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 .
February 26, 2019
This Weekly's Hot Topics
  • California Attorney General unveils new legislation that is aimed at curbing increasing drug prices. (California News)
  • Executives from seven Big Pharma companies will meet with Senate Finance Committee. (National News)
  • CMS Interoperability and Patient Access Proposed Rule Listening Session March 5. (CMS News)

California News
- California Attorney General Xavier Becerra and California Assembly Member Jim Wood held a press conference to unveil new legislation that they say is aimed at curbing increasing drug prices. The bill will prohibit "collusive agreements in which a drug company transfers anything of value to delay a competitor's research, marketing, or sale of a competing version of its drug."  You can access the Fact Sheet on the bill here.  
- Last Friday was the deadline for California Legislators to introduce bills for consideration this year. As of Friday morning, there were nearly 1300 Assembly bills in print.  On the Senate side, there were 540 bills in print, excluding resolutions. It was expected that about 600 more Assembly bills and 250 more Senate bills were to be introduced before the night was over.  
- In case you have not seen so yet, the CMA Q2 Resolutions have been released and include two resolutions written by members of the Specialty Delegation in which MOASC President, Warren Fong, M.D. is a member. One such Resolution of interest is:
All of the resolutions for Q2 are here: Q2 Resolutions.

- The CMA is soliciting applications for appointment to CMA's Councils. At the October House Of Delegates meeting, many CMA members expressed a willingness to serve on one of CMA's Councils, which consider and often revise Resolutions during the year-round process, and also develop Major Issue reports and recommendations. Applications will be solicited in May, but it is not too early to request endorsements from your specialty societies and geographic delegations (and, of course, from the Specialty Delegation itself). Contact Nathan Skadsen of your interest.
- Both before and after Gavin Newsome's election, CMA has provided input to the Governor and his key staff as efforts begin to widen healthcare coverage and lower the costs of obtaining it. Tam Ma, Governor Newsom's Deputy Legislative Secretary and a health policy expert, will address the Meeting of Specialty Societies on March 14, in which MOASC President, Warren Fong, M.D. will attend. This meeting is also a great chance for your society to inform CMA of its top priorities in a setting where you can get support from other specialty societies as well. MOASC & ANCO welcome member input by March 8th to take to Sacramento. Contact with your priorities. Thank you.

Noridian News  
Noridian/JEMAC has the following updates on their website
MLN Connects Provider eNews:
Announcements : SNF Provider Review Reports: Review Your Data by March 4; SNF-PPS Patient Driven Payment Model: Updated Resources; Promoting Interoperability Program: 2019 Resources
Events:  MIPS: 2019 QCDR Measure Development and Review Webinar Series-February 28 and March 5; Home Health Quality Reporting Program In-Person Training-March 5 and 6; Open Payments: Transparency and You Call-March 13; MIPS Data Submission Office Hours Sessions-March 19; SNF Value-Based Purchasing Program: Phase One Review and Corrections-March 20 
Publications:  Quality Payment Program: 2017 MIPS Performance Feedback Web-Based Training Course-New; Appeals Call: Audio Recording and Transcript-New; LCDs MLN Matters Article-Revised; How to Use the Medicare National Correct Coding Initiative Tools Booklet-Revised; How to Use the Medicare Coverage Database Booklet-Revised; Advance Care Planning Fact Sheet-Reminder
* HPTCs Code Set-April 2019 Update
* DMEPOS Fee Schedule-April 2019 Update
* Modification of the MCS Claims Processing System Logic for Modifier 59, XE, XS, XP, and XU Involving the NCCI PTP Column One and Column Two Codes
* Multi-Jurisdictional Contractor Advisory Committee (CAC) Meeting Documents
Forthcoming  Noridian JEMAC meetings/webinars/workshops include:
* Home Health Referrals and Clinical Documentation Requirements Webinar (February 26)
* Submitting Your Enrollment Online-Part 1 Webinar (I&A; February 27)
* Modifier 59, National Correct Coding Initiative (NCCI) and Medically Unlikely Edits (MUE) Webinar (February 28)
* Mammography, Pap and Pelvic Screenings-After Hours Webinar (February 28)
* What To Do With Rejections for Overlapping Claims Webinar (March 7)
* PECOS Part 1: Full Overview of PECOS Webinar (March 13)
* Telehealth Services Webinar (March 19)
* Telehealth Services-After Hours Webinar (March 21)
* PECOS Part 2: Full Overview of PECSO Webinar (March 27)
* Independent Diagnostic Testing Facility (IDTF) Enrollment Webinar (April 10)
* Medicare Part A/B Revalidation Webinar (April 24)
* Submitting Your Enrollment Online-Part 1 Webinar (I&A; May 29)
* Submitting Your Enrollment Online-Part 2 Webinar (PECOS; June 26)
Visit http://med.noridianmedicarecom/web/jeb/education/training-eents  for more information and to register.
- Medicare FFS Response to the 2018 California Wildfires MLN Matters Article - Revised. The MLN Matters Special Edition Article SE18025 on Medicare Fee-for-Service (FFS) Response to the 2018 California Wildfires is updated. This article was revised to advise providers that the public health emergency declaration and Section 1135 waiver authority for the State of California were renewed on February 6.

MOASC News  
- MOASC is looking for feedback from members regarding individual instances of copay accumulator use in California.  Specific information needed are the names of the healthplans, group numbers (if applicable), PBMs and employers, with just your contact information. The information you provide would go a long way in helping patient and provider advocacy groups and organizations like MOASC & ANCO to fight to limit their use. Please send your information to . Thank you.
- Researchers find 'modest improvement' in physician burnout and call for continued efforts to address the problem. Despite the drop, burnout remains an issue, and the burnout rate among physicians is higher than in other professions, researchers wrote.
MOASC is interested in how their members are coping with the stressors, and burnout that follows, in today's healthcare environment. Please take a few moments to respond to the following questions.
Thank you for your time.
-  MOASC's LunchTime Series presents " How to maximize the impact of life science reps and resources at your practice" on Wednesday, February 27,  2019  at 12:00pm PT.  Unannounced and poorly timed visits from life sciences reps can disrupt a practice's already packed schedule. Coordinating the logistics of these visits cause distraction and steal valuable time from staff, ultimately impacting the quality of patient care and experience. RxVantage is a free cloud-based solution designed to maximize office efficiency by automating the scheduling process, while still allowing the practice to have complete control over visitation rules and expectations. To register click on the link
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ANCO News  
Registration is now open for the 19th Multidisciplinary Management of Cancers: A Case-based Approach, taking place at the Silverado Resort and Spa in Napa on March 15-17, 2019. Go to to register and arrange for housing.
- SAVE THE DATES--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.
National News 
- Executives from seven Big Pharma companies will line up for questioning from the Senate Finance Committee in a hearing dubbed "Drug Pricing in America: A Prescription for Change, Part II." Committee Chairman Chuck Grassley (R-Iowa) started the inquiry into drug prices last month. Grassley has supported efforts to crack down on manufacturer pay-to-delay tactics that stall generics from entering the market, as well as legislation to expedite generic drugs and biosimilars to market, which faces opposition from drug companies.
- More than a quarter of physicians (28%) report that the prior authorization process required by health insurers for certain drugs, tests and treatments have led to serious or life-threatening events for their patients  according to a new survey by the American Medical Association. Learn more at www.cmadocs/org/newsroom/news/view/ArticleId/27952/Survey-finds-prior-authorization-hurdles-have-led-to-serious-adverse-events.
- Health care joint venture aims to cut drug costs, improve care . A joint venture to reduce costs and improve care for employees of Amazon, JPMorgan Chase and Berkshire Hathaway will focus on insurance benefits, primary care and pharmacy costs, according to unsealed testimony from a court case. The nonprofit venture, led by Dr. Atul Gawande, initially aims to reduce costs and improve care for over 1.2 million employees of the three companies. GeekWire
- Pfizer and Ochsner Health System will jointly develop digital tools to improve access to clinical trials. The partnership did a "proof of value" project, using Fast Healthcare Interoperability Resource standards to transfer simulated patient data from Ochsner's EHR to Pfizer's data capture system. MobiHealthNews
- Several phone apps are sending sensitive user data, including health information, to Facebook without users' consent, according to a report by The Wall Street Journal. An analytics tool called "App Events" allows app developers to record user activity and report it back to Facebook, even if the user isn't on Facebook, according to the report.
CMS News 
- CMS Administrator Seema Verma invites all Medicare fee-for-service providers and industry-wide stakeholders to the Interoperability and Patient Access Proposed Rule Listening Session followed by an overview by CMS experts on March 5 . Learn about the provisions that impact you and get answers to your clarifying questions to help formulate comments for formal submission. Topics include:
  • Patient access through application programming interfaces
  • Health information exchange and care coordination across payers
  • Public reporting and prevention of information blocking
  • Provider digital contact information
  • Revisions to the conditions of participation for hospitals and critical access hospitals RFIs
CMS encourages you to review the proposed rule prior to the listening session. On February 11, CMS released the Interoperability and Patient Access proposed rule outlining opportunities to make patient data more useful and transferable through open, secure, standardized, and machine-readable formats, while reducing restrictive burdens on health care providers. In addition, CMS released two Requests for Information (RFIs) to obtain feedback on:
Interoperability and health information technology adoption in post-acute care settings
Role of patient matching in interoperability and improved patient care.
CMS opened the data submission period for MIPS eligible clinicians who participated in Year 2 (2018) of the Quality Payment Program (QPP). Data can be submitted and updated any time from January 2, 2019 to April 2, 2019, with the following exceptions:
For clinicians who reported Quality measures via Medicare Part B claims throughout the 2018 performance year, CMS will receive your quality data from claims processed by your Medicare Administrative Contractor, and claims for services furnished during 2018 must be processed within 60 days after the end of the 2018 performance period. CMS Web Interface users need to report their Quality performance category data between January 22 and March 22, 2019. Submit your 2018 MIPS data by visiting the QPP website and log-in using your QPP access credentials. CMS encourages clinicians to log in early to get familiar with the system. Please note, clinicians who are not sure if they are eligible to participate in the QPP can check eligibility status using the QPP Participation Status Tool. For more information about how to submit data, please review resources available in the QPP Resource Library. CMS also recently posted new 2019 resources to the library, be sure to check the full list. If you need further assistance, please contact the QPP by phone at 1-866-288-8292, (TTY) 1-877-715-6222,, or via a local technical assistance organization offering no-cost support.
- The Centers for Medicare & Medicaid Services (CMS) has published a new infographic with summarized information about beneficiaries in the Medicare program. The Medicare Beneficiaries at a Glance infographic includes information on types of Medicare coverage, utilization of healthcare services, average cost for specific services, top chronic conditions, beneficiary satisfaction and access to care, and usual source of care for calendar year 2016. For example, did you know that 3.7 million individuals enrolled in Medicare in 2016? Or that the top chronic condition among Medicare beneficiaries is high blood pressure? To find these and other statistics, please visit the CMS Medicare Beneficiaries at a Glance infographic at: 
Affiliate Association News 
ASCO is inviting all oncology practices to participate in the 2019 Survey of Oncology Practice Operations which aims to give practices a deeper look at a variety of oncology management topics, including productivity, revenue, staffing levels, salaries, expenses, and more. The Survey is open through March 8. Learn more and take the Survey at 
- American Cancer Society Cancer Action Network invites you to a lunchtime discussion on Chimeric Antigen Receptor T-Cell (CAR T) Therapy: A New Advancement for Fighting Cancer , presented by Joseph Alvarnas, MD, Associate Clinical Professor Department of Hematology, City of Hope Comprehensive Cancer Center. Monday, March 11, 2019, 11:15 a.m. - 1:00 p.m., The California Endowment 1000 Alameda St., Los Angeles, CA 90012, (800) 449-4149, Tahoe room. Each new year brings major advancements in how we treat cancer and improve outcomes. None has been more pivotal than the development of Chimeric Antigen Receptor T-cell (CAR T) therapy.  Please join ACS for an educational discussion that will provide an overview of CAR T-cell therapy. Learn about the way in which CAR T-cell therapy treats blood cancer, what CAR T means for the future of cancer treatment, as well as key considerations and the current patient access environment.  Complimentary lunch will be provided. Free parking onsite. RSVP by March 6 to Jessica Parker: or call 916-813-1252.
- Registration is open for the ACCC 45th ANNUAL MEETING & CANCER CENTER BUSINESS SUMMIT (AMCCBS), a national thought leadership forum where the intersection of BUSINESS, QUALITY, TECHNOLOGY, and POLICY leads to solutions for a changing healthcare industry. Hosted by the Association of Community Cancer Centers (ACCC), Cancer Center Business Summit, and Foley & Lardner LLP, AMCCBS is a dynamic event for key stakeholders immersed in the business and policy of cancer care. Join healthcare executives, business leaders, and multidisciplinary providers-from C-suite executives, oncology specialists, directors and administrators-to professionals in health IT, public policy, research, pharmacy and biotechnology, academia and consultancy, from March 20 - 22, 2019, in Washington D.C.
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. The deadline for submitting a research proposal is April 30. For more information, visit
The Academy of Oncology Nurse & Patient Navigators (AONN+) is pleased to share that the application period for the Certification Exams being held at the AONN+ Midyear Conference in San Diego is through 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 
-ASH joined other provider groups, patient advocates, laboratories, and diagnostic test manufacturers in a letter to the Centers for Medicare and Medicaid Services (CMS) to express concerns about the recent implementation of the National Coverage Determination (NCD) for Next Generation Sequencing (NGS) for Medicare Beneficiaries with Advanced Cancer. The organizations believe that the new interpretation will restrict patients' access to medically necessary and relevant testing of germline mutations in cancer patients and will adversely impact cancer patients' care and outcomes. To read the full letter, click here.
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 . In addition, The Doctor's Company, the nation's largest physician-owned medical malpractice insurer, offers up to a 10% premium discount to physicians whose practices have achieved QOPI Certification. Learn more at
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.
NCCN has published the following updates at
breast cancer (V4.2018), chronic lymphocytic leukemia/small lymphocytic lymphoma (V3.2019), cutaneous melanoma (V1.2019), primary cutaneous lymphomas (V2.2019).
Industry News
- Coherus BioSciences informs MOASC and ANCO that in 2018, the U.S. Food and Drug Administration approved U DENYCA™ (pegfilgrastim-cbqv) a biosimilar to Neulasta® (pegfilgrastim). Biosimilars are intended for use in place of existing, branded biologics to treat a range of chronic and often life-threatening diseases, with the potential to reduce costs. For additional information, please visit
- StemlinTheapeutics  informs ANCO and MOASC that the United States Food and Drug Administration has approved Elzonris f or patients with blastic plasmacytoid dendritic neoplasm (BPDCN).
In This Issue

Spotlight On Oncology 



(San Francisco, February 28-March 2) 
(Napa, March 15-17)
11th Annual Palliative Care Summit
(San Francisco, April 8-9) 
 5th World Congress on Controversies in Breast Cancer (CoBrCa): When is Less More? 
(Use code cobrca10 for ANCO Member Discount;
San Francisco, September 4-6) 
(NCCN, San Francisco, September 27-28) 
8th International Cancer Metastatis Congress
(San Francisco, October 25-27) 
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 |