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
.
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- January 31, is the deadline for applications to the Global Challenge to Prevent Breast Cancer. California News
- First-ever Surgeon General for California appointed. California News
- COPA has updated their PBM Issues spreadsheet. Affiliate Association News
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- This Thursday, January 31, is the deadline for applications to the Global Challenge to Prevent Breast Cancer. Learn more and apply at: www.ToPreventBreastCancer.org. The goal of this important initiative is to surface transformative ideas to catalyze the field of breast cancer prevention research. The application has been streamlined (less than 2 pages), and it is not too late to submit a strong entry. Winners will receive an award and cash prize, and have the opportunity to present to leaders in the field. The best ideas will influence $15 million in grant funding to be disseminated by CBCRP over the next five years. CBCRP needs your ideas! The Global Challenge is looking for ideas from both researchers (faculty, students, postdocs, and other researchers) and non-researchers (advocates, patients, community members, laypeople, or anyone else). This competition is open to applicants from across the globe; you do not need to be in California to apply.
- Governor Gavin Newsom announced the appointment of Burke Harris on Martin Luther King, Jr. Day, as the first-ever surgeon general for California, describing her as a "pediatrician, entrepreneur, and nonprofit CEO" who has "dedicated her professional career to understanding the link between adverse childhood experiences and toxic stress in children, and the effect both have on future health outcomes." As surgeon general, Burke Harris will "urge policymakers at every level of government and leaders across the state to consider the social determinants of health, especially for children."
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MOASC & ANCO encourages Californians to support SB 38, as introduced by
Senators Hill, Glazer, McGuire, and Portantino on December 3, 2018, regarding flavored tobacco products. Existing law, the
Stop Tobacco Access to Kids Enforcement (STAKE) Act, prohibits a person from selling or otherwise furnishing tobacco products, as defined, to a person under 21 years of age. Existing law authorizes specified enforcing agencies to assess civil penalties for violations of the
STAKE Act. This bill would prohibit a tobacco retailer from selling, offering for sale, or possessing with the intent to sell or offer for sale, a flavored tobacco product, as defined. The bill would authorize an enforcing agency to assess civil penalties under the
STAKE Act for a violation of this prohibition.
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- MLN Connects Provider eNews:
Announcements
: New Medicare Card: Web Updates; CDC Opioids Training Modules; Open Payments Data Update; Reporting Changes in Ownership-Reminder
Events:
New Electronic System for Provider Reimbursement Review Based Appeals Call-February 5; New Part D Opioid Overutilization Policies Call-February 14.
Publications:
Proof of Delivery Documentation Requirements MLN Matters Article-New; Appropriate Use Criteria for Advanced Diagnostic Imaging Fact Sheet-New; New MBI: Get It, Use It MLN Matters Article-Revised; ICD-10-CM, ICD-10-PCS, CPT, and HCPCS Code Sets Educational Tool-Reminder
* Clinical Lab Basics
* Modifier Tutorials Available
Forthcoming
Noridian JEMAC meetings/webinars/workshops include:
* Provider Enrollment Supporting Documentation Webinar (February 13)
* Ordered, Referred and Prescribed Services Webinar (February 20)
* Transitional Care Management Webinar (February 21)
* Submitting Your Enrollment Online-Part 1 Webinar (I&A; February 27)
* PECOS Part 1: Full Overview of PECOS Webinar (March 13)
* Telehealth Services Webinar (March 19)
* Telehealth Services-After House 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)
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- SAVE THE DATE! Saturday, February 23, 2019 for MOASC's Oncology Summit, Advancing Cancer Care in the Elderly, at the Hyatt Regency Huntington Beach Resort & Spa. Mark your calendar and keep watch for further information on speakers and topics. [email protected].
- MOASC Member, City of Hope CME presents, Current Trends in Urologic Oncology CME Conference, February 8 to February 10, 2019, The Pines Lodge, Beaver Creek Resort, CO. Support this program and invite a colleague to join you.
- MOASC's LunchTime Series presents the interactive tool, "Know Your State" webinar Wednesday, February 13, 2019 at 12:00pm PT. Learn more about a resource for educating your patients about medication access and affordability options in California and the other 49 states. Sponsored by Johnson & Johnson, topics within the tool include: Medicaid expansion, state pharmaceutical assistance programs (SPAPs), Low-income subsidy (LIS) eligibility information, state health insurance assistance programs (SHIPs), standard prior authorization (PA) forms, National Foundations and other nonprofit resources, oral parity laws, advocacy connector, biosimilar legislation, continuity of care and state legislature resources. Join by calling (908) 316-2436 conference ID 73711760. Contact the MOASC Office if you have any questions [email protected].
- MOASC member, City of Hope CME would like to invite physicians and nurses to save the date for their upcoming conference, How the Experts Treat Hematologic Malignancies, March 21 to 23, 2019 at the Waldorf Astoria, Las Vegas.
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- 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 http://www.multicancers.org to register and arrange for housing.
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National News
- The Community Oncology Pharmacists Association (COPA) has updated their PBM Issues spreadsheet based on responses received back from their membership. If you have additional sources or information, please contact Ricky Newton at [email protected]. Click
HERE to view the Spreadsheet.
- Some business-related tax deductions previously allowed under law are no longer available under the Tax Cuts and Jobs Act, which took effect last year. Danielle Lackey explains provisions and limits that employees should be alerted to.
TLNT
- Individuals with head and neck cancers and the mutated gene PIK3CA, but not those without the mutation, who took nonsteroidal anti-inflammatory drugs had 25% to 78% higher survival rates compared with those who didn't use NSAIDs, researchers reported in the Journal of Experimental Medicine.
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CMS News
- Are you in compliance with Qualified Medicare Beneficiary (QMB) billing requirements? The Centers for Medicare and Medicaid sent a reminder about the QMB requirements asking if your office is in compliance. Medicare providers may not bill people in the QMB program for Medicare deductibles, coinsurance, or copays, but state Medicaid programs may pay for those costs. Providers who inappropriately bill individuals enrolled in QMB are subject to sanctions.
To mitigate risk to your organization, it is best to verify that your organization has established processes to routinely identify the QMB status of Medicare beneficiaries prior to billing for items and services. Correct billing problems that occur. If you erroneously bill individuals enrolled in the QMB program, recall the charges (including referrals to collection agencies) and refund the invalid charges they paid.
States require providers to enroll in their Medicaid systems for claim review, adjudication, processing, and issuance of Medicaid RAs for payment of Medicare cost-sharing. Check with the states where your beneficiaries reside to determine the enrollment requirements. CMS recommends the following resources:
Use Medicare 270/271 HIPAA Eligibility Transaction System (HETS) data; see MLN Matters® Article SE1128
Check your Medicare Remittance Advices (RAs); see MLN Matters Article MM10433
Check state automated Medicaid eligibility-verification systems
For More Information, use the hyperlinks below:
Materials
from 2018 Medicare Learning Network call
- In separate comment letters to CMS, ASCO and ASH have urged the agency to ensure that every Medicaid enrollee with cancer can access the high-quality care needed to treat their disease. The comments were submitted in response to a proposed rule on Medicaid and the Children's Health Insurance Program (CHIP) Managed Care that aims to streamline the Program's regulatory requirements, reduce administrative burdens, and increase flexibility for state governments. Read ASCO's letter at
www.asco.org/sites/new-www.asco.org/files/content-files/Comments-CMS-MMC-Jan-2019.pdf?
; read ASH's comments at
www.hematology.org/Advocacy/Testimony.aspx
.
- 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 the 2018 MIPS Data Submission FAQs and other 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, [email protected], or via a local technical assistance organization offering no-cost support.
- CMS announced a new Medicare Part D payment model designed to lower drug prices, as well as what it called "transformative updates" to the Medicare Advantage Value-Based Insurance Design framework. The Part D Payment Modernization model will require participating plans to assume additional risk in the catastrophic phase, while the MA model changes will allow more customized benefits, enable coverage of hospice care and expand access to telehealth services.
HealthLeaders Media
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Affiliate Association News
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Have you reserved your spot at The ACCC Infusion Center of the Future Forum on February 26-27, 2019 in Atlanta? This is an incredible opportunity to learn from your peers at Memorial Sloan Kettering Cancer Center, The Sidney Kimmel Comprehensive Cancer Center, the University of Texas MD Anderson Cancer Center, the Winship Cancer Institute, the University of Colorado Cancer Center, and the Lehigh Valley Health Network.
The Infusion Center of the Future Forum
is an invaluable opportunity to hear from world-class infusion center leaders about how they've used predictive analytics and machine learning to improve patient access, reduce patient wait times, improve nurse satisfaction, and reduce healthcare delivery costs. There is no charge for attending this event, though travel and accommodation expenses are your responsibility.
- Don't forget that applications for the ASCO-Sponsored Patient Advocacy Booth will be accepted online beginning Monday, January 28 at 9 PM PST through Friday, February 1 at 9 PM PST. Once the application period opens, the link to the application will be visible under the ASCO-Sponsored Patient Advocacy Booth header. Please note that only applications received online during this time-frame will be considered. As space is limited to 32 organizations, ASCO assigns space to qualified organizations on a first-come, first-served basis.
- Submit your abstract for the ASCO Annual Meeting, taking place May 31-June 4, in Chicago. The Meeting will bring together the brightest minds in oncology research, education, and care into a single community to benefit patients with cancer everywhere. From the high-profile Plenary and Clinical Science Symposia to thematic poster discussion sessions, ASCO recognizes the importance of showcasing your research to a worldwide audience. Submit your research by February 12 at 8:59 PM (PST).
- NCCN has published the following updates at
www.nccn.org
: acute myeloid leukemia (V1.2019), B-cell lymphomas (V1.2019), bladder cancer (VV1.2019), CLL/SLL (V2.2019), cervical cancer (V3.2019), cutaneous melanoma (V 1.2019), genetic/familial high-risk assessment: breast and ovarian (V3.2019), Merkel cell carcinoma (V2.2019), non-small cell lung cancer (V3.2019), occult primary (cancer of unknown primary (CUP; V2.2019), systemic light chain amyloidosis (V1.2019), uterine neoplasms (V2.2019).
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- Astra Zeneca has some additional information on IMFINZI™ (durvalumab) ASP which is listed in the CMS OPPS file as: Inj., durvalumab 10mg; J9173; (9492-APC & "G"-SI); $73.971. The payment rate is the average sales price (ASP) per 10mg of IMFINZI™ (durvalumab) as documented by the CMS Hospital Outpatient PPS Addendum A. Effective from January 1, 2019 through March 31, 2019.
- Verastem Oncology
, informs MOASC and ANCO of their upcoming live and engaging presentation on an Oral Monotherapy for adults with relapsed/refractory CLL/SLL after at least 2 prior
therapies.
Presented by Steven G. Wong, MD,Tuesday, February 19, 2019 at 6:30PM PST, The Derby in Arcadia. space is limited. To register email Manny De Santiago at [email protected] or call 626-374-8701.
For more information and to view the invitation click HERE.
- Adaptive Biotechnologies informs ANCO and MOASC that its cloneSEQ Assay is now FDA-cleared and covered by Medicare for detecting and monitoring minimal residual disease (MRD) in bone marrow samples from patients with multiple myeloma or B-cell acute lymphoblastic leukemia (ALL).
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MOASC CALENDAR
Oncology Summit
(February 23, 2019)
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(Napa, March 15-17)
(NCCN, San Francisco, September 27-28)
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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
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| www.moasc.org
ANCO: P.O. Box 151109, San Rafael, CA 94915 | P (415) 472-3960 | F (415) 472-3961 | www.anco-online.org
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