California Oncology Weekly

"Where California Oncologists Go For Answers!"

A publication of the
Medical Oncology Association of Southern California, Inc.
February 4, 2020

This Weekly's Hot Topics    
  • TOMORROW, February 5, attend the Advanced CSCC Regional Lecture. Affiliate Association News
  • Assembly Bill 890 would give nurse practitioners autonomy. California News
  • HHS lifts limit on fees that providers can charge when sending patient health data to a third party. National News

California News

- Health officials have confirmed the first two cases of the new strain of coronavirus in Los Angeles and Orange counties, brought by travelers who came from the epicenter of the outbreak in Wuhan, China. In both counties, health authorities are following up with anyone who has had close contact with the patients, but they noted that casual contact with an infected person, such as visiting the same grocery store or movie theater, carries only "minimal risk of developing infection." Experts say that most Americans just need to wash their hands and proceed with their usual plans. "Don't panic unless you're paid to panic," said Brandon Brown, an epidemiologist at UC Riverside who has studied many deadly outbreaks. "Public health workers should be on the lookout. The government should be ready to provide resources. ... But for everyone else: Breathe."
- Assembly Bill 890 would give nurse practitioners autonomy. This bill would, specifically, allow NP's to work on their own without the need of physician oversight. Current scope of practice for Nurse Practitioners, with greater restrictions for Physician Assistants, in California, is an apparent slowing of care because when a nurse practitioner orders a prescription or medical supplies, it requires a physician's signature.
- In late October , you may have received a notice from the Department of Health Care Services (DHCS) regarding a process for resuming the clawbacks under Medi-Cal. There
is, currently, an injunction against DHCS on the clawbacks that is still pending a decision by the Court. Until now, the clawbacks have remained on hold due to an informal agreement between the parties. However, given the amount of time which has passed, the DHCS decided to re-instate the clawbacks. While the DHCS notice you received is a pre-emptive administrative maneuver to prepare for resuming the clawbacks, a date certain has not been provided to providers. Please note, California Pharmacist Association has learned that the DHCS is scheduled to resume the clawbacks on February 13, 2020. CPhA will continue to combat this action by DHCS because we know that this will cause irreparable harm. While the administrators of the Medi-Cal program have administratively decided to move forward, CPhA will re-engage the courts to stop this action. Please continue to be engaged in efforts to fight the actions of DHCS. If you have any questions, please do not hesitate to contact Nick Chiappe at
- In order to fight the reinstatement of the clawbacks, CPhA is preparing to go back to court. Take this quick survey immediately, as the ability to continue to stave-off the clawback is directly related to your participation in the is survey. (If you have multiple pharmacies, please submit a response for each one).

Noridian News 

Noridian/JEMAC has the following updates on their website 
Overpayments and Next Steps
Information for providers on what to do when a Demand letter is received. Submitting a new claim should be avoided. Read the complete update
Add DOS for PPV HCPCS Codes (90670, 90732), and Remove Next Eligible Dates for PPV HCPCS - Revised CR11335
CR 11335 instructs Medicare's Common Working File (CWF) to send the Date of Service (DOS) for both PPV HCPCS codes (90670 and 90732) to the Medicare Beneficiary Database (MBD). Read the complete update
Clinical Laboratory Fee Schedule and Laboratory Services Subject to Reasonable Charge Payment - CY 2020 Annual Update - Revised CR11598
CR 11598 provides instructions for the Calendar Year (CY) 2020 Clinical Laboratory Fee Schedule (CLFS), mapping for new codes for clinical laboratory tests, and updates for
laboratory costs subject to the reasonable charge payment. Read the complete update
Safeguards for Medicare Patients in Hospice Care
Medicare Part B Immunization Billing: Seasonal Influenza Virus, Pneumococcal, and Hepatitis B - Revised
Skilled Nursing Facility Prospective Payment System - Revised
Claims, Pricers & Codes
OPPS Pricer File: January 2020
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 visit:

MOASC News  

- MOASC's "Spotlight On Hematology," was held on Saturday, February 1, 2020, at the Waterfront Beach Resort in Huntington Beach.Topics presented were Acute Myeloid Leukemia, Myeloproliferative Neoplasm, Immunotherapy, Lymphoma, Acute Lymphoblastic Leukemia, and Multiple Myeloma. Thank you to AbbVie, Alexion, Amag Pharmaceuticals, Amgen, Astrazeneca, Coherus Biosciences, Merck, Pharmacyclics an AbbVie Company and Janssen Biotech, Inc., Takeda and Verastem, for their generous support of this meeting. If you would like copies of the handouts, please contact the MOASC office at 909-985-9061 ext. 1 or email

Join Dr. Ashkan Lashkari (MOASC Board member and key opinion leader from Providence Tarzana Medical Center, who will lead a round table discussion on NSCLC and Metastatic NSCLC on February 18, 2020 at 7PM, at Estate Restaurant + Bar - 1519 Wilshire Boulevard, Santa Monica, CA 90403. This program is open to, and intended for medical oncologists treating NSCLC/Metastatic NSCLC. RSVP at .
On Saturday, March 14, come celebrate MOASC's 30th Anniversary and listen to the  "Exciting Advances in Oncology"  as the focus of the MOASC 2020 Annual Oncology Summit Educational Symposium,  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 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

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The ANCO Board of Directors elected new Officers at its organizational meeting on January 21. Daniel P. Mirda, M.D., was re-elected as President; Michael Zachary Koontz, M.D., was elected as Vice President; and, Thach-Giao Truong, M.D., was elected as Treasurer. ANCO thanks Bradley Ekstrand, M.D., for his service as Vice President and Robert Robles, M.D., for his service as Treasurer.
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
ANCO members are encouraged to provide feedback on California's CURES program by completing a recently e-mailed UC Davis survey. The e-mail was from the Medical Board of California.

ACCC's 2020 Patient Assistance & Reimbursement Guide has the most up-to-date information on cancer drug assistance and reimbursement programs to help your patients alleviate the financial burden of their treatment. 
REGISTER for the 20th Multidisciplinary Management of Cancers: A Case-based Approach taking place in Napa on March 13-15.
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
Follow ANCO on Twitter at @ANCO News.

National News
- Tonight, President Donald Trump will call on Congress to support the administration's efforts to lower the cost of healthcare, according to a senior administration official. He will make "very specific requests" of lawmakers and will talk about lowering drug prices, banning surprise medical bills, promoting transparency and offering more price and quality information. He is also expected to contrast his healthcare vision with Democrats' ideas.
- After a federal judge denied the policy, HHS  lifted a limit on fees that providers and companies are allowed to charge when a patient requests to send their health data to a third party. The judge ruled that some portions of a 2016 HHS guidance are impermissible under the Administrative Procedure Act (APA). The APA governs how federal agencies develop regulations and conduct notice-and-comment rulemaking. The limit on fees that organizations are allowed to charge third parties, such as law firms or life insurers, no longer applies. But Roger Severino, director of the HHS' Office for Civil Rights, said that fees are still capped when a patient requests access to their own records.
- Oncology drugs, biologic therapies, antirheumatic and immunomodulators are the predictors of expected increase in hospital drug spend from July 1, 2020 to June 30, 2021. Full Story .

CMS News

Next Tuesday, February 11, 10am - 12pm PST, the Center for Medicare and Medicaid Innovation (CMMI) will present the final of -Future Direct Contracting webinars: 
Direct Contracting Payment Part 2 Office Hours, as a follow-up to the Direct Contracting Model Options Payment Part 2 Webinar on January 22nd.
Big Changes to Evaluation and Management Codes in 2021 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 more about the changes in the following attachments:
  1. E&M Overview
  2. CPT® Evaluation and Management (E/M) Office or Other Outpatient (99202-99215) and Prolonged Services (99354, 99355, 99356, 99XXX) Code and Guideline Changes
  3. CPT E/M Office Revisions-Level of Medical Decision Making (MDM) 

Additional Resources: American Medical Association

MOASC will be providing educational resources throughout 2020 to assist with the conversion. Questions regarding the changes can be sent to
- On January 27, CMS took action to cover Food and Drug Administration approved or cleared laboratory diagnostic tests using Next Generation Sequencing (NGS) for patients with germline (inherited) ovarian or breast cancer. NGS tests provide the most comprehensive genetic analysis of a patient's cancer because they enable simultaneous detection of multiple types of genetic alterations. Medicare first began covering laboratory diagnostic tests using NGS in March 2018 for Medicare patients with advanced cancer that met specific criteria. As a result of last week's decision, more Medicare patients will have access to NGS in managing other types of inherited cancers to reduce mortality and improve health outcomes.
Using genetic tests gives patients a more complete profile of their cancer cells and may help identify proven, targeted treatments. Patients who use NGS tests may also find they are good candidates for cancer clinical trials. CMS wants to ensure that patients have ready access to this diagnostic test when appropriate. Therefore, CMS provided Medicare's Administrative Contractors with discretion over whether to cover certain other indications. Read the  Decision Memo. See the full text of this excerpted CMS Press Release.

On January 8, MOASC joined ASCO for the Virtual Prior Authorization Advocacy Day, to ask Congress to pass prior authorization legislation. H.R. 3107, the Improving Seniors' Timely Access to Care Act, would help streamline prior authorization practices within the Medicare Advantage program to reduce delays in care for patients. It would require prior authorization be completed electronically, and would standardize the process, reducing administrative burdens. The bill would also enhance transparency around the use of prior authorization to help us further understand how these practices can be improved to reduce delays in care for patients. MOASC successfully engaged twelve federal lawmakers via twitter; five of them are co-sponsoring the bill. We will keep you updated as this progresses.

- 2020 is the last performance year (PY) for all Next Generation ACOs (NGACOs), regardless of entry date. CMS has stated there will not be a NGACO option for 2021 under current rules, despite sustained calls from MGMA and others to extend participation. This means current NGACO participants will have to move into the Medicare Shared Savings Program (MSSP), the newly announced Direct Contracting model, or the traditional fee-for-service landscape. For those considering a move from an NGACO to an MSSP ACO, your participation options would likely be limited to only the Enhanced track, meaning you could not join under one of the lower risk levels offered in the Basic track.
- The February 2020 CMS/CMMI newsletter highlights evaluation reports and publications that can be accessed by going to the data and reports page of the Innovation Center webpage. Reports highlighted in this edition: Comprehensive End-Stage Renal Disease Care Model; Accountable Care Organization Investment Model; Next Generation Accountable Care Organization Model.

Affiliate Association News

- TOMORROW, February 5 , MOASC member, The Angeles Clinic, with the Association of Community Cancer Centers (ACCC), will be hosting Advanced CSCC Regional Lecture, featuring Dr. Omid Hamid and Dr. Mark Faries. These experts will discuss caring for patients with CSCC and high-risk non-melanoma skin cancers. This event is complimentary (dinner provided), at Del Frisco's Double Eagle Steakhouse, 10250 Santa Monica Blvd, Suite 1700 Los Angeles, CA 90067. Seating is limited to the first 50 registrants Register online at  View invitation  HERE .


Next Tuesday, February 11, is the deadline to Submit an Abstract  of your findings at ASCO 2020, the largest multidisciplinary oncology conference in the world. There are more than 3,500 opportunities for scientific presentations and discussions. The 2020 ASCO Annual Meeting is being held May 29 - June 2, 2020 at McCormick Place in Chicago, IL.


On February 18, MOASC Board member and key opinion leader, Dr. Ashkan Lashkari (Providence Tarzana Medical Center), with Targeted Oncology™, will lead a round table discussion on NSCLC / Metastatic NSCLC. The program starts at 7pm, at Estate Restaurant + Bar, 1519 Wilshire Boulevard, Santa Monica, CA 90403. This program is open to, and intended for medical oncologists treating NSCLC/ Metastatic NSCLC. RSVP at


-Cedars-Sinai 3rd Annual Gastrointestinal Tumor Conference is scheduled for Saturday, April 25, 2020,itwill 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:


Save the Date! National Cancer Survivors Day® is Sunday, June 7, 2020.


- Oncology practices participating in the Centers for Medicare & Medicaid Innovation's Oncology Care Model (OCM) are willing to take on two-sided risk, according to the results of a survey conducted by the Community Oncology Alliance (COA). The results suggest that oncology practices are confident they can succeed in delivering high-quality and cost-effective cancer care as the health care system undergoes a paradigm shift from fee-for-service to value-based care. A total of 68 OCM practices responded to the 15-question survey which was available online between December 4-20, 2019. The survey results found:

47.1% (32 practices) opted to remain in the OCM with one-sided risk.

36.8% (25 practices) chose to remain and enter into two-sided risk.

32.4% (22 of the 25 practices) selected two-sided risk and had not received a single performance-based payment. 

16% (11 practices) said they were dropping out of the OCM.

Ten of the 11 practices leaving the OCM had not received a performance-based payment over the preceding four performance periods.

One practice indicated it had received at least one performance-based payment but opted to leave the OCM. Readthe full OCM survey results on the COA website.


ACCC's 2020 Patient Assistance & Reimbursement Guide has the most up-to-date information on cancer drug assistance and reimbursement programs to help your patients alleviate the financial burden of their treatment. 


NCCN has published updated guidelines for bladder cancer and chronic lymphocytic leukemia/small lymphocytic lymphoma at





In This Issue


Spotlight On Hematology
February 1, 2020

Oncology Summit 
March 14, 2020

City of Hope CME presents: Immunotherapy of Cancer: CAR T Cell to Checkpoint Inhibitors
March 18-21, 2020


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.



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