executive Director-Designate
.
With deep appreciation for his years of outstanding leadership, ANCO is announcing that
Executive Director
Jose Luis Gonzalez will be retiring from his role as the
Executive Director
at the end of June 2020. Over the next few months, Jose will remain involved in ANCO's daily operations in order to facilitate the smooth transition to new leadership.
Courtney brings strategic foresight to build on the success of ANCO and help navigate the organization into its future. We are excited to have Courtney as our new
Executive Director
and we look forward to your continued support and partnership as we welcome her in her new role.
- ANCO has Moved!
Please note we have moved our offices. Our new mailing address is:
ANCO,
Post Office Box 2954,
Alameda, CA 94501. The ANCO telephone number remains the same--
415-472-3960 (Office); our e-mail addresses are
director@anco.org and
courtney@anco.org. And,
also note the ANCO's FAX number has been disabled.
- ANCO's Annual Professional Education Meeting 2019 is taking place at The Claremont Resort in Berkeley on October 17. Register at
https://bit.ly/2Sz3OsY
.
-
SAVE THE DATE
for ANCO's
4Q2019 Hematologic Malignancies Updates
taking place in San Francisco on November 16. A meeting announcement will be mailed in early October.
- Follow ANCO on Twitter at
@ANCO News
.
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National News
- Last week, Speaker Nancy Pelosi released the U.S House of Representatives drug pricing plan. The bill would require Medicare to negotiate prices on a minimum of 25 drugs annually. Drugs that would provide the greatest savings to taxpayers, patients, and all payers, would be prioritized. The plan also includes a provision to cap out-of-pocket spending for Medicare beneficiaries enrolled in the Part D prescription drug program at $2,000 annually.
- COA is still soliciting PBM waste stories. Thanks to New Mexico oncologists and AMA President, Dr. Barbara McAneny for stepping up and providing her story and a patient, to NPR.
COA has NPR very interested in a story on how PBM-mandated pharmacy use produces wasted drugs. It would be VERY HELPFUL to get some more patient stories about waste. You may not realize the waste because the patient receives the drugs at home and may not bring in the unused drugs. However, PLEASE research.
As you know an NPR story has the reach and influence to put pressure on the PBMs mandating use of their specialty/mail order pharmacies. Please share your story with Nicolas Ferreyros, Director of Communications, Community Oncology Alliance (COA) at nferreyros@coacancer.org or (713) 377-0689.
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CMS News
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CMS has received nearly 29 million comments on its proposed physician fee schedule, with many urging the agency not to lower reimbursements so it can make higher payments for evaluation and management services. Aspublished in last week's
California Oncology Weekly, comments were due last Friday,
September 27th for the
CY 2020 Proposed Rules.
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Last Wednesday, CMS introduced a final rule designed to reduce health care costs and mitigate administrative burdens on health care providers. The agency expects the policy to free up an estimated 4.4 million hours of time spent on paperwork and save the US health care system $843 million per year. The Omnibus Burden Reduction Final Rule, part of the CMS' Patients over Paperwork initiative, will allow hospitals to review their policies and procedures less frequently and allow health systems to implement unified and integrated quality assessment and improvement programs for all member hospitals, among other measures.
For More Information:
Final Rule
- CMS Administrator Seema Verma, told insurers that they need to support policies on transparency, value-based payments, interoperability and data access, cautioning them that the health insurance industry is under threat from disgruntled patients, doctors and politicians. Speaking at the America's Health Insurance Plans' 2019 National Conference on Medicare, Verma said that patients are tired of high costs, surprise bills and a system that's too complex and difficult to navigate. She also noted that patients are unhappy with the hassles of insurance and worried that their claims would be denied, citing the low customer satisfaction ratings among private payers. The administrator stated that providers are upset with private insurers, too, due to increasingly onerous administrative burdens such as prior authorizations and quality reporting. Verma reiterated that doctors spend too much time dealing with insurance claims instead of caring for their patients. She also cited evidence that it's contributing to record-setting rates of burnout among physicians. Verma said that improved technology and access to data are necessary to a multi-payer alignment strategy that includes private insurance. She said that reducing the administrative burden for patients and providers would facilitate the adoption of value-based payments, which would ultimately be good for payers. Verma also promised to lower regulatory burden for private insurers and highlighted the administration's efforts on value-based drug payments.
- CMS posted files on its website showing costs and coverage for 2020 Medicare Advantage and Medicare Part D plans. Fewer plans follow the HMO model, 63% of an average state's plans with drug coverage will include a no-deductible tier, and about 91% will offer drug benefits beyond standard Medicare coverage.
ThinkAdvisor (free registration)
- Ahead of the start of open enrollment on Oct. 15, CMS expects average monthly premiums for Medicare Advantage plans to drop from $26.87 this year to $23 next year, the lowest in 13 years, while the average number of plans per county will increase from 33 to 39. MA enrollment is expected to climb to 24.4 million next year, up 9.9% from 22.2 million this year.
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Affiliate Association News
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- The First Annual Leadership, Empowerment, and Development (LEAD) conference will take place on October 4th and 5th at the Loews Hotel in Santa Monica, California. This 2-day conference will focus on Enriching Experiences for Women in Hematology and Oncology through CME-certified clinical updates, career development workshops, professional networking opportunities, and one-on-one mentoring sessions. The target audience for this meeting is women in hematology/oncology careers seeking professional networking and science-based insights into the hematology/oncology landscape. Additional conference information, including the program agenda, can be found at
www.LEADoncology.com. Of note, fellows can register for the conference free of charge by using the promo code FELLOWS100. If you have any questions, please contact: Patti Bunyasaranand, MS, Program Manager, Bio Ascend LLC, 404-310-1180 cell, 312-277-6893 fax bunyasaranand@bioascend.com www.bioascend.com.
- You are cordially invited to the Research To Practice (RTP) "Year in Review, "moderated by Dr. Neil Love, Saturday, October 12, 2019 at Loews Santa Monica Beach Hotel 1700 Ocean Avenue Santa Monica, California. Physicians, nurses and other healthcare providers are welcome. This activity is accredited for CME-ABIM MOC and CNE. To view the invitation, click
HERE. To register or to learn more, please www.ResearchToPractice.com/Meetings/ YIR2019/CA
- MOASC Member, City of Hope CME presents: Multidisciplinary Approaches to Cancer Symposium on October 10-13, 2019 at the Waldorf Astoria, Las Vegas. This intensive program will provide participants with an enhanced ability to interpret and apply best treatment options into their individual cancer practices. For more information click
HERE. To register go to: https://cme.cityofhope.org/eventinfo_10946.html.
- Join the Inland Empire Oncology Nursing Society fundraiser event for The Leukemia & Lymphoma Society's Light The Night, on October 26, 2019 at the Auto Club Speedway of California in Fontana, money raised through Light The Night allows The Leukemia & Lymphoma Society (LLS) to fund treatments for patients who are suffering from all forms of blood cancers. In 2018, LLS helped advance 19 of 21 approved blood cancer therapies. Beating cancer is in our blood.
Donate NOW!
- The 2019 Innovatix + Essensa National Meeting & Expo is only 1 month away October 28-30 in Atlanta! As a MOASC purchasing member, you pay no registration fee for the conference or the sessions. There is still time to register for this annual event providing three highly anticipated days of learning, networking, and business development. Make sure you don't miss out on this exclusive opportunity,
REGISTER TODAY. Please review the National Meeting web page for additional details and register to attend today before space or time runs out! REGISTER TODAY
- Research To Practice will hold their First Annual Oncology Nursing Retreat taking place this year November 8 - 10, 2019 at the Diplomat Beach Resort Hotel in Hollywood Beach, Florida. This educational meeting will focus on covering a plethora of common solid tumors & hematologic cancers with expertise from a stellar faculty panel of clinical investigators and nurse practitioners (33 in total). There is no fee for oncology nurses to participate.
For more information and to register, click on this link:
- While at the 61st ASH Annual Meeting and Exposition in Orlando, plan to attend the Women in Hematology Networking Reception, Accelerating Equity, Diversity, and Inclusion with a Focus on Women in Hematology. Guest Lecturer Dr. Julie Silver, Associate Chair, Department of Physical Medicine and Rehabilitation, Harvard Medical School, December 9, Hyatt Regency Orlando, Regency Ballrooms T/U, 7:30 p.m. - 9:30 p.m.
RSVP by Tuesday, November 19.
- Round 2 registration is now open, and data submission will run through December 3, 2019, for ASCO's Quality Oncology Practice Initiative. QOPI is an oncologist-led, practice-based quality assessment program for outpatient oncology clinics. Register for QOPI at
https://myqopi.asco.org/registration/login.aspx.
- Register to secure your place at the 61st ASH Annual Meeting and Exposition in Orlando, December 7-10, 2019. The meeting will provide invaluable education, science, and networking opportunities. To register, you will need to sign in using your ASH username
moasc@moasc.org and password. If someone else is registering for you, please provide them with your credentials to avoid delays. If you have forgotten your credentials, you may reset them on the ASH website using the "Forgot your Username or Password" links. Please note that SPARGO, Inc. is the only official housing and registration provider for the 61st ASH Annual Meeting and Exposition. For more information on housing and registration fees, please visit the ASH website. View the preliminary program online.
- NCCN has published updated guidelines: breast cancer, soft tissue sarcoma
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Eisai
and Merck has announced that the USFDA has approved Lenvima and Keytruda in combination for the treatment of patients with advanced endometrial carcinoma that is not MSH-H or dMMR, who have disease progression following prior systematic therapy and are not candidates for curative surgery or radiation.
- Janssen Oncology has announced that the USFDA has approved Erleada for patients with metastatic castration-sensitive prostate cancer (mCSPC). In addition, the United States Food and Drug Administration has approved Darzalex for adult patients with multiple myeloma in combination with bortezimib, thalidomide, and dexamethasone in newly diagnosed patients who are eligible for autologous stem cell transplant (ASCT).
- Sanofi Genzyme has announced that Libtayo has been assigned HCPCS code J9119 effective October 1.
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MOASC CALENDAR
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4Q2019 Hematologic Malignancies Updates (San Francico; November 16)
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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.org
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