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 .
September 24, 2019
This Weekly's Hot Topics

  • As with the Community Oncology Alliance COPA group, part of the California Pharmacists Association's public relations effort to outline the negative impacts that PBMs have on the viability of community pharmacies is through personal impact stories. California News
  • September 27, your comments are due for the CY 2020 Proposed Rules CMS News
  • Tomorrow! ASCO seeks: comment for Systemic Therapy for Melanoma and application for their Leadership Development Program AND Health Policy Leadership Development Program. Affiliate Association News

California News

The Orange County Pharmacists Association released their 24th episode of their podcast on pharmacy and healthcare. Their new episode highlights an issue affecting many pharmacists in California: DIR Fees and the Medi-Cal clawbacks. The podcast features CPhA President Dr. Ken Thai who speaks with OCPhA member and podcast host, Dr. Tony Dao. You can listen to it by clicking here.
- As with the Community Oncology Alliance COPA group, p art of the California Pharmacists Association's public relations effort to outline the negative impacts that PBMs have on the viability of community pharmacies is through personal impact stories. One strategy is gathering personal stories from pharmacists, or patients about their first hand account of PBM abuse. Another strategy is to provide a video testimonial that will be used in advocacy and media outreach efforts. If you are willing to share your written story, please email Nick Chiappe at AND Nicolas Ferreyros, Director of Communications , . If you are willing to share your personal testimony by video, please email Nick Chiappe and he will add your name to the list of interview candidates. 
- Provider PBM Complaint Hotline, a s a result of   AB 315   (Wood) as well as AB 2674 ,  is open at the California Department of Managed Health Care. DMHC is now required to review "patterns of provider complaints for unfair billing patterns," once you go through the provider dispute resolution process. You may have recently received a message from one of your health plans regarding this matter. If you have complaints about billing patterns from your PBM or a health plan, physicians and pharmacies need to submit a complaint through this process. The DMHC will only act on "patterns" of complaints, so multiple providers need to submit complaints to establish a record of problems in order for DMHC to act. This is standard procedure for claims filed by providers and consumers alike.
The link to submit a provider complaint to the Department is   here Towards the bottom of the page you will see "Submit a Provider Complaint". If you click on that link it will take you to an online portal where providers can register and submit complaints to DMHC online. If you need assistance, you can contact the DMHC Provider Complaint phone line at 1-877-525-1295. DMHC encourages you to read the information on this page about eligible and ineligible claims and the requirement to first go through the Provider Dispute Resolution (PDR) process.
The California Medical Association (CMA) will host a webinar entitled Medicare Changes: What Physicians Need to Know About 2020 Changes to Audits and Reimbursements and Other Updates on October 10 at 12:15PM. Register at .
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 . Thank you for your continued support of CAPP.

Noridian News 

- Noridian/JEMAC has the following updates on their website 
New Medicare Card: Transition Period Ends in Less Than 4 Months; Hospices: Call for Panel on Assessment Instrument and Quality Measures-Nominations due September 30; Local Coverage Determination Meetings; Average Sales Price Files: October 2019
Medicare Part B Clinical Laboratory Fee Schedule: Revised Information for Laboratories on Collecting and Reporting Data for the Private Payor Rate-Based Payment System-Revised; Quality Payment Program: 2019 MIPS Resources; Advance Care Planning-Revised; Medicare Billing: CMS Form CMS-1500 and the 837 Professional-Revised; Medicare Secondary Payer-Revised; Radiation Oncology Listening Session: Audio Recording and Transcript; Medicare Secondary Payer Provisions Web-Based Training Course-Revised; Quality Payment Program for Merit-based Incentive Payment System (MIPS) APMs in 2019 Web-Based Training Course-Revised; SNF-PPS: Patient Driven Payment Model Videos

* Appealing Resubmitted Claims
* Medicare Part B Clinical Laboratory Fee Schedule: Revised Information for Laboratories on Collecting and Reporting Data for the Private Payor Rate-Based Payment System-Revised SE19006 
* October 2019 Update of the Ambulatory Surgical Center (ASC) Payment System CR11457
* Provider Enrollment Application and Correspondence Details Available in NMP
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)
For more information and to register visit:

MOASC News  

- Targeted Oncology ™welcomes MOASC to its Strategic Alliance Partnership Program. MOASC will also be partnering with The American Journal of Managed Care®.  Targeted Oncology is a multimedia resource that offers content and expert opinions on standard and emerging treatments in the oncology field. "We are so honored to work with MOASC," said Michael J. Hennessy Jr., president of MJH Life Sciences™, parent company of Targeted Oncology™ and AJMC®. "By teaming up with the association, we look forward to supporting oncologists improving the quality of, and access to, patient care."
Mark your calendars for November 14, 2019, to attend the "MOASC Educational Series Program.Bobbi Buell will speak to billing changes across the board and California benchmarks with specific healthplan issues; Carynne Godfrey,  Noridian representative will address specific Medicare changes; Dawn Holcombe & Willis Triplett will bring attendees up to date regarding USP800 (eff. 12/1/19) and any revisions to USP797, Arthur Lurvey, MD, FACP, FACE Medicare Contractor Medical Director, will speak on New E&M codes for 2021; New imaging rules; Payment changes; Classification of Physician Relationship to Patient; Off - label Coverage, Remedios Turner , Medi-Cal representative will review state initiatives of coverage and more.
- 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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ANCO News  

- ANCO's Annual Professional Education Meeting 2019 is taking place at The Claremont Resort in Berkeley on October 17. Register at .

- The  ANCO-UCSF Precision Oncology Symposium is taking place at the Marine's Memorial Club in San Francisco on Saturday, November 9. Download the meeting announcement at
- ANCO members will receive a complimentary registration when they register as an "Early Bird ANCO Member" for the Best of WCLC 2019-San Francisco on September 23Learn more at ; register at .
- ANCO's VuMedi Channel ASCO Highlights 2019 is now available. Watch the presentations and listen to the speakers from ANCO's ASCO Highlights 2019 at

- September 25 Deadline Fast Approaching! ANCO annually funds one  Young Investigator Award  (YIA) for a qualified Northern California early-career cancer researcher through Conquer Cancer®, the ASCO Foundation. We encourage all eligible Northern California Fellows and Trainees to apply. The YIA is a one-year, $50,000 grant that provides research funding to promising physicians to support their transition from final years of subspecialty training to faculty appointment and to encourage and promote quality research in clinical oncology. In addition, ANCO funds two  Merit Awards  for the 2020 ASCO Annual Meeting and an award to attend the 6thAnnual Scientific and Career Development Retreat in October 2020, which is by invitation only. Learn more at . For questions about eligibility and the application, please contact Conquer Cancer at .
- ANCO physician members, their practice staff, and representatives from ANCO's corporate members must register to access password protected content on the new ANCO website ( ) at .
Follow ANCO on Twitter at  @ANCO News .

National News

General Chapter <800> will be official December 1, 2019, and is not subject to any pending appeals. USP plays no role in enforcement of <800>. State and other regulators may make their own determinations regarding the enforceability of <800>. 
<800> is informational and not compendially applicable, during the postponement and pending resolution of the appeals of <795> and <797>. On June 1, 2019, USP published revisions to <795> Pharmaceutical Compounding - Nonsterile Preparations and <797> Pharmaceutical Compounding - Sterile Preparations, as well as a new chapter <825> Radiopharmaceuticals - Preparation, Compounding, Dispensing, and Repackaging. After publication of the revised and new compounding standards, USP received appeals on certain provisions in <795>, <797>, and <825>. USP's Bylaws provide that the official date of a standard under appeal must be postponed while an appeal is pending. In light of these appeals, USP is postponing the official dates of the revised <795> and <797> and the new chapter <825>. In the interim, the currently official chapters of <795> (last revised in 2014) and <797> (last revised in 2008) will remain official.  For any questions, please contact the Healthcare Quality & Safety Team at

CMS News 

CMS has published a final rule for calculating $4 billion in state Medicaid disproportionate-share hospital cuts  for fiscal 2020 and $8 billion for each subsequent year through 2025. The DSH cuts were supposed to go into effect Oct. 1, but the House of Representatives on Thursday passed a continuing resolution to fund the government and within that was a provision to delay the cuts until Nov. 21. The Senate will likely consider the same bill this week.
A federal judge, last week, overturned the CMS rule that cut Medicare payments for some hospital clinic visits, siding with hospitals who sued to prevent the changes. AU.S. District Judge in Washington ruled that the Trump administration had exceeded its authority when it expanded the so-called site-neutral pay policy to evaluation and management services at off-campus hospital clinics. The goal was for Medicare to pay the same rate to hospitals as to independent physicians. In her ruling Judge Collyer said the CMS rule, in effect since Jan. 1, didn't qualify as a method for controlling unnecessary spikes in hospital use as the government had argued.
Under a recently finalized rule, providers enrolling in Medicare, Medicaid, or CHIP will be required to disclose current or previous "affiliations" with other providers or suppliers with certain public integrity infractions. Specifically, CMS will require disclosure during enrollment of any current or previous affiliation with another provider and/or supplier that has uncollected debt or has been excluded, suspended, or had billing privileges revoked from a federal healthcare program. Until it is updated, CMS will not require new disclosures via the CMS-855 form and providers will only make required disclosures upon specific request from CMS. The rule also provides CMS with additional authority around preventing or revoking enrollment for certain infractions. These provisions go into effect Nov. 4, 2019. To learn more, review CMS'  fact sheet.

Affiliate Association News

- ASCO seeks comments BY TOMORROW, on its draft guideline entitled  Systemic Therapy for Melanoma (by September 25); and, Diagnosis and Management of Squamous Cell Carcinoma of Unknown Primary in the Head and Neck (by September 27) at 
Apply BY TOMORROW, September 25, for ASCO's Leadership Development Program AND Health Policy Leadership Development Program. ANCO and MOASC encourage eligible members (physicians who have completed their subspecialty training between 2010 and 2015) to apply at . Learn more and apply at .
COA met with a new NPR national reporter last week in DC. Part of the conversation turned to PBMs and drug waste from mail order pharmacies. Now the reporter is interested in doing a story! COA is looking for patient stories about PBM mail order waste. Do you think you have a patient that would be willing to talk to the reporter about it? Ideally COA needs a story of big mail order waste ($100k+ in drugs) and a patient that is relatively eloquent. COA will also want to connect the reporter with their oncologist. Please contact Nicolas Ferreyros, Director of Communications,
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 .  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 .
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 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: .
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 . Each year, the Innovatix + Essensa National Meeting & Expo brings together members, contracted suppliers, and staff from Premier's Alternate Site Programs division for three highly anticipated days of learning, networking and business development. The educational sessions feature nationally recognized policy leaders and influencers who share their knowledge about ways to help your business thrive. Please plan to register early to secure your spot as space is limited, and we anticipate it to fill quickly. 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.
Download the mid-year update on the MyCOA Members Portal! This update is available exclusively to COA's members and subscribers through the MyCOA member portal:
Already a member? Just click here and log in to  MyCOA.
Need to sign up? Click here to sign up on  MyCOA for free!
Start planning now for the meeting you cannot miss! Take a look at the preliminary program for the 61st ASH Annual Meeting and Exposition, December 7-10, 2019, in Orlando. Start planning your meeting now and ensure you have access to the most up-to-date information on this year's exciting sessions, speakers, and events. While there, 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.
JOIN TODAY the  Friends of Community Oncology PAC a political action committee registered with the Federal Election Commission (FEC). As the only independent PAC entirely funded by supporters of community oncology and dedicated solely to community oncology, the PAC is bipartisan, supports the campaigns of congressional champions, and gives critical visibility to their issues. Through the PAC, members are off the sidelines and engaged with key lawmakers. Active political engagement is vital to protect patients and practices from burdensome legislation and overreaching regulatory action. To become a member or for more information go to
NCCN has published updated guidelines: .

Industry News

Janssen Oncology invites you to their upcoming webinar Prostate Cancer: Understanding Today's Treatment Challenges on September 30, 2019 at 5:00pm PST. For more information click here and to register click go to

In This Issue


Educational Series 
November 14, 2019

Oncology Summit 
March 14, 2020


(NCCN, San Francisco, September 27-28) 

8th International Cancer Metastatis Congress
(San Francisco, October 25-27) 
Supportive Care in Oncology
(ASCO, San Francisco, October 25-26) 

Kaiser Permanente National Oncology Symposium (Los Angeles, November 8-9)
  ANCO-UCSF Precision Oncology Symposium (San Francisco, November 9)

Best of WCLC San Francisco
Early Bird ANCO member registration available; November 23) 

ASCO's Gastrointestinal Cancers Symposium
(San Francisco, January 23-25, 2020) 

ASCO's Genitourinary Cancers Symposium
(San Francisco, February 13-15, 2020) 

Stanford's Review of the 61st Annual ASH Annual Meeting (Half Moon Bay, February 15, 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  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|

ANCO: P.O. Box 151109, San Rafael, CA 94915 |  P (415) 472-3960 | F (415) 472-3961 |