California
Oncology
Weekly
"Where California Oncologists Go For Answers!"
A publication of the
Medical Oncology Association of Southern California, Inc.
June 30, 2020
|
|
|
This
Weekly
's Hot Topics
|
- Medi-Cal Managed Care contractor problems MOASC News
- Anthem Blue Cross using CVS for medications administered in the office MOASC News
- Medicaid targeted distribution portal open until July 3 National News
- CMS has published Open Payments Program Year 2019 CMS News
|
|
|
-
Noridian's
COVID-19 page
has information and guidance related to COVID-19.
To support providers, a COVID-19 Hotline has been established to help with COVID-19 related inquiries. The hotline number is: 866-575-4067. Customer services representatives will be available Monday-Friday from 8 a.m.-6 p.m. CDT. This hotline will answer questions on provisional billing privileges and enrollment flexibilities afforded by the COVID-19 waiver for health care facilities and providers, as well as accelerated payments related to COVID-19.
Upcoming webinars
-
ICD-10 and Other Coding Revisions to NCDs - July 2020 Update - Revised CR11655
CR 11655 informs providers about updated International Classification of Diseases, 10th Revision (ICD-10) conversions as well as coding updates specific to National Coverage Determinations (NCDs). Read the complete update
-
Open Meeting Announcement - July 15, 2020
This article has been published for notice under contract numbers: 01111 (CA), 01211 (AS, GU, HI, NMI), 01311 (NV), and 01911 (CA, HI & Territories). Read the complete update
Open Meeting Announcement - July 16, 2020
This article has been published for notice under contract numbers: 01111 (CA), 01211 (AS, GU, HI, NMI), 01311 (NV), and 01911 (CA, HI & Territories). Read the complete update
-
Noridian Medicare Portal: Eligibility and MBI Lookup Inquiry Webinar - July 23, 2020
This event includes: Eligibility Inquiry Requirements, MBI Lookup Tool Requirements Read the complete update
-
Medicare Fee-for-Service (FFS) Response to the Public Health Emergency on the Coronavirus (COVID-19) - Revised SE20011
The Secretary of the Department of Health & Human Services declared a public health emergency (PHE) in the entire United States on January 31, 2020. Read the complete update
-
Noridian Medicare Portal: Claim Status Webinar - July 28, 2020
This event includes: How to perform a Claim Status Inquiry, Additional features available on a Claim Status Inquiry Read the complete update
|
|
|
-
MOASC is interested to know if any member is having increasing challenges with their Medi-Cal Managed Care contractors. MOASC has been made aware of a northern California contractor, Lasalle, requesting more than $800,000 in drug refunds due to Lasalle's internal error of drug overpayment. If you are accepting Medi-Cal Managed Care patients and experiencing ANY onerous issues with your Medi-Cal Managed Care contractor (excessive processing time, delays in getting authorizations, failure to get paid, etc.) please contact moasc@moasc.org. Thank you.
-
MOASC has received information from members that Anthem Blue Cross is now using CVS as their specialty pharmacy for medications administered in the office
or outpatient hospital setting beginning tomorrow, July 1, 2020. This applies to specialty drugs covered through the patient's commercial HMO plan. The main concern is that this policy creates both "brown bagging" and "white bagging" of drugs and both have very serious safety issues, which can ultimately result in delayed treatment causing adverse outcomes and potentially shorten life expectancy. Is your office in receipt of this letter from Anthem Blue Cross? If so, please email the MOASC Office at moasc@moasc.org
-
Thank you for your participation in MOASC's LunchTime Series teleconference
last week. COVID-19 Billing and Coding Updates for Your Cancer Centerwas presented by Teri Bedard, BA, R.T. (R)(T), CPC Director, Client Services, Revenue Cycle Coding Strategies.
This recording will be available for the next 30 days by dialing 1-888-203-1112 and enter the pass code 679077560.
To view the handouts for the presentation, please email the MOASC office at moasc@moasc.org
-
What can MOASC do to further support you?
Your input is valuable. How can MOASC improve upon this publication and all communications to you? Please take a moment to respond to the following survey. It should take you less than 5 minutes to complete.
Upon receipt of your completed survey, you will be automatically entered into a drawing to win a $50 Amazon gift card. TAKE THE SURVEY NOW!Thank you in advance for your time and feedback to participate in this survey. If you have any further comments, issues and concerns, please feel free to contact moasc@moasc.org.
-
As patients are delaying appointments and procedures due to the COVID-19 pandemic, MOASC is extending your membership to October 1, 2020
. The health and well-being of MOASC members, and the patients they serve, are of utmost importance to MOASC. With three months of free membership we hope to help you adapt to the changes with the necessary tools and resources to continue to be successful. The remaining nine months will be assessed at a prorated amount.
MOASC is able to do this with the generous support from your Industry Sponsors:
AstraZeneca, Pfizer, Puma Biotechnology, AbbVie, Merck, Verastem, Amgen, Astellas, Bristol Myers Squibb, Johnson & Johnson, Foundation Medicine, Genentech, Genomic Health, Kite Pharma, Eli Lilly, Novartis, Oncology Supply, Regeneron, Sanofi-Genzyme, Stemline Therapeutics
and Takeda.
Together, we will continue to advance oncology in California. If you have any questions, please contact the MOASC Office by phone 909-985-9061 ext.1 or at moasc@moasc.org.
|
|
|
-
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.
- Use ANCO's job board to post or search for employment opportunities at ANCO member practices.
-
Follow ANCO on Twitter at @ANCO News.
|
National News
-
HHS has opened a new "Medicaid Targeted Distribution" portal through which Medicaid-dependent physicians can apply to receive a portion of the $15 billion "targeted distribution" for Medicaid providers. Physicians must apply for the funding before July 3, 2020. The funding does not need to be repaid. Reminder: Medicaid targeted distribution portal open until July 3.
-
The FDA has approved Phesgo-a combination of pertuzumab, trastuzumab and hyaluronidase (zzxf), that can be administered at home
by a health care professional, for injection under the skin to treat adult patients with HER2-positive breast cancer that has spread to other parts of the body, and for treatment of adult patients with early HER2-positive breast cancer. Patients should be selected based on an FDA-approved companion diagnostic test.
-
The CDC has released NEW 2015-2018 Caregivng Infographics
.
You are encouraged to share the Infographics with your patients and their caregivers, which highlights characteristics of caregivers and the caregiving situation. The National Infographic includes data from 44 states, Puerto Rico and District of Columbia.
-
The US physician shortage could reach 139,000 by 2033, while the expected shortfall of radiologists, neurologists and other physician specialists ranges from 17,100 to 41,900, according to an Association of American Medical Colleges report completed before the COVID-19 pandemic,
which could worsen the issue. Researchers said hospitals, especially those in rural areas, are modifying scope of practice rules, relocating physicians and rehiring retired physicians to address the shortage.
-
The health systems and medical practices that are most dependent on fee-for-service models have suffered greater losses during the COVID-19 pandemic than those that had moved toward greater adoption of value-based care. Providing a data infrastructure will be especially important. High-cost therapies pose a particular challenge to health insurers, but value-based drug reimbursement models that link payments to observed or expected outcomes could be a solution. Designing such models is challenging. Stakeholders are convening to discuss the barriers to designing such models, and it has developed a framework for them. CMS believes that, "our fee-for-service system is insufficient for the most vulnerable Americans because it limits payment to what goes on inside a doctor's office." Adding that, "...effective implementation of value-based reimbursement models encourages providers to care for the whole person and address social risk factors critical to improving quality of life of their patients. Phasing in value-based care works for patients, physicians, providers of care and payors."
-
The Institute for Clinical and Economic Review (
ICER) posted a protocol describing their annual analysis, ICER's "Unsupported Price Increase" (UPI) report - that will examine significant prescription drug price increases and determine whether or not new clinical evidence exists that could be used to support those increases.
-
OptumRx, the pharmacy benefit provider for UnitedHealthcare
, will reinstate its mandatory e-prescribing policy for controlled substances effective July 1, 2020.
|
CMS News
- CMS has published Open Payments Program Year 2019 data, along with newly submitted, and updated, payment records for previous program years. The data is accessible at https://openpaymentsdata.cms.gov/.
-
CMS' annual Medicare Physician Fee Schedule and Quality Payment Program rule, which normally publishes in July, will include proposals that would permanently expand reimbursement for telehealth services,
according to CMS analyst Emily Yoder. She urged health care providers to comment on the rule and "to help us decide on the flexibilities that we implemented that we want to see made permanent," but she noted that some Medicare telehealth reimbursement changes will require action from Congress to be made permanent. Specific changes CMS is seeking to finalize that were originally included in the first COVID PHE are in the interim final rule.
-
The HHS Office of Inspector General will be auditing Medicare payments for advanced care plans to ensure clinical documentation supporting in-person services meets federal regulations. The OIG plans to release a report on its findings next year.
|
Affiliate Association New
s
|
-
Being informed keeps patients in charge of their journey. Ensure your patients gain knowledge about issues that matter to them. Invite your patients to join you on Wednesday, July 15, 2020 for the Community Oncology Advocacy Summit: Cancer Care in a COVID-19 World. The Community Oncology Advocacy Summit is a free, virtual learning event for patients with cancer and patient advocates. COVID-19 has turned the health care world upside down. This event will empower patients and advocates to obtain the best treatment knowledge possible in an uncertain world. Attendees will learn about the latest in cancer policy and legislation, what cancer care will look like in the future, issues that impact your treatment, and much more. I hope you'll join us and the thousands of other attendees for this exciting live event. Click Here to Register!
-
The International Lung Cancer Congress will hold their 21st Annual meeting on July 23-25, 2020. The live webcast will provide current, practical information on the management of lung cancer, as well as a look at the novel agents and strategies with the potential to shape the future of lung cancer therapy. Leading international and national experts will provide perspectives on how to apply the latest data on targeted agents, immunotherapy, surgery, and radiation oncology in the clinic. Click here to register.
-
ASH has decided to transition the ASH Meeting on Hematologic Malignancies to a virtual experience to provide important education while assuring the wellbeing of the hematology community around the world. From August 27 to September 12, 2020 the ASH Meeting on Hematologic Malignancies features the top experts in the field, comprehensive clinical content, and exciting updates in each of the core hematologic malignancies, including: Leukemia; Lymphoma; Myelodysplastic syndromes; Myeloma and Myeloproliferative neoplasms. By transitioning the ASH Meeting on Hematologic Malignancies to a virtual experience that will combine both live and on-demand sessions. Visit their website for schedule updates.
-
Cedars-Sinai 3rd Annual Gastrointestinal Tumor Conference is on Saturday, September 12, 2020. Concise and comprehensive updates on the most recent research and advances in immunotherapy for gastrointestinal cancers, will be presented. 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.
-
The Community Oncology Alliance (COA) and CancerCare, national leaders in advocacy and support for people affected by cancer, launched the COA/CancerCare Patient Financial Assistance Fund to reduce the financial burden on patients in need. These grants will help qualified patients in active treatment pay their rent, mortgage, and utilities, or purchase food and general household supplies. They can also access other programs from CancerCare, including psychosocial support, educational workshops, support groups, and additional financial assistance for expenses such as pet care. The new program offers a $500 grant to help with the financial strain caused by the COVID-19 pandemic.
Community oncology practices can register for COA/CancerCare assistance programs online at
https://communityoncology.org/cancercareprograms/
-
ASCO's Nominating Committee is seeking recommendations for potential candidates for the upcoming ASCO election
, for service beginning in June 2021. All members are invited to recommend individuals you believe possess the qualities needed to lead the Society in the future. Your participation in this process will help ensure that our Society's leaders represent the diversity of our membership. Please contact ascoelection@asco.org with any questions.
-
ASCO's CancerLinQ has launched the SmartLinQ QOPI Certification Pathway
, an application that empowers oncology practices to automate quality measure tracking and reporting for participation in ASCO's Quality Oncology Practice Initiative (QOPI) Certification Program, a three-year certification recognizing practices' commitment to high-quality care for outpatient oncology practices.Learn More.
-
Please review the below email and let
Kara Martin Martin@nccn.org know which NCCN Guidelines for Patients you request (if you haven't already). The information will be sent in print-ready files in the coming weeks. Thank you.
Metastatic Breast Cancer
Prostate Cancer
Lung Cancer (early stage)
Lung Cancer (metastatic)
Please fill out the information listed below if you are interested. Supplies are limited, so we encourage you to place your order soon.
Name:
Title:
State Oncology Society: MOASC
Patient Guideline(s) Requested:
-
NCCN has updated Prostate Cancer v2.2020 and Hepatobiliary Cancers v4.2020.
For the complete updated versions of the NCCN Guidelines, NCCN Guidelines with NCCN Evidence Blocks™, the NCCN Drugs & Biologics Compendium (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.
|
Industry News
-
Targeted Oncology has a new podcast and is in search of a community oncologist to join the editor and an academic physician to discuss one of the following topics:
Targeted therapies in breast cancer (PARP inhibitor and HER2-directed therapies); Immunotherapy in melanoma; The impact of the microbiome on colorectal cancer; Targeted therapies in ovarian cancer; or Immunotherapy in triple negative breast cancer. They are currently are looking to fill 5 spots. Episodes are 30 minutes long. If you are interested and/or need more information, please send an email to Nichole Tucker at NTucker@targetedonc.com by July 2, 2020. Targeted Talks Podcast
-
Merck & Co., Inc
announces the FDA approval of pembrolizumab (KEYTRUDA®) for patients with recurrent or metastatic cutaneous squamous cell carcinoma (cSCC) that is not curable by surgery or radiation.
- Astellas announces the assignment of a product-specific, permanent J-code for enfortumab vedotin-ejfv (PADCEV). CMS released the July 2020 Quarterly Healthcare Common Procedural Coding System (HCPCS) File, which includes the designation of J9177 for PADCEV with the effective date of July 1, 2020. For more information click here
- Genentech
announced the FDA granted approval to Phesgo, a new fixed-dose combination of Perjeta and Herceptin available in a single vial. It can be administered under the skin (subcutaneous injection) in just minutes, significantly reducing the amount of time a patient spends receiving treatment when compared to hours with IV administration. The Genentech press release including Important Safety Information is linked here and the FDA release is linked here.
|
|
|
MOASC CALENDAR
(Huntington Beach, July
23-25)
(Virtual, Various Dates)
(Davis, New Dates:
March 11-12, 2021)
|
|
|
|
|
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
|
|
| |
|
