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.
January 23, 2018
This Weekly's Hot Topics
  • Understanding Medicare Changes; An Impossible Dream? (California News)
  • Spotlight On® Hematology(MOASC News)
  • Health care provider organizations working to streamline prior authorizations to improve access(National News)

California News 
- The California Medical Association (CMA) will host a webinar entitled Understanding Medicare Changes; An Impossible Dream? with Arthur Lurvey, M.D., Contractor Medical Director, Noridian Healthcare Solutions, on January 24 at 12:15PM. For more information, please visit
The Centers for Medicare & Medicaid Services (CMS) issued guidance allowing states, for the first time ever, to implement Medicaid work requirements through 1115 waivers. California Health Care Foundation (CHCF) is maintaining a list of resources and analyses about Medicaid waiver activity across the country, including work requirements, and the likely impacts. While California is not one of the states currently contemplating new work and community engagement requirements for adults on Medi-Cal, the program faces the prospect of significant changes at the federal level. Last spring, the House passed legislation that would have reduced federal funding for Medicaid by $880 billion over the next decade. Speaker of the House Paul Ryan has pledged to make similar efforts a priority in 2018.


Noridian News  
Noridian/JEMAC has posted more updates to its website
* MLN Connects
Announcements--New Payment Model to Improve Quality, Coordination, and Cost-Effectiveness for Both Inpatient and Outpatient Care; SNF Quality Reporting Program Confidential Feedback Reports; Hospital Quality Reporting: Update CY2018 QRDA I Schematron; Proper use of the KX Modifier for Part B Immunosuppressive Drug Claims-Reminder; 2018 Vallue Modifier Results and Payment Adjustment Factor
Publications--QRUR Video Presentation-New; Avoiding Medicare Fraud & Abuse: A Roadmap for Physicians Web-based Training-Revised
* Therapy Claims for January2018 and Overutilization of the Modifier KX-Reminder
* MolDX: SLCO1B1 Genotype Billing and Coding Guidelines-R1
* MolDX: MGMT Promoter Methylation Analysis LCD-R1
* MolDX: Vysis Kit by Abbott Coding and Billing Guidelines Article Retirement-Effective October 24, 2016
* MolDX: SMPD1 Genetic Testing Billing and Coding Guidelines-R1
* NMP and/or IVR Use Required for Eligibility Inquiries-Effective February 5, 2018
* Enrollment Application Status Tool Use Required-Effective February 5, 2018
* MolDX: Next Generation Sequencing Billing and Coding Guidelines-R1
* HCPCS Codes Subject to and Excluded from CLIA Edits CR10446
* Self-Service Reopenings Required Use-Effective February 5, 2018
Upcoming Noridian/JEMAC webinars include
* Evaluation and Management Modifiers Webinar (January 24)
* Medical Oncology Webinar (January 25)
* Noridian Medicare Portal Registration and Functionality Webinar (January 25)
* Advance Beneficiary Notice of Nonycoverage (ABN) Webinar (February 6)
* Modifier 59, NCCI, and MUE Webinar (February 7)
Providers can also view the Evaluation and Management (E/M) Modifiers Education on Demand tutorial. 
To read the complete update  and for more information, visit:
Effective February 5, Noridian/JEMAC will require providers to use the Enrollment Application Status Search self-service tool to access application related details. Visit the tool at . In addition, effective February 5, Noridian/JEMAC will require providers to use the Noridian Medicare Portal (NMP) and/or the Interactive Voice Response (IVR) for all eligibility inquiries. For more information, visit  and .

MOASC News  
THIS Saturday, January 27, 2018 is MOASC's Spotlight On® Hematology, in Huntington Beach. MOASC's Spotlight On Series presentation brings highlights of the 2017 ASH annual meeting. MOASC awarded educational grants to 3 UCI Fellows who attended the ASH Annual in Atlanta, GA on December 9 - 12, 2017. They, and UCI faculty will present their discoveries through interactive discussions on ASH highlights. For more information and to register please contact the MOASC office at .
Thank you to all the MOASC members who participated in the 2017 offerings of MOASC . In 2017 MOASC worked hard to bring education to, and advocate for, their members. Read MOASC's 2017 Year in Review for highlights.  Year in Review
MOASC's LunchTime Series presentation of, Benchmarking and 2018 Updates, is scheduled for Wednesday, January 31st at 12:00pm. Presented by Roberta L. Buell, Principal onPoint Oncology, Inc. RSVP to  or call 909-985-9061x1.
You are cordially invited to MOASC's 3rd Annual Oncology Summit®, Harnessing the Power of Immunotherapy. March 3, 2018 at the Waterfront Hilton, Huntington Beach. Topics & speakers: *Head and Neck Ezra Cohen, MD, UCSD *Colon Cancer Marvan Fakih, MD, COH *Lung Cancer Karen Reckamp, MD, COH *Breast Cancer Sara Hurvitz, MD, UCLA *Melanoma Omid Hamid, MD, The Angeles Clinic & Research Institute. Register at .  
Once you are registered for the MOASC Oncology Summit®, you are invited to participate in the Biocept Advisory Board Meeting, Saturday, March 3, 2018, 2pm - 5pm, immediately following the MOASC Oncology Summit®. Topic: Liquid Biopsies: The Future is Now. Register early as there is limited seating for the advisory board. Honorarium is provided. The purpose of the ad board is to:
1.        Compare the relative strengths and limitations of liquid biopsy against those of conventional tissue biopsies;
2.        Discuss current and emerging testing technologies with respect to sensitivity, specificity, and clinical applications for patients with cancer;
3.        Evaluate clinical evidence pertaining to specific testing modalities that may help to individualize treatment protocols for patients with cancer;
4.        Discuss which cancer types are best suited for liquid biopsy testing;
5.        Discuss the clinical value of plasma testing be used be used in conjunction with tissue testing;
6.        Discuss the value of doing targeted marker liquid biopsy testing vs. large panels for liquid biopsies.
MOASC member, UC Irvine, presents their 3rd Annual UCI Hematology Symposium on Saturday, April 21, 2018, will feature regional and national experts bringing you state-of-the-art updates on sickle cell disease, modern anticoagulants, CAR-T Cell therapy, and others.  New this year, we will feature a Case Conference segment with individual case presentations and interactive discussions.  We hope to see you at the 3rd Annual UCI Health Hematology Symposium.
- Oncology nurse urgently needed at MOASC Member practice in Long Beach, CA. For more information contact Ann at

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ANCO News  
ANCO, in association with the Organizing Committee of the San Antonio Breast Cancer Symposium and Encore Medical Education, is hosting the Best of San Antonio Breast Cancer Symposium San Francisco (Best of SABCS San Francisco) at The Claremont Hotel on Saturday morning, January 27, 2018. Hope S. Rugo, M.D., is the Regional Director for the Best of SABCS San Francisco. For more information and to register, visit
The 18th Multidisciplinary Management of Cancers: A Case-based Approach returns to the Silverado Resort and Spa in Napa on March 16-18, 2018. The meeting is sponsored by the Association of Northern California Oncologists, Stanford Cancer Institute, UC Davis Comprehensive Cancer Center, and UCSF Helen Diller Family Comprehensive Cancer Center. Go to for more information, to register, and arrange for housing.

National  News

AHIP, the Blue Cross Blue Shield Association and four other health care provider organizations are working to streamline prior authorizations to improve access to timely and affordable care while reducing administrative burdens. The groups agreed to reduce the number of providers subject to prior authorization rules, improve communication, and regularly review services and medications that require prior authorization. Becker's Hospital Review
With regard to IV fluid supplies, the FDA is continuing to work on on importation, most recently from Brazil, and anticipates an easing of the IV fluid shortage over the coming weeks. They also continue to work to increase capacity in Puerto Rico. The FDA is working with manufacturers to extend expiration dates, where possible, to enable extended use of existing supplies. Read ASCO's summary of the FDA's statement on IV fluids at 
The National Cancer Institute (NCI) is seeking participants for an online evaluation survey intended to support cancer control and prevention efforts. Survey responses will provide feedback on NCI's Cancer Control P.L.A.N.E.T. (Plan, Link, Act, Network, with Evidence-based Tools), a Web portal that offers access to data and resources to help planners, program staff and researchers design, implement and evaluate evidence-based cancer control programs. Responses to the 5- to 10-minute survey will remain anonymous.
As Congress continues to "kick the can down the road," to February 5th, H.R. 849: Protecting Seniors' Access to Medicare Act of 2017, and other critical legislation still being negotiated. Please contact your Senate cosponsors and House members who voted in favor of repeal, and urge them to include IPAB repeal in the CR or any moving legislation.  Please include your Senate and House Leadership in your communications.  H.R. 849 amends the Patient Protection and Affordable Care Act (PPACA) to terminate the Independent Payment Advisory Board (IPAB).
- $500 Non-Invasive Blood Test Could Detect 8 Types Of Cancers -- But It's A Long Way Off. Scientists are excited about the possibilities offered by the test, which could offer a diagnosis even before symptoms start showing. The test, which can also help doctors determine where in a person's body the cancer is located, is called CancerSEEK.
The health system-led generic-drug company sent a shockwave through the healthcare industry, but experts warned that it would take plenty of time and capital to ultimately lower drug prices and mitigate shortages.  Read More

CMS News 
- The New Medicare Card Open Door Forum originally scheduled for today, has been postponed and will be rescheduled. CMS will inform you of the new date at a later time. Thank you for your continued participation and support in the CMS Open Door Forums.
- CMS has announced that doctors and other eligible clinicians participating in the Quality Payment Program can begin submitting their 2017 performance data use a new system on the Quality Payment Program website ( ).  For a fact sheet on the data submission system, including more information for clinicians participating in APMs, please visit . On Thursday, February 1st at 3pm PT, the CMS San Francisco Regional Office is offering a call for clinicians to discuss data submission as part of the Quality Payment Program. All clinicians and practice managers interested in the Quality Payment Program are invited and encouraged to attend. Other Quality Payment Program updates, as well as options for clinicians in small practices to receive free, customized technical assistance will be discussed. Registration is free and available at
To listen via phone:  1-877-267-1577; Meeting Number: 994 157 205
To view the presentation online: 
- The Model Performance Period for BPCI Advanced starts on October 1, 2018 , and runs through December 31, 2023. For more information about the model and its requirements or to download a Request for Applications document, the application template, and attachments, visit the BPCI Advanced webpage. Applications must be submitted via the  Application Portal ,  which will close on March 12, 2018, at 8:59 pm PT.
The CMS Innovation Center will hold a Q&A Open Forum on Tuesday, January 30 from 9 to 10 pm PT.  Register  in advance. See the full text of this excerpted  CMS Press Release

Affiliate Association News 

ASCO and the American Society for Radiation Oncology (ASTRO) have launched their new, joint platform for quality reporting, making it easier for oncologists to comply with federal government reporting requirements in 2018. The new QOPI Reporting Registry, a Qualified Clinical Data Registry (QCDR), now makes it possible for any practice with at least one active ASCO or ASTRO member to report their quality performance data either electronically or manually, based on their preference. Learn more at .
ASCO and ASCO's State/Regional Affiliates, along with 62 other national provider groups, state/local organizations, and patient groups signed on to a letter that was delivered to House leadership requesting a legislative fix to ensure the Merit-Based Incentive Payment System (MIPS) score adjustment is not applied to Part B drug payments. An essentially identical version of the letter was also sent to the Senate Finance Committee and leadership. Read the letter at .
The second annual  ASCO-SITC Clinical Immuno-Oncology Symposium,  January 25-27 in San Francisco , will feature more than 40 expert faculty discussing the latest clinical and translational advances in immuno-oncology. These specialists will facilitate in-depth discussions on cutting-edge research currently shaping the clinical application of immunotherapy, as well as provide insight into what this research means for future patient care.
ASCO seeks applications for volunteers at . Your application will be used for all upcoming Volunteer Corps opportunities and 2018 committee consideration. Apply by January 31, 2018 for 2018 committee consideration. 
It was a busy year for COA and community oncology. From the OCM to PBMs to 340B and more, we had our hands full. Read the COA 2017 Year in Review for highlights of what we accomplished together and the challenges ahead. Check out the COA 2017 Year in Review.
- Attend the  2018 Community Oncology Conference!  Reserve your seat for April 12-13, 2018  at the Gaylord National Hotel & Convention Center, right outside of Washington, DC. The discounted hotel room block will sell out.  What are you waiting for?    Register today!  
You are invited to the  2018 ASCO Annual Meeting  in Chicago from June 1-5, 2018 . First,  reserve your hotel now  to ensure the best accommodations and experience. The Scientific Program Committee seeks abstracts across 24 disease-based and cross-cutting tracks in oncology research for this meeting. When submitting, select the track and subcategory that best fits the focus of your research. The deadline to submit is February 13, 2018, at 8:59 PM (PST) to be considered for presentation or publication at this year's Annual Meeting. Abstract submission guidelines .

2018 Highlights of ASH®. Get a synopsis of the top hematology research presented at the latest ASH annual meeting and learn how it can help improve your patient management and care strategies at Highlights of ASH. For more information or to register, click 
here .
ACCC's Trending Now in Cancer Care, based on results to their 2017 Trends Survey, are now available at .
ACCC's 2018 Patient Assistance and Reimbursement Guide is now available at .
NCCN has published updates to the below. For the complete updated versions, please visit Recent updates include: colon cancer (V1.2018), lung cancer screening (V3.2018), rectal cancer (V4.2017), small cell lung cancer (V2.2018), testicular cancer (V1.2018)

Industry News 

AstraZeneca informs ANCO and MOASC that the United States Food and Drug Administration has approved Lynparza for use in patients with deleterious or suspected deleterious gremline BRCA-mutated (gBRCAm), human epidermal growth factor receptor 2 (HER2)-negative metastatic breast cancer (MBC) who have been previously treated with chemotherapy in the neoadjuvant, adjuvant or metastatic setting. Patients with hormone receptor positive (HR+) breast cancer should have been treated with prior endocrine therapy or be considered inappropriate for endocrine treatment. Patients are selected for therapy based on an FDA-approved companion diagnostic for Lynparza.
AstraZeneca will host a dinner meeting entitled Head to Head Progression-Free Survival Data for Patients who have Progressed After EGFR TKI Therapy with Hatim Husain, M.D., Moores Cancer Center, University of California, San Diego, at Morimoto Restaurant in Napa on March 17 at 6:30PM. RSVP to Jason Yonehiro at (415) 205-3699 or

Boehringer Ingelheim Pharmaceuticals informs ANCO and MOASC that the United States Food and Drug Administration has approved Gilotrif for the first-line treatment of patients with metastatic non-small cell lung cancer (NSCLC) whose tumors have non-resistant epidermal growth factor receptor (EGFR) mutations as detected by an FDA-approved test. 

Pfizer Oncology informs ANCO and MOASC that CMS has assigned HCPCS code C9028 to Besponsa (.1mg). 

Teva Oncology informs ANCO and MOASC that the United States Food and Drug Administration has approved Trisenox in combination with tretinoin for the treatment of adults with newly-diagnosed low-risk acute promyelocytic leukemia (APL) whose APL is characterized by the presence of the t(15;17) translocation or PML/RAR-alpha gene expression

In This Issue
Spotlight on Hematology 
 January 27, 2018
Huntington Beach, CA

LunchTime Series
January 31, 2018

Oncology Summit
March 3, 2018
Huntington Beach, CA

(San Francisco, January 25-27) 

(Berkeley, January 27)

(San Francisco, February 8-10

(Napa, March 16-18)

(San Francisco, 
April 27-28)  
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 |