California Oncology Weekly
"Where California Oncologists Go For Answers!"
A publication of the
Medical Oncology Association of Southern California, Inc.
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This Weekly's Hot Topics
- It is URGENT you support HR913 & HR3107 National News & Affiliate Association News
- FDA analyzes insurance claims to replicate clinical trial results National News
- Results of California legislative session California News
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- Friday, 2/21, was the last day for legislators to submit new bills to be considered for this legislative session.
Besides previously addressed bills, here are some of the newly introduced healthcare-related measures that will also be on our agenda this year:
SB 983
, the Cancer Medication Recycling Act, sponsored by MOASC, ANCO and the American Cancer Society-Cancer Action Network, would create a program allowing cancer patients to return unused oral anti-cancer medications to their physician and allow the physician to redistribute those medications to other patients.
SB 1216
(Hueso) would require a hospital to "not interfere" with a patient's use of medicinal marijuana, but it would require a hospital to prohibit the smoking or vaping as a means to access the drug.
AB 2747
(Santiago) would mandate that OSHPD release to any labor union and nonprofit health policy organization the following data sets: "Hospital Discharge Abstract Data Record, an Emergency Care Data Record, and an Ambulatory Surgery Center Data Record" which includes the date of birth, race, date of services, and principal diagnosis of patients.
AB 2830
(Wood) continues Dr. Wood's interest in setting up an all payer claims database 'to collect health information related to health care cost, quality, and efficiency by January 1, 2022." The bill would direct the office to take a number of actions with respect to developing and implementing the Health Care Cost Transparency Database, including, ensuring the database can map to other databases, contracting with a data collection vendor, as necessary, collecting and incorporating data from other state and federal agencies, developing and maintaining a master person index, a master provider index, and a master payer index, developing data quality and improvement processes, and developing an information security program to ensure the privacy of individuals and the security of the data collected. The bill would authorize the office to impose a user fee on eligible users of the database in an amount that does not exceed the office's administrative costs in providing eligible users access to the database.
- The Governor presented his State of the State address last week and focused on the issue of homelessness. Of note, he strongly urged county behavioral health departments to spend down their Proposition 63 resources on community-based care before the end of the state's fiscal year on June 30, 2020. He also indicated a plan to more fundamentally reform Proposition 63 and use those funds in a more targeted way. Advocates are hopeful that it will encourage counties to partner with community providers to access that funding and provide more care.
The Governor also touted his Cal-AIM Medi-Cal proposal and his proposed investment of $695 million to "leveraging Medi-Cal as a tool to help California's most vulnerable residents: the homeless, our children, and people cycling in and out of the criminal justice system."
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- Noridian/JEMAC has the following updates on their website
Recent Announcements Published to "Latest Updates"
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Information on what steps a provider should take when a claim is denied for no receipt of documentation after being requested by the Supplemental Medical Review Contractor (SMRC) has been added to the SMRC webpage. Read the complete update
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Comprehensive Error Rate Testing (CERT) Clinic Webinar on March 25,
2020
includes: CERT Introduction, Answer presubmitted questions, Progress Reports and Website Tour Read the complete update
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A temporary license is a license that allows a provider to practice medicine in a hospital or other facility until a full license is issued. Some temporary licenses are issued just for teaching hospitals and are good for only a certain period of time. Read the complete update
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2019 1099-INT and/or 1099-MISC Tax Forms are now available on the Noridian Medicare Portal (NMP). The 1099 inquiry is available through the Financials function. Read the complete update
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Accepting Payment from Patients with a Medicare Set-Aside Arrangement has been Revised (SE17019) and
is based on information received from Medicare beneficiaries, their legal counsel, and other entities that assist these individuals, indicating that physicians, providers, and other suppliers are often reluctant to accept payment directly from Medicare beneficiaries who state they have a MSA and must pay for their services themselves. Read the complete update
- Effective February 21, 2020, the Noridian Medicare Portal (NMP) now allows users to do multiple clerical error reopening adjustments on a single claim with one transaction. Read the complete update
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Billing and Coding Guidelines: Truxima (rituximab-abbs) had been retired, eff. 12/18/19.
This article was retired based on the FDA approval of this drug for all the same approved indications as Rituxan effective 12/18/19. Read the complete update
- Revised CMS-855R Required May 1, 2020, will be posted on the CMS forms website in this month. Read the complete update
- Quarterly Update to the MPFSDB in April 2020 (CR11661), informs you that the Centers for Medicare & Medicaid Services (CMS) issued payment files to the MACs based upon the 2020 Medicare Physician Fee Schedule (MPFS) Final Rule, published in the Federal register on November 15, 2019. Read the complete update
Forthcoming Noridian JEMAC meetings/webinars/workshop
* Submitting Your Enrollment Online Part 1(I&A) Webinar (February 26)
* Common Error when Enrolling in Medicare Webinar (March 4)
* Submitting Your Enrollment Online Part 2 *(PECOS) Webinar (March 18)
* Rebuttal, Reconsiderations and CAPS Webinar (April 8)
* Medicare Part A/B Revalidation Webinar (April 22)
For more information and to register:
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- As part of the longitudinal study published in JAMA, researchers constructed physician networks (or clusters) using Medicare claims to identify physician pairs who had previously shared patients within a single episode of cancer care from 2005 to 2006. Oncologists who had prescribed cancer drug bevacizumab within this baseline period were matched with those who prescribed the biological product during the three years after its approval (from 2007 to 2010) to make the assessments...
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Engage with the experts who can help you get a better picture of what
Advances in Oncology care will look like moving forward. Register now for the MOASC 2020 Annual Oncology Summit Educational Symposium on Saturday, March 14, and celebrate MOASC's 30th Anniversary, at the Hyatt Regency Huntington Beach. Speakers will highlight advances in several areas of oncology including melanoma, lymphoma, breast, colon, prostate, kidney, and lung cancers, among others. To register, contact the MOASC office at moasc@moasc.org or 909-985-9061 x1. #MOASC30
- MOASC Member, City of Hope CME presents: Immunotherapy of Cancer: CAR T Cell to Checkpoint Inhibitors, March 18, 2020 to March 21, 2020 at the Waldorf Astoria, Las Vegas, Nevada. For more information click
here
. To register go to
https://cme.cityofhope.org/eventinfo_11295.html
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- Applications now being accepted for ANCO's Travel Awards to Fellows and Young Clinicians to support attendance at the ASCO Annual Meeting,
ASH Annual Meeting, or other national oncology meeting in 2020. The deadline for submission is March 31. Awards will be announced by April 30. Learn more at
https://anco.org/membership/fellow-benefits/
.
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REGISTER
for the 20th Multidisciplinary Management of Cancers: A Case-based Approach
taking place in Napa on March 13-15.
- 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
- Large national regulators, including the U.S. Food and Drug Administration and United Kingdom's National Institute for Health and Care Excellence (NICE), are considering increasing the use of data gathered outside of clinical trials on the effectiveness of treatments, often referred to as real-world data. The Institute for Clinical and Economic Review (ICER), has signed a deal with private technology company Aetion to help it use patient health data in its reports on whether individual drugs are priced properly. The FDA is running a pilot project using Aetion's technology to analyze insurance claims to try to replicate clinical trial results, as part of a requirement to comply with healthcare legislation called the 21st Century Cures Act. It is seeking to determine under what circumstances such data could replace clinical trials, which have long been the foundation of medicine regulation.
- Express Scripts released its annual Drug Trend Report, which analyzes costs and spending for 33.6 million members enrolled in one of its drug plans. The pharmacy benefit manager found that medications for inflammatory conditions such as psoriasis and rheumatoid arthritis drove 43.7% of spending, by far the highest among the different classes. By comparison, diabetes and oncology drugs each contributed less than 20% of spend, the report shows. However, oncology drugs took the top spot for increased spending for Medicare beneficiaries, at 36.4%. The impact of specialty drugs is continuing to grow, according to the report. Though these products account for just 2% of prescriptions, they were responsible for 47.7% of spending in 2019, up from 44.7% the year prior.
- The number of cancer cases around the world could increase by 60% in the next 20 years, and low- and middle-income countries might see up to an 81% increase, according to the World Health Organization's 2020 World Cancer Report. The report said governments could save 7 million lives by 2030 if they invest in cancer resources.
CNN
- MOASC and ANCO have signed onto a letter, and encourages members to support, HR913, the Clinical Treatment Act. The bill would require Medicaid to cover routine care costs for patients on clinical trials with life-threatening conditions. To contact your Congressional Representatives in support of HR913, please go to
https://asco.quorum.us/action_center/
.
- Support is encouraged for
HR3107, The Improving Seniors' Timely Access to Care Act
. The bill would streamline prior authorization practices within the Medicare Advantage program. See also the Affiliate Association News section below.
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CMS News
- As mandated by the 21st Century Cures Act, CMS and Office of the National coordinator for Health Information technology (ONC) released a strategy identifying clinical documentation, usability, public health reporting and federal reporting requirements as the primary contributors to health IT-related administrative burden and suggesting ways the federal government can alleviate that burden. Strategies include incorporating provider preferences and workflow considerations in electronic prescribing of controlled substances to facilitate reporting.
On Friday, HHS acknowledged that electronic health records pose a significant burden on clinicians and suggested tactics the federal government can pursue to ease the pain. The agencies have been working on the strategy since mid-2017. A draft strategy was released in late 2018 and elicited more than 200 comments from the public.
Today's featured fact sheet covers
coordination of benefits and provides information on the adopted standards for these transactions.
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Affiliate Association News
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- MOASC & ANCO join ASCO in urging members to support HR913, the Clinical Treatment Act, that would require Medicaid to cover routine care costs for patients with life-threatening conditions on clinical trials; and HR3107, The Improving Seniors' Timely Access to Care Act, that would streamline prior authorization practices within the Medicare Advantage program.
- As of January 1, 2021, there will be significant changes to the office and outpatient Evaluation and Management (E&M) services (CPT® codes 99202-99215) 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. Read about the changes on ASCO Practice Central. ASCO will be providing educational resources throughout 2020 to assist with the conversion. Questions regarding the changes can be sent to ASCO staff at billingandcoding@asco.org.
- Register for the 2020 COA Conference: Focusing On The Future - Together. COA Conferences help community oncology physicians, pharmacy leaders and business representatives connect the dots across specialties, with a special focus on what is relevant for independent community oncology practices. When practices come together to discuss the important initiatives on a national stage, it drives progress in a way that is truly beneficial to patients. Attend the 2020 Community Oncology Conference taking place April 23-24 in Orlando. Learn more and register at
www.COAConference.org
.
- Cedars-Sinai 3rd Annual Gastrointestinal Tumor Conference is scheduled for Saturday, April 25, 2020, it will provide concise and comprehensive updates on the most recent research and advances in immunotherapy for gastrointestinal cancers. A stellar faculty has been assembled to share developments in precision medicine, research, and immunotherapeutic approaches to the treatment of cancers of the pancreas, liver, and gastric/esophagus. For more information and to register go to:
cedars.cloud-cme.com/gicancercme
.
- Save the Date! National Cancer Survivors Day® is Sunday, June 7, 2020.
www.ncsd.org
Get a jumpstart on planning your NCSD 2020 event by registering it (free of charge) with the National Cancer Survivors Day Foundation at
ncsd.org/register.
- NCCN has published updated guidelines at
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MOASC CALENDAR
City of Hope CME presents: Immunotherapy of Cancer: CAR T Cell to Checkpoint Inhibitors
March 18-21, 2020
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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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