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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- You know the saying, the only two certainties in life are death and taxes. Well, today, April 16, National Healthcare Decision Day comes on the heels of tax day. Organized by the Conversation Project, an offshoot of the Institute for Healthcare Improvement, it's a day designed to highlight the importance of advance planning and to "encourage patients to express their wishes regarding healthcare and for providers and facilities to respect those wishes, whatever they may be." According to a 2017 study in Health Affairs, only 36.7% of Americans have an advance directive.
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- The California Medical Association (CMA) reports:
* Anthem Blue Cross recently announced changes to its Prudent Buyer Participating Physician Agreement and fee schedule effective July 1, 2019. Learn more at
* Anthem advised CMA that the edit that will trigger for diagnosis codes within the same ICD-10 family and the look back period associated with the edit is two months. CMA has requested that Anthem issue an updated notice to physicians clarifying these points.
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- Noridian/JEMAC has the following updates on their website
Announcements:
Physician Compare: Supplemental Preview Period Open until April 27; Open Payments: Review and Dispute Data by May 15; Patients Over Paperwork April Newsletter; New Part D Opioid Overutilization Policies: Myths and Facts; Quality Payment Program CMS Web Interface and CAHPS for MIPS Survey: Register by July 1; Quality Payment Program: 2018 MIPS Data Submission Preliminary Feedback; Provider Minute Video: The Importance of Proper Documentation.
Publications:
Medicare Fraud & Abuse: Prevent, Detect, Report; Promoting Interoperability Programs; Telehealth Services-Revised; Medicare Fraud & Abuse Poster-Reminder; Quality Payment Program Merit-based Incentive Payment System (MIPS): Quality Performance Category in 2019 Web-Based Training Course-Revised.
* Additional Information Required for Coverage and Pricing for Category III CPT Codes-R8
* MolDX: Oncotype DX Genomic Prostate Score for Men with Favorable Risk Prostate Cancer LCD-R3
* Chemotherapy Administration-R19
* MLN Connects-April 11, 2019
* MSI Reminder: There is Still Time to Evaluate Our Services MSI
* MolDX: Myriad's BRACAnalysis CDx Billing and Coding Guidelines-R2
* MolDX: DecisionDx-UM (Uveal Melanoma) LCD-R2
Forthcoming Noridian JEMAC meetings/webinars/workshops include:
* Using the Medicare Beneficiary Identifier (MBI) Webinar (April 17)
* Preventive and Screening Services Webinar (April 23)
* Modifier 59, NCCI and MUEs Webinar (April 24)
* Medicare Part A/B Revalidation Webinar (April 24)
* What's New in the Second Quarter 2019 Webinar (April 25)
* Preventive and Screening Services after Hours Webinar (April 25)
* Reopenings Webinar (April 30)
* Computed Tomography of the Abdomen and Pelvis Webinar (April 30)
* What's New in the Second Quarter 2019 Webinar (May 1)
* Using the Medicare Beneficiary Identifier (MBI) Webinar (May 21)
* Submitting Your Enrollment Online-Part 1 Webinar (I&A; May 29)
* Using the Medicare Beneficiary Identifier (MBI) Webinar (June 13)
* Submitting Your Enrollment Online-Part 2 Webinar (PECOS; June 26)
- A new document, titled Electronic Payments on the Medicare Secondary Payer Recovery Portal (MSPRP) and Commercial Repayment Center Portal (CRCP) Frequently Asked Questions and Answers, is now available in the Downloads section of the Coordination of Benefits and Recovery Overview What's New page on CMS.gov.
Educational Events - April 2019
Providers are encouraged to attend the many educational events offered by Noridian in April.
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The top 9
factors MOASC physicians have identified as creating stress, causing burnout, which may impact their ability to practice medicine are:
Amount of Work; Amount of time spent with authorizations; Cost of drugs to my patients and to me; Difficulty in finding a new partner or replacement; Difficulty in taking time off; EHR; Mandated policies and/or procedures; Reduced Income; Reduced Reimbursement.
Thank you to those who submitted your candid responses to our Physician Burn-Out Survey. For a copy of the survey responses please contact
moasc@moasc.org
- MOASC is asking if you have an instance of the application of a copay accumulator, please contact the MOASC Office
moasc@moasc.org
with your experience
. Even if the patient name is redacted, it would go a long way in helping MOASC & ANCO, the California Cancer Caucus and many other patient and provider advocacy organizations' work on legislation to limit their use. Thank you.
- MOASC's LunchTime Series presents "
Glioblastoma and the Current Biomarkers Being Investigated as Treatment Strategies"
webinar on Wednesday, April 24, 2019 at 12:00pm PT. Sponsored by AbbVie. To register contact the MOASC office at moasc@moasc.org, or by calling 909-985-9061 x1.
- SAVE-THE-DATE for MOASC's Spotlight On Oncology, August 17, 2019 in Huntington Beach. Through a restricted grant from MOASC, selected oncology fellows and faculty from the University of California, Irvine (UCI), present the premier topics from their attendance at the 2019 Annual ASCO meeting. The presentations promote collegial discourse among colleagues along with networking in an informal setting. Contact the MOASC Office for more information at
moasc@moasc.org.
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- The new ANCO website (www.anco.org) is now live! ANCO physician members, their practice staff, and representatives from ANCO's corporate members must register to access password protected content.
- The ANCO
Executive Director
has announced his intention to retire effective July 1, 2020
. The ANCO Board of Directors accepted his transition plan and timeline with the goal of identifying and installing a successor by the time ANCO's annual business cycle starts in September 2019. In the meantime, ANCO will conduct a regional and national search for a successor.
- ANCO is now on Twitter; follow @ANCO News.
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ANCO is organizing a series of Hematologic Malignancies Updates in 2019 on May 18 in Palo Alto, September 14,
in Sacramento, and November 16 in San Francisco. These Updates are supported by AstraZeneca, Celgene, Janssen Oncology, Pharmacyclics, and Takeda Oncology. Watch for the first meeting announcement in late March; register online at
- thesecondopinion has been serving the California cancer community for 50 years by providing free, comprehensive second opinions to cancer patients and their families. They will celebrate the anniversary with an informational and educational luncheon on Thursday, May 9, that will feature a presentation by Charles Graeber, author of The Breakthrough: Immunotherapy and the Race to Cure Cancer. For more information, visit www.thesecondopinion.org or call (415) 775-9956.
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National News
The difference between death and taxes is death doesn't get worse every time Congress meets.
Will Rogers, actor humorist, social commentator.
- In a major test case, Medicare is poised to cover a promising but expensive new type of cancer treatment, with significant restrictions meant to hold down the cost.
Cancer patients, doctors and drug companies are urging the Trump administration to remove the restrictions and broaden coverage so more patients can benefit from the treatment, known as CAR T cell therapy, or CAR-T. But insurance companies are pushing for the restrictions.
- The House Ways and Means Committee has cleared a proposed amendment to the Physician Payment Sunshine Act that would require manufacturers and suppliers to report to the CMS the value of any samples of medical devices, drugs and biologicals they give to physicians. This could include samples used for educational purposes. Medtech Insight
- The Comprehensive Addiction and Recovery Act of 2016 required the U.S. Department of Health and Human Services to create a task force to identify gaps or inconsistencies, and propose updates to best practices and recommendations for pain management, including chronic and acute pain. READ MORE
- A bipartisan bill that aims to stop "evergreening," a practice drugmakers use to extend monopolies by obtaining additional patents on minor drug changes, has been introduced by Sens. Dick Durbin, D-Ill., and Bill Cassidy, R-La. "The REMEDY Act will increase competition and help reduce drug costs," Durbin said. Axios
,
- Earlier this month,
the
House Subcommittee on Health, Employment, Labor, and Pensionshearing resulted in a bipartisan agreement on the issue of surprise medical bills that result when patients go to hospitals that are outside their insurance network: The bills have got to go. More than half of states provide consumer protection from unexpected out-of-network charges, but most of the laws aren't comprehensive. The result is a bipartisan public policy problem in need of a federal solution. The House subcommittee discussed possible legislative solutions, such as placing caps on how much out-of-network providers can charge, relying on doctors and insurers to determine payments within set parameters and the like. With bundling, patients would receive a single in-network bill, then hospitals would negotiate with specialists to determine how much they are paid. Industry representatives from hospitals and insurance companies are pushing back on specific proposals, but there is widespread agreement that any solution must protect patients and keep them out of billing negotiations. President Trump has also called the issue a priority, and legislation is expected to pass sometime this year.
- Introduced last week in this publication, pharmacy benefit managers are undergoing increased scrutiny. Two lawmakers have asked the Health and Human Services inspector general to investigate so-called spread pricing practices by these pharmaceutical middlemen as part of a larger inquiry into rising drug costs. In an April 8 letter released on April 10, the heads of the Senate Finance Committee pointed to instances where PBMs have purportedly used this practice to make millions of dollars in excess profits at the expense of state Medicaid programs. Spread pricing is a crucial but little-known part of the opaque pharmaceutical pricing system and refers to fees PBMs pay pharmacies and bill back to Medicaid. Stat: Lawmakers Ask The Trump Administration To Investigate PBM Pricing
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With the increase utility of telemedicine in oncology, more connectivity capabilities with patients is always a consideration.
Anelto Health has launched HomeAssure, a senior care solution that uses cellular connectivity from AT&T to monitor patients remotely, while built-in alerts, questionnaires and a 24/7 call-center service aim to cut down on unnecessary hospital trips. HomeAssure comes with an app that allows family members and friends to keep in touch and track patients' activity. MedCity News
.
- ASCO submitted comments on drug pricing to the Senate Committee on Finance
focused on concerns about the negative effects of certain PBM practices on patients and the cancer care system. These concerns include errors in filling prescriptions, treatment doses being altered without consultation with oncology care providers, duplicate patient copays due to incomplete dispensing, and drug waste resulting from incorrect doses or treatments being sent directly to a patient's home. Read ASCO's statement at
- ASCO, ANCO and MOASC urge members to contact their Congressional Representatives
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CMS News
- This is the first year that Quality Payment Program performance information will be publicly reported, so CMS is offering a supplemental Physician Compare preview period. Eligible clinicians and groups are encouraged to check their information before the preview period closes on April 27. Learn more at https://www.asco.org/advocacy-policy/asco-in-action/review-your-quality-payment-program-performance-information-it.
- ASH joined patient and provider groups in a letter to CMS expressing concern that the current Medicare inpatient reimbursement for CAR T-cell therapy is inadequate to protect patient access to treatment. The signees urged CMS to include policies in the FY2020 Inpatient Prospective Payment System proposed rule to improve the reimbursement associated with delivering CAR T-cell therapy to patients. Learn more at
https://www.hematology.org/Advocacy/Testimony.aspx.
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Affiliate Association News
- The 2019 ASCO Annual Meeting is the world's largest multidisciplinary oncology conference. By attending, you will witness the leading minds in our field explore the latest, cutting-edge research and set the course for the future of cancer treatment. Join us to collaborate with and learn from world-renowned faculty discussing state-of-the-art treatment modalities, new therapies, and ongoing controversies in the field.Register for ASCO 2019 by April 24 for the Best Rates!
- The Academy of Oncology Nurse & Patient Navigators (AONN+) application period for the Certification Exams being held at the AONN+ Midyear Conference in San Diego ends April 26.
The test date will be May 16. The AONN+ Midyear Conference takes place in San Diego from May 17-19. Learn more at
https://aonnonline.org/certification
- The deadline for submitting a research proposal is April 30. ASCO seeks applications for research grants for projects that use data from CancerLinQ Discovery, an offering of ASCO's CancerLinQ initiative, as a source. CancerLinQ Discovery provides curated sets of de-identified data from cancer patients to academic researchers, government agencies, and others in the oncology community to generate practical knowledge that will improve care. With grants of $32,500 each, ASCO will provide early and mid-career clinical oncology and health service investigators with real-world evidence that can inform their research. Research topics may include--but are not limited to--adoption of treatment guidelines across the U.S.; development of quality measures with the highest impact for clinical care; measuring the impact of educational programs on clinical practices; supportive evidence for informing ASCO policy priorities; or novel research on other topics. For more information, visit
www.conquer.org/cancerlinq-discovery-research-support-grant
.
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Submit your research on improving the quality of cancer care by
May 14.
The ASCO Quality Care Symposium, September 6-7 in San Diego, encompasses the latest strategies and methods for quantification of patient experience, provider efficiency, clinical outcomes, and quality and safety in the cancer care field. The Symposium will include a variety of sessions that will cover the latest science in precision and personalized medicine. Oral abstract presentations will feature the highest-quality science submitted to the Symposium and Poster Walks will allow for networking while exploring the presentation of the newest science. This meeting will bring leaders in quality improvement science together to participate in stimulating conversation with opportunities for networking among physicians, nurse practitioners, physician assistants, and others.
ASCO Quality Care Symposium
.
- Inland Empire Oncology Nursing Society is proud to announce the upcoming 5th Annual Education Fair for all medical professionals on May 18&19 at the Downtown Marriott in Riverside, CA. from 8:00am to 3:00pm. The Nursing Education agenda is geared toward oncology professionals - however the information is valuable in all aspects of nursing and care-giving. There is not one among us who has not been impacted by the effects of cancer in a loved one, friend or colleague. Registration for ONS members is $55.00. Registration for NON-ONS members is $65.00. Your paid registration includes, breakfast, lunch, give-aways, parking and 5 CEU's.
- Data abstraction for ASCO's QOPI Round 1 will close on June 3. Round 1 final reports will be available approximately two weeks after the round closes. Learn more at
- ASCO's Oncology Practice Conference takes place in San Diego on September 5. Focused on the business of cancer care, this conference will address the needs of practice administration and operations, with timely and practice strategies for the challenges faced by all those involved in the business of cancer care. Learn more and register at
https://meetings.asco.org/opc/register
.
- Join ASH on September 6-7, 2019, at the Fairmont Chicago, Millennium Park for the 2019 ASH Meeting on Hematologic Malignancies to gain knowledge that can help you make an immediate impact in your practice. The meeting will feature top experts in the field, comprehensive clinical content, the latest clinical research, and opportunities to interact with colleagues in an intimate, small-group setting with no competing sessions. The program content will be structured as "How I Treat" presentations, which will showcase each speaker's evidence-based treatment approaches, present cutting-edge scientific data that can be translated into new strategies for diagnosis and treatment, and address what to do in cases where there is no data. For more details or to register, please visit the
ASH Website
.
- ASCO and ASH have issued a clinical practice guideline update on the management of cancer-associated anemia with erythropoiesis-stimulating agents. Learn more at
- NCCN has published the following updates at
www.nccn.org
:
bone cancer (V2.2019), Hodgkin lymphoma (V1.2019), management of immunotherapy toxicities (V2.2019), pancreatic adenocarcinoma (V2.2019), soft tissue sarcoma (V2.2019).
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- Janssen Oncology informs ANCO and MOASC that the United States Food and Drug Administration has approved Balversa for patients with locally advanced or metastatic urothelial carcinoma, with susceptible FGFT3 or FGFR2 genetic alterations, that has progressed during or following platinum-containing chemotherapy, including within 12 months of neoadjuvant or adjuvant platinum-containing chemotherapy.
- Merck informs ANCO and MOASC that the United States Food and Drug Administration has approved Keytruda for the first-line treatment of patients with stage III non-small cell lung cancer (NSCLC) who are not candidates for surgical resection or definitive chemo-radiation or metastatic NSCLC.
- Genentech informs MOASC and ANCO of their FDA-approved therapy HERCEPTIN HYLECTATM
injection for subcutaneous use. For more information click HERE.
- Pfizer Oncology informs ANCO and MOASC that the indications for Ibrance now include male patients.
- Johnson & Johnson's startup arm JLABS will launch JLABS @ Washington, D.C., with a 32,000-square-foot facility at the Research and Innovation Campus of the Children's National Health System. The facility will cater to companies developing medical devices, health technologies, precision diagnostics and drugs for various applications, including pediatrics.
FierceBiotech
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MOASC CALENDAR
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(NCCN, San Francisco, September 27)
(NCCN, San Francisco, September 27-28)
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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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