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.
March 14, 2017
Hot News
*The California Chronic Care Coalition (CCCC) is on a mission to inform patients in California about their rights as health care consumers and they need your help!  (Go to California News)
*Opposing AB 265 (Wood)  (Go to California News)
* Noridian edits for code G0498 only covers Yondelis (J9999), at this time  (Go to Noridian News)
*Hematology-Oncology Physician Opportunity  (Go to MOASC News)
*Oncologists may be unknowingly leaving hundreds of millions in federal funding on the table  (Go to CMS News)

California News 
The California Chronic Care Coalition (CCCC) is on a mission to inform patients in California about their rights as health care consumers and they need your help! Daily, patients navigate obstacles obtaining the care they need, such as: Scheduling appointments with specialists; Accessing life-saving medicines; Attaining tests and examinations.
CCCC is promoting, an online resource to help patients identify when, why and how to file a complaint with their health plan and/or the California Department of Managed Health Care (DMHC) to demand the care they need and deserve. The Partner Toolkit provides all the resources you need to educate your network about their patient rights. The information is free and easy to access. Newsletter content & sample blog post
Social media posts PowerPoint slides - for group presentations; Flyer/Insert/Handouts - for patient and community events; Website badge - promote on your website and encourage your networks to do the same. In addition, representatives are available for group presentations, roundtable briefings, patient and community events and conferences. 
Thank you so much for your support of and commitment to California's patients. We all know how difficult it is to navigate the complex health care system, especially those with multiple chronic conditions. We appreciate your help in sharing this tremendous resource with all Californians.  Please contact Beth Hadley at or 916-658-0144 for more information or to discuss ways to work together to provide these resources to your networks.
- Being a co-signer to the group letter opposing AB 265 (Wood), MOASC wishes to thank you for reaching out to your patients, staff, colleagues, and affiliated hospitals.  As you know, AB 265 would ban patients in California from receiving copayment assistance programs from pharmaceutical manufacturers when a therapeutically equivalent or interchangeable brand or generic drug is available at a lower cost.  This is of great concern to the patient advocacy community because copay assistance programs are a valuable resource for many patients who may be struggling to afford increasing out of pocket costs with their insurance coverage for medications.  Which is why we are continuing to actively oppose this bill through letters, calls, email and social media.
Can we count on you to post to your social media channels?
Below are a few sample posts we've drafted for your convenience:
  • Stop the ban of RX copay assistance programs for patients. #NoOnAB265
  • Patients rely on RX copay assist programs to help pay high OOP costs for meds. #StopAB265
  • Why WOOD someone ban RX assistance programs to help patients #Access needed meds? #NoOnAB265
The California Dialogue on Cancer is pleased to announce the American Cancer Society's upcoming 80% by 2018 California Colorectal Cancer Roundtable events in Sunnyvale on March 21st and Los Angeles on March 22nd.  The featured speaker for the Roundtables will be Richard Wender, MD, Chief Cancer Control Officer of the American Cancer Society.  These events will be an opportunity to connect with different groups (community clinics, health plans, companies, hospitals, and community members) who are working toward our collective goal of 80% nationwide screening for adults aged 50+ by 2018.  Participation is free.  Please register by March 10th.  For more information, click on the following links.
The Center for Cancer Prevention and Treatment at St. Joseph Hospital in Orange invites you to attend: Primary Care and Oncology: Practical Lessons, An Advanced Practice Clinician (Mid-Level) Symposium. This one-day event will be held on April 27th, in Southern California. Pre-registration is required, as seating is limited. CEU's/CME's will be provided. Breakfast and lunch will be included. For more information on the symposium, see the flyer below, or  click here to register.

Noridian News
Noridian edits for code G0498 only covers Yondelis (J9999), at this time. Noridian failed to include additional drugs that could be infused via pump for an extended period of time. Recognizing this error, Noridian has assured that:
1. A new coverage article is being prepared and will be published by Noridian/JEMAC very soon. It includes several additional covered drugs-J9000 (doxorubicin), J9181 (eoposide), J9190 (flororacil), and J9371 (vincristine). Additional drugs will be added if necessary.
2. Depending on the number of impacted claims, a mass adjustment MAY be ordered. Until then, you should appeal and the denial may be overturned.
- Noridian/JEMAC has posted the following updates to its website
* MLN Connects Provider News
Announcements --Home Health Care: Proper Certification Required; Home Health Quality Reporting Program Provider Training-May 3 and 4; Clinical Laboratories: Report Lab Data through March 31; Hospice Quality Reporting Program: Rerun Your Quality Measure Reports
Claims, Pricers, and Codes --April 2017 Average Sales Price Files
Events --
Publications --Medicare Enrollment Resources Educational Tool-New; Chronic Care Management Services Call: Audio Recording and Transcript-New; Advance Care Planning Fact Sheet-Reminder
* ASC Payment System-April 2017 Update CR9998
* Self-Service Reopenings Through Noridian Medicare Portal-More Options Available!
* DMEPOS Fee Schedule-April 2017 Update CR9988
Forthcoming Noridian/JEMAC webinars 
* Noridian Medicare Portal Functionality for Part B Providers (March 23)
* Reopenings Webinar (March 28)
* Noridian Medicare Portal Registration for Part B Providers (April 4)

Noridian Medicare Portal Functionality Webinar for Part B Providers - March 23, 2017 
The Noridian Provider Outreach and Education (POE) staff is hosting a Noridian Medicare Portal Functionality for Part B Providers webinar on March 23, 2017 at Noon Pacific Time. 
Read the complete update.

  DHCS/Medi-Cal News 
DHCS/Medi-Cal has announced that it will extend the deadline for Medi-Cal meaningful use reporting for the 2016 program year to May 2. After that date, DHCS will only accept 2017 attestations.

  MOASC News
- The City of Hope conference,  How the Experts Treat Hematologic Malignancies , will be March 16 - 18, 2017 at the Mandarin Oriental, Las Vegas . City of Hope experts will provide the conferee with the most recent advances in bone marrow transplant, multiple myeloma, lymphoma and leukemia. Updates on improved curative and palliative treatments and evolving molecular and immunologically-based system therapies, as well as important, completed or ongoing clinical trials, will be profiled and discussed. This activity has been approved for AMA PRA Category 1 Credit™. Please register at one of the following: 626-218-5622 or
The 2nd Annual UC Irvine Health Hematology Symposium, presented by the Department of Pathology and the Department of Medicine, Division of Hematology/Oncology, will take place on Saturday, March 25, 2017, at Disney's Paradise Pier Hotel, Anaheim, CA.
Topics will include: * Molecular diagnostics in selected disorders; * Myelodysplastic syndrome;
* Primer on flow cytometry for the general practitioner; * Venous thromboembolism;* Approach to the evaluation of anemia;* Selected vector-borne diseases;* Lupus anticoagulant and antiphospholipid antibody syndrome.  For registration or more information please contact Dannielle Lampkin at  or 714-456-8621 or visit the Hematology Symposium registration website,

- The Center for Cancer Prevention and Treatment at St. Joseph Hospital in Orange invites you to attend: Primary Care and Oncology: Practical Lessons , An Advanced Practice Clinician (Mid-Level) Symposium. This one-day event will be held on April 27th, in Southern California. Pre-registration is required, as seating is limited. CEU's/CME's will be provided. Breakfast and lunch will be included. For more information on the symposium, see the flyer below, or  click here to register .
Hematology-Oncology Physician Opportunity - Bakersfield, CA
Comprehensive Blood & Cancer Center (CBCC) has an immediate opening for a Hematology-Oncology specialist.
Requirements: California medical license in good standing with no past negative actions. BC/BE in Hematology/Oncology and authorized to work in the United States.
CBCC is a 100,000 ft outpatient comprehensive cancer center with 200+ team members providing support.  CBCC is one of approximately 200 physician group practices nationwide participating in the OCM project, a model designed to support higher quality and more coordinated cancer care. Please see our website for a detailed listing of services offered.
Our comprehensive team of experts includes:
6 hematology and medical oncologists; 2 radiation oncologists; 2 dermatologist/Mohs surgeons
1 ENT surgeon; 1 Pain management physician; 1 Infectious Disease specialist; 1 Naturopathic physician; 7 mid-levels; 1 onsite Radiologist with offsite support; 1 LCSW; Mind-Body medicine
Certified patient navigators and genetic counselor; Onsite physician dispensary.
Please submit all inquiries to:
Anthony LaMacchia, Comprehensive Blood & Cancer Center, 6501 Truxtun Avenue,
Bakersfield, CA 93309

Like us on Facebook  Follow us on Twitter   View our profile on LinkedIn

  - ANCO is organizing a series of Hematologic Malignancies Updates in 2017. The first Update will take place on May 6 at the Sacramento Hyatt Regency on May 6 with Mehrdad Abedi, M.D., University of California, Davis, Sandy Wong, M.D., University of California, San Francisco, and Julian Davis, M.D., University of California, Davis. The latest research on novel treatment modalities for hematologic malignancies, myeloma, and amyloidosis, along with case studies for these diagnoses, will be presented. These updates are supported by Janssen Biotech, Merck, Pfizer Oncology, and Pharmacyclics. Watch for a meeting announcement in late March .

National  News
The  Institute for Clinical and Economic Review  (ICER) has posted a  Draft Scoping Document  that will shape an upcoming report on poly (ADP-ribose) polymerase (PARP) inhibitors for treatment of ovarian cancer . ICER's report is expected to review the evidence on rucaparib (Rubraca™, Clovis Oncology), niraparib (Tesaro, Inc.), and olaparib (Lynparza™, AstraZeneca). Report analyses will also provide information on the cost-effectiveness and potential short-term budget impact of the therapies. The Draft Scoping Document will be open to public comment for three weeks until March 27, 2017 at 3pm Pacific Time.

Anthem Blue Cross has announced that effective May 15, Myriad Genetic Laboratories will no longer be an in-network laboratory provider. A complete list of in-network participating laboratories may be obtained online at  > Provider > Find a Doctor. 

Anthem Blue Cross is implementing important changes to its national drug list (formulary) effective April 1. Review these changes at .

UnitedHealthcare's commercial reimbursement policies will begin requiring biosimilar biological products to include a modifier that identifies the manufacturer of the specific product for dates of service on or after June 1. Specifically, the modifier for Q5101 (filgrastim) Zarxio will be ZA (Novartis/Sandoz) and the modifier for Q5102 (infliximab) Inflector will be ZB (Pfizer/Hospira).

CMS News
- Oncologists may be unknowingly leaving hundreds of millions in federal funding on the table that would compensate them to better care for the sickest Medicare beneficiaries , and CMS is launching a national campaign, TOMORROW, Wednesday, to encourage physicians to take advantage of the funds. CMS has been  paying physicians an average of $42 per patient per month   for consulting with specialists and coordinating chronic care services. While the program could help lower costs for treating patients with chronic issues, the program, which started on Jan. 1, 2015, hasn't been utilized by physicians due to a lack of awareness about the care management billing code and push back from patients who would be on the hook for the 20% copayment every time their physicians bill for it. Physicians must obtain permission from patients to bill for coordinated care. CMS hopes its campaign will make patients and doctors aware that the financial burden on patients isn't the barrier it's are perceived to be. Most Medicare beneficiaries have supplemental insurance that will cover co-pays for them. The campaign will also highlight a series of regulatory changes made this year to incentivize billing for care management. The agency raised the reimbursement amount for the care management code by $1 per use, and introduced three new chronic care management codes. The codes pay more depending on the complexity of the patient's needs. The new reimbursement scale ranges from $43 to over $141.
The campaign will involve social media postings, webinars and 
a new campaign website  
with information the billing code. CMS will also distribute display posters and postcards to providers to share with patients that highlight chronic care management benefits. The agency plans to release an animated video to play in doctors' offices that explains the benefits of chronic care management services. Contact the MOASC Office on how to bill for these codes.  

Affiliate Association News  
ACCC and the Association for Molecular Pathology (AMP) are pleased to present a series of free Virtual Molecular Tumor Boards on March 16 and 24 . Register at
4 Reasons to Attend the 2017 Community Oncology Conference, on April 27 & 28, 2017 at the Gaylord Hotel, National Harbor, MD (just outside Washington DC).
1)The  packed agenda covers the timeliest topics in today's community oncology landscape;
2)Hear from national oncology leaders including Skip Burris, MD, Daniel George, MD, and Kavita Patel, MD. The keynote speaker is figure skater and Olympic gold medalist Scott Hamilton;
3)Hear firsthand from national and regional payers, employers, and coalitions as they discuss the latest efforts they are engaged in to move cancer care payment reform forward. The 2017 Conference will feature the sixth Payer Exchange Summit;
4)With a record-setting 1,200+ in attendance, the opportunities to network with physicians, practice administrators, pharmacists, nurses, and thought-leaders in community oncology are unsurpassed.
The Spring Round of ASCO's QOPI is open for reporting. The Spring Round will close on May 9. Learn more at

To better understand the contributions of advanced practice providers (APPs) working in oncology, ASCO is partnering with four other healthcare provider organizations (Advanced Practitioner Society for Hematology and Oncology, American Academy of PAs, Association of Physician Assistants in Oncology, Oncology Nursing Society) to conduct a survey that will examine the specific roles and responsibilities of APPs within the cancer care delivery team. Read more about the survey at If you are contacted to participate, you will receive the survey via postal mail or an e-mail from ASCO urges members to complete the survey and return it as instructed by March 29. The survey should take 20 minutes or less to complete.
ASCO is tracking legislation that would increase the legal age for the purchase of tobacco products to 21 , known as "Tobacco 21," in multiple states. The minimum age of legal access to tobacco products is set by the U.S. government at 18 years of age, however, state and local governments can set older ages. ASCO is committed to policies that will contribute to the reduced prevalence of tobacco use and prevent the occurrence of cancer and other smoking-caused diseases. Last year, ASCO posted a new policy brief,  Minimum Legal Age for Purchase of Tobacco Products , in support of increasing the minimum legal age of purchase of tobacco products to 21 years of age.  View  a report on these tobacco 21 bills in the states.
- ASCO Removes Restrictions on Researchers™ Conflict of Interest .   ASCO has removed all restrictions on author relationships previously in the 2013 Policy for Relationships with Companies statement, and all eligible manuscripts and abstracts otherwise will be considered for peer review, regardless of any financial relationships of authors. The decision was announced in the official journal of ASCO, in January 2017.
Applications are now being accepted for ASCO's Quality Training Program at . This comprehensive 6-month program is oncology-focused and teaches clinicians how to improve quality using evidence-based decisions and how to reduce clinical and process variation for predictable and sustainable results. In 2017, there will be two regional locations, including Portland, OR (Session 1: April 20-21; Session 2: June 28-29; and Session 3: October 18).
ASH and the College of Pathologists (CAP) have published an evidence-based guideline that addresses the initial work-up of acute leukemia. Read the guideline at .
NCCN has published updated NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) with NCCN Evidence Blocks™ for non-small cell lung cancer (V4.2017); pancreatic adenocarcinoma (V3.2017), and for Colon and Rectal Cancers. The NCCN Guidelines® for Rectal Cancer are currently available as Version 3.2017. The NCCN Guidelines for Colon Cancer are currently available as Version 2.2017.   For the complete updated versions of the NCCN Guidelines, NCCN Guidelines with NCCN Evidence Blocks™, the NCCN Compendium®, the NCCN Chemotherapy Order Templates (NCCN Templates®), and the NCCN Imaging Appropriate Use Criteria (NCCN Imaging AUC™), please visit .

Industry News 
- Genentech BioOncology informs ANCO that the United States  Food and Drug Administration has approved Tecentriq for treatment of local advanced or metastatic urothelial carcinoma in patients with disease progression during or after platinum-containing chemotherapy or have progression within 12 months of neoadjuvant or adjuvant treatment with platinum-containing chemotherapies.

- Heron Therapeutics informs ANCO that NCCN has granted Sustol a Category 1 recommendation for use in patients receiving highly or moderately emetogenic chemotherapy (HEC or MEC) and has identified Sustol as a preferred agent for preventing CINV following MEC.

In This Issue



LunchTime Series
March 29, 2017
NCCN Meeting in Florida 
March 23-25, 2017

COA Annual Meeting 
  April 27-28, 2017

ASCO National Meeting in Chicago
June 2-6, 2017


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 |