California
Oncology
Weekly
"Where California Oncologists Go For Answers!"
A publication of the
Medical Oncology Association of Southern California, Inc.
June 9, 2020
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This
Weekly
's Hot Topics
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- Assembly Bill 2100 unanimously passed the Assembly Health Committee and the Appropriations Committee. California News
- In an effort to further support you, MOASC would like your feedback on developing a California Clinical Trials network. MOASC News
- HHS is allocating an additional $250 million in Coronavirus Aid, Relief, and Economic Security Act money to help US health care systems treating COVID-19 patients. National News
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Senate and Assembly leaders issued a joint budget proposal last week, unifying the Legislature against billions in cuts proposed by Gov. Gavin Newsom as a deadline looms to pass a spending plan for California. The legislative proposal closely resembles a framework previously put forward by the Senate, which would delay cuts for months in anticipation of federal bailout. If that aid does not come, the state would dip further into reserves and defer payments to future years to avoid severe reductions to education and safety-net programs. Negotiations with Newsom, who proposed steep cuts to close a projected $54 billion deficit brought on by the coronavirus pandemic, are ongoing. The Legislature must pass a balanced budget by June 15 or forgo its pay. Read more from Alexei Koseff of the San Francisco Chronicle.
- Assembly Bill 2100 unanimously passed the Assembly Health Committee and the Appropriations Committee. Now, AB2100 is pending
a full Assembly Floor vote and you are asked to
reach out to your elected Assembly Member to vote YES on AB 2100.
AB 2100 (Wood)
would make the necessary changes to Medi-Cal's administration of the pharmacy benefit to its beneficiaries, in line with Governor Gavin Newsom's objective of moving the pharmacy benefit out of Medi-Cal Managed Care and into fee-for-service (FFS) without causing undue harm or burden to patients. The bill also corrects the "below-acquisition cost" reimbursement issue caused by the newly adopted methodology mandated by the Affordable Care Act in 2016.
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Following are the articles that will be found in
- Claim Status Category Codes and Claim Status Codes Update
- Implement Operating Rules - Phase III Electronic Remittance Advice (ERA) Electronic Funds Transfer (EFT): Committee on Operating Rules for Information Exchange (CORE) 360 Uniform Use of Claim Adjustment Reason Codes (CARC), Remittance Advice Remark Codes (RARC) and Claim Adjustment Group Code (CAGC) Rule - Update from Council for Affordable Quality Healthcare (CAQH) CORE
- Remittance Advice Remark Code (RARC), Claims Adjustment Reason Code (CARC), Medicare Remit Easy Print (MREP) and PC Print Update
- Summary of Policies in the Calendar Year (CY) 2020 Medicare Physician Fee Schedule (MPFS) Public Health Emergency (PHE) Interim Final Rules
- Value-Based Insurance Design (VBID) Model - Implementation of the Hospice Benefit Component
- Supplier Education on Use of Upgrades for Multi-Function Ventilators - Revised
- Therapy Codes Update - Revised
- International Classification of Diseases, 10th Revision (ICD-10) and Other Coding Revisions to National Coverage Determination (NCDs)--October 2020 Update - Rescinded
- Medicare providers can now submit their medical record documentation electronically, whether attached to the original claim submission or in response to a documentation request.
Read the complete update
- Medicare Fee-for-Service (FFS) Response to the Public Health Emergency on the Coronavirus (COVID-19) - Revised SE20011. The Secretary of the Department of Health & Human Services declared a public health emergency (PHE) in the entire United States on January 31, 2020.
Read the complete update
- Upcoming Education: Please see Noridian's schedule of events webpage for upcoming trainings on Telehealth and COVID-19.
JEA
,
JEB
,
JAF
, and
JFB
- How to Avoid Duplicate Claim Denials training session on June 11, 2020 from 10:00am to 11:00am-PDT. Duplicate denials continue to be one of the top billing errors. Unnecessary duplicate filing of Medicare claims cost the provider's office valuable time and resources as well as Medicare's time and money to process them.
Register here
.
- Medicare Physician Fee Schedule (MPFS) Webinar - June 17, 2020. This event includes: Medicare Physician Fee Schedule Basics, Locating fee schedules, Indicator list and descriptors, Resources, Questions and Answers
Read the complete update
- Duplicate Claims Webinar - June 25, 2020. This event includes: Claim Denial Reasons and Solutions, Repeat Modifiers, Noridian Medicare Portal (NMP), Resources
Read the complete update
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- In an effort to further support you, MOASC would like your feedback on developing a California Clinical Trials network. This would allow you to participate in various clinical trials without having to do all the work on your own, saving both time and money; while offering your patients access to potentially life-saving drugs. Before endeavoring into this project, MOASC must determine if there is a real need for such a network and if members would be interested in participating. Please take a few minutes to respond to our survey by Monday, June 15, 2020.
Take the survey NOW!
Thank you!
- MOASC is collaborating with Targeted Oncology™ in an effort to provide members additional clinical education. Each Targeted Oncology™ virtual meeting is designed around a specific disease type, presenting case-based data, driven by peer-dialogue and led by expert physicians. Discussions also include diagnostics, current therapy guidelines and potential treatment options. These meetings are intended for actively practicing oncologists treating patients with the presented disease. Post-meeting and on-site, an HRA® survey will be provided to better understand physicians' educational needs in a regional, live event. You will be offered compensation of $300 by HRA® for your contributions to the meeting and your completion of the short survey.
Skin Cancers
will be discussed on Wednesday, June 17, 2020 at 7:00pm to 8:30pm-PDT. Gino K. In, MD, PhD, Keck School of Medicine, USC will present to those practicing oncologists treating skin cancers. Please register
www.targetedonc.com/events
. If you have any questions, please do not hesitate to contact MOASC at
[email protected]
or 909-985-9061 ext. 1.
- MOASC presents a webinar for Physicians on
Thursday, June 18, 2020
, 5:30pm PDT.
Arthur Lurvey, MD, FACP, FACE, California Medicare contractor Medical Director, will discuss Updates on Dealing with Issues related to the COVID-19 Pandemic. Physicians, NPP's and all interested staff are welcome. The webinar affords physicians to enter into live dialogue with the California Medicare medical director. Objectives:
How to get the latest clinical resources from CMA, CMS, CDC, and NIH
;
The latest federal rules regarding physician payments and loans
;
To differentiate and use various forms of telemedicine to treat patients
;
To improve documentation and correct charts
;
New Preauthorization for selected topics starting July 1
; and T
he new E&M office definitions starting in 2021.
For more information, and to register for this webinar, contact the MOASC office at
[email protected]
or call 909-985-9061 x1.
- MOASC LunchTime Series Teleconference on Wednesday, June 24, 2020 at 12:30pm PDT. Topic: COVID-19 Billing and Coding Updates for Your Cancer Center. Presented by Teri Bedard, BA,RT,CPC, Director, Client Services, Revenue Cycle Coding Strategies. Since March, CMS has updated the coding guidelines and waivers multiple times. Staying up to date can seem daunting with changes happening quickly, this teleconference will highlight the areas you need to know for your cancer center. We will review the changes to telehealth services, supervision, provider-based designations, and coding for services. Objectives: As a result of attending this session, participants will be able to: 1) Understand the changes to telehealth services specific to oncology services; 2) Understand changes to physician supervision for therapeutic services; and 3. Understand how to code for services with necessary modifiers and place of service codes. For more information, and to register for this webinar, contact the MOASC office at
[email protected]
or call 909-985-9061 x1.
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Dear MOASC Members,
As you are aware, our membership year is coming to an end and ramping up for the 2020-2021 year. During these unprecedented times, MOASC continually monitors the public health crisis, the re-opening and economic recovery of the state. The health and well-being of MOASC members, and the patients they serve, are of utmost importance.
In order to support you, your staff and your patients during this difficult time, when cash flow has been negatively impacted, MOASC is extending your membership to October 1, 2020.
This will provide you with three months of free membership. The remaining nine months will be assessed at a prorated amount.
MOASC is able to do this with the generous support from our Industry Sponsors:
AstraZeneca, Pfizer, Puma Biotechnology, AbbVie, Merck, Verastem, Amgen, Astellas, Bristol Myers Squibb, Johnson & Johnson, Foundation Medicine, Genentech, Genomic Health, Kite Pharma, Eli Lilly, Novartis, Oncology Supply, Regeneron, Sanofi-Genzyme, Stemline Therapeutics
and Takeda.
MOASC knows every aspect of your practice has been disrupted and is here to help you adapt to the changes with the necessary tools and resources to be successful.
Together, we will continue to advance oncology in California. If you have any questions, please contact the MOASC Office by phone 909-985-9061 ext.1 or at
[email protected]
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The Association of Northern California Oncologists (ANCO) continues to monitor the novel coronavirus (COVID-19) pandemic and is committed to providing the membership the best possible information with which to make clinical and personal well-being decisions.
We encourage member practices to let ANCO know of COVID-19 resources they are depending upon and found useful and how they are responding to COVID-19 and serving their patients and staff at [email protected] (Use Subject: COVID-19: RESPONSE). Thanks!
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Applications period has been extended 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 or 2021. Awards will be announced 30 days after the deadline; funds will be disbursed during the year in which the national meeting to be attended takes place. Learn more at
https://anco.org/membership/fellow-benefits/
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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
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Use ANCO's
job board
to post or search for employment opportunities at ANCO member practices.
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Follow ANCO on Twitter
at @ANCO News.
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National News
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A House bill would direct HHS to study whether greater use of telehealth during the coronavirus pandemic improved access and patient outcomes. The study would encompass overall telehealth usage, various types and modalities of telehealth services offered to patients and settings where telehealth was used.
mHealth Intelligence
- The director of health care at the Government Accountability Office (GAO), expressed concerns during a Senate panel hearing that the FDA is not adequately inspecting foreign drug firms, leaving the US supply chain at risk as the number of foreign-made drugs sold in the US continues to grow. The director also voiced concerns on the agency's practice of warning foreign drug firms of impending inspections, which is not being applied to US drug makers. Becker's Hospital Review
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HHS is allocating an additional $250 million in Coronavirus Aid, Relief, and Economic Security Act money to help US health care systems treating COVID-19 patients, even as some providers have decided not to accept federal assistance due to worries about government conditions or potential risks. Healthcare Finance
- Physician practices and hospitals need to adjust to the new normal brought by the COVID-19 pandemic and seize the momentum for rapid change and capabilities to improve patient experience and boost access to care. To adapt to the new normal, health organizations must shift from fee-for-service to value-based care, find ways to lower health care costs while delivering high-quality results, and create a "digital front door" that can offer unique experiences to patients, noted chief innovation officer of Colorado-based health system SCL Health. Becker's Hospital Review
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CMS News
- The Centers for Medicare & Medicaid Services, Center for Program Integrity will host a series of Special Open Door Forum (SODF) calls to educate the public about a new initiative underway to develop a Medicare Fee for Service (FFS) Documentation Requirement Lookup Service prototype. Also, to allow physicians, suppliers, IT and Electronic Health Record (EHR) Developers and Vendors, and/or all other interested parties to provide feedback to CMS and inform how interested parties can get involved or track the progress of this initiative.
CMS is collaborating with ongoing industry efforts to streamline workflow access to coverage requirements, starting with developing a prototype Medicare FFS Documentation Requirement Lookup Service and is participating in two workgroups to promote development of standards that will support the Lookup Service. One workgroup is a private sector initiative hosted by Health Level Seven (HL7), the Da Vinci project. The second workgroup is The Office of the National Coordinator for Health Information Technology (ONC) Fast Healthcare Interoperability Resource (FHIR) at Scale Taskforce (FAST).
By working with HL7, ONC, other payers, providers, and EHR vendors, CMS is helping define the requirements and architect the standards-based solutions. In parallel, CMS is preparing to support pilots testing the information exchanges for Medicare FFS programs and possibly coordinate pilots with volunteer participants to verify and test the new FHIR based solutions.
The goals of the Documentation Requirement Lookup Service prototype are to reduce provider burden, reduce improper payments and appeals, and improve "provider to payer" information exchange. The prototype will be made accessible to pilot participants and will allow providers to be able to discover the following at the time of service and within their EHR or practice management system:
1. If Medicare FFS requires prior authorization for a given item or service; and
2. Documentation requirements for:
3. Home Oxygen Therapy
4. Continuous Positive Airway Pressure (CPAP) Devices
5. Home Blood Glucose Monitors and Supplies
6. Non-Emergency Ambulance Transportation (NEAT)
7. Respiratory Assist Devices (RAD)
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Affiliate Association New
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- Register for the June 9 web conference, "How telehealth can increase access to care and improve healthcare quality," 11am-12:30pm PDT. The Agency for Healthcare Research and Quality (AHRQ) presenters will discuss the impact of telemedicine on chronic disease management and the factors that help or hinder the use of telemedicine in urban areas. The Web conference also will cover the evidence of how telehealth can be used routinely and during public health emergencies such as a pandemic.
Learn more and register
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This is your chance to make a difference in bringing about change. Has your practice suffered from these issues with Express Scripts?
- Your pharmacy is not allowed to participate in Express Scripts commercial or Part D networks;
- Your pharmacy is reimbursed below cost from ESI on what they reimburse verses the direct cost of the drug;
- Your pharmacy is reimbursed below cost from ESI on what they reimburse less cost of drug plus DIR fees plus pharmacy staff salaries and benefits plus all other direct and indirect costs;
- Patients you have that participate in Prime Therapeutic commercial and Medicaid networks is now being managed by ESI as of April 1, and
- You have received notice that patients that participate in Prime Therapeutic Part D networks are going to be managed by ESI as of January 1, 2021
If you have, please click on this survey https://www.surveymonkey.com/r/ESICancerCare. Frier Levitt is collecting this data to determine an action plan for which they will follow up with next steps. It is very important that on the very last question to provide specific examples directly to Jesse Dresser [email protected] regarding being reimbursed below cost from ESI which includes direct and indirect costs. If you do not provide specific information, Frier Levitt will not be able to provide next steps. Jesse walks through and describes each question on the survey by clicking on this link https://vimeo.com/425976701. Hopefully this will help if you are confused and need more direction on any of the questions in the survey. This survey is very important as COPA has, for over a year, discussed multiple issues with filling drugs for your patients that participate in ESI networks and either not be able to participate in network or are reimbursed below cost. Please complete the survey by Monday June 22. The very last question asks for the date you are submitting all specific data and examples to Jesse. If you finish the survey by June 22 and need additional time to submit the examples, please note the date you will be submitting that information. Please do not make the date later than June 29. Thank you.
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Over the past year COA/COPA spent a lot of resources with Frier Levitt through surveys with oncology practices from across the country, regarding CVS' slow rolling the processing of network applications. COA has seen no oncology practices following up with Frier Levitt. For a cost of $1,500, Frier Levitt will review your application to see if CVS is slow rolling your application. If it is determined that this is the case your practice will be included in a letter written by Frier Levitt to CMS, pertinent members of Congress, CVS and any other parties deemed important on this issue, demanding CVS stop the slow rolling of these applications. If CVS responds appropriately by discontinuing the slow rolling of your application, only those practices that will be noted in the letter will be guaranteed to receive the benefit of any action by CVS on this issue. Please contact Jesse Dresser [email protected] at Frier Levitt and let him know that you wish to participate in this matter. Please do this by the June 30. Thank you.
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The success of the 2020 Virtual Community Oncology Conference has inspired COA to meet with advocates virtually on July 15.
To help cancer patients and advocates get the best possible cancer care in this brave new COVID-19 world, COA is hosting their first-ever Virtual Community Oncology Advocacy Summit.
More details are coming soon, so sign up to receive the latest updates!
- The International Lung Cancer Congress will hold their 21st Annual meeting on July 23-25, 2020. The live webcast will provide current, practical information on the management of lung cancer, as well as a look at the novel agents and strategies with the potential to shape the future of lung cancer therapy. Leading international and national experts will provide perspectives on how to apply the latest data on targeted agents, immunotherapy, surgery, and radiation oncology in the clinic. Click
here
to register.
- Cedars-Sinai 3rd Annual Gastrointestinal Tumor Conference is on Saturday, September 12, 2020. Concise and comprehensive updates on the most recent research and advances in immunotherapy for gastrointestinal cancers, will be presented. 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:
cedars.cloud-cme.com/gicancercme
.
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The American Society of Hematology has decided to transition the
ASH Meeting on Hematologic Malignancies
to a virtual experience
to provide important education while assuring the wellbeing of the hematology community around the world. Registration will open in the next few weeks. Visit their
website
for schedule updates.
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The American Society of Clinical Oncology (ASCO) Nominating Committee is seeking recommendations for potential candidates for the upcoming ASCO election
, for service beginning in June 2021. All members are invited to recommend individuals you believe possess the qualities needed to lead the Society in the future. Your participation in this process will help ensure that our Society's leaders represent the diversity of our membership. Please contact
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Industry News
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Pfizer plans to support biotech's most promising clinical R&D programs by investing up to $500 million. Small to midsize companies will be the focus in the areas of inflammation and immunology, internal medicine, hospital, oncology, rare disease and vaccines.
MarketWatch
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Pharmacyclics
will present a live broadcast on redefining approaches in frontline chronic lymphocytic leukemia (CLL) treatment.
The broadcast is scheduled for Wednesday, June 17th at 4:30 and 6:30pm. Click
here
to register and for more information.
- Takeda Oncology changed the name of their patient support program from Takeda Oncology 1Point to
Takeda Oncology Here2Assist
effective May 18, 2020
.
Please note that only the name is changing. Patients and providers will continue to have the same high level of comprehensive, personalized support. Please review the
attached information
for important details.
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Deciphera presents an educational webinar on QINLOCK for the treatment of adult patients with advanced GIST who have received prior treatment with 3 or more kinase inhibitors, including imatinib.
More Information
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As medical practices outline plans to reopen amid COVID-19, there's a lot to get done to make sure patients and staff are safe. When it comes to vendors and reps, RxVantage has got this covered. From editable policies and visitation guidelines to sample drop protocols and tips for running hassle-free video conferences, this playbook includes everything you need to reopen your office with confidence. Included in the playbook, 1) Customizable policy for vendor/rep visits 2) Protocol for sample drops 3) Meal delivery protocol 4) Workflow in case of facility re-closure 5)Process checklist for employing and enforcing schedule changes.
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MOASC CALENDAR
"Updates on Dealing with Issues related to the COVID-19 Pandemic"
June 18, 2020
COVID-19 Billing and Coding Updates for Your Cancer Center.
June 24, 2020
(Davis, New Dates:
March 11-12, 2021)
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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 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.
MOASC: P.O. Box 161, Upland, CA 91785 | P (909) 985-9061 | F (909) 804-5006| www.moasc.org
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