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 .
June 11, 2019
This Weekly's Hot Topics  

  • The state Budget Conference Committee completed their job.California News
  • GET YOUR ENTRY IN TODAY! Support Teen Cancer America and IfOnly to see The Who at Wembly Stadium.National News
  • CMS amplifies the CDC Guideline for Prescribing Opioids.CMS News

California News

- Last Sunday night The Budget Conference Committee completed their job and held a vote only, rapid-fire session that ended around 9:30pm. There were many health care items that needed to be resolved in Conference. Outlined below are some of the key ones.  The Legislature has until this Saturday, June 15, to finalize their budget bills and send them to the Governor's desk.  The Governor has until July 1st to sign the legislation. 
  • Expanding Medi-Cal to undocumented residents ages 19-25 and over the age of 65 APPROVED.
  • Increased funding for state-only subsidies for families below 600% of the federal poverty level. APPROVED as Conference Compromise.
  • Continuing the ACA Individual Mandate.  APPROVED
  • Restoring optional Medi-Cal benefits.  APPROVED as Conference Compromise.   The Governor has proposed to restore optical benefits to the Medi-Cal program, utilizing the Prop 56 tobacco tax funding stream.  The Senate proposed to adopt that plan, but to also include additional optional services not currently offered, including audiology, podiatry, speech therapy and incontinence creams.  The Assembly proposed to include all of the Senate proposed services, as well as chiropractic. The Conference Committee approved all optional benefits, except Chiropractic, to be funding out of the General Fund - not Prop 56. 
  • Investments in Medi-Cal from Prop 56 tobacco tax funds.  APPROVED as Conference Compromise.   The Governor proposes spending nearly $500 million from Prop 56 on a whole host of Medi-Cal and Denti-Cal investments, including funding for family planning, supplemental payment rates and loan forgiveness programs for physicians, dentists, HIV/AIDS services, home health, etc.  He has proposed that all of these allocations sunset in three years, as he sees these allocations as a bridge to a single payer health care delivery system. 
  • Managed Care Organization Tax.  APPROVED as Conference Compromise.   This is the tax on health plans that when matched with federal funds brings approximately $1 billion investment into our Medi-Cal system.  The Governor has not included it in any of his budget proposals indicating the state had a great number of waivers pending at the federal level and he wanted to make sure the timing was right to submit the plan for CMS approval.  The Assembly and the Senate both adopted the MCO tax, but with different revenue numbers.  The Conference Committee approved place holder trailer bill language to authorize the MCO tax, but they did not score revenue from the tax - pending federal approval.
  • Hospital Reimbursement for New High Cost Drugs.  REJECTED.  The Assembly adopted placeholder trailer bill language to establish a new reimbursement methodology for hospitals outside of the DRG payment system to account for the cost of newly approved, high-cost drugs.  The Conference Committee did not approve this proposal. 
Anthem Blue Cross will pay $2.8 million to the state of California and invest $8.4 million to improve how it logs consumer calls as part of a settlement with the Department of Managed Health Care over its allegations that the insurer was failing to identify, process or resolve consumer complaints.
- Join the California Medical Association (CMA) for a webinar entitled Value-Based Payment Program Performance Measures: What Physicians Need to Know About the Incentive Payments, on June 13, 2019 at 1:00pmLearn more and register at 
- The California Medical Association (CMA) is proud to support the introduction of  "The Improving Seniors' Timely Access to Care Act of 2019" introduced by California physician Congressman Ami Bera, M.D., and Representatives Mike Kelly (R-PA), Suzan DelBene (D-WA) and Roger Marshall, MD (R-KS). The bill will streamline health care bureaucracy to allow Medicare patients to receive more timely access to care and help relieve physicians of unnecessary, costly and time-consuming administrative tasks.
- Save the date for the 2019 Sacramento Regional Colorectal Cancer Roundtable on June 27, 2019.  Be sure to block out this time for an opportunity to discuss best practices with colleagues in your region. Please click here to learn more details.

Noridian News  

- Noridian/JEMAC has the following updates on their website
Quality Payment Program: MIPS 2019 Call for Measures/Activities Ends July 1; Promoting Interoperability Programs: Submit Comments on Proposed Changes by June 24; Promoting Interoperability Program: Submit a Measure Proposal by June 28; Hospice Provider Preview Reports: Review Your Data by July 1; ICD-10-PCS Procedure Codes: FY2020; Average Sales Price Files: July 2019
Chimeric Antigen Receptor (CAR) T-Cell Therapy Revenue Code and HCPCS Setup Revisions; July 2019 Update of the Hospital Outpatient Prospective Payment System (OPPS); Quality Payment Program: 2019 Measure Development Plan Annual Report
* Positron Emission Tomography Scans Coverage-R15
* Educational Events June 2019
Forthcoming Noridian JEMAC meetings/webinars/workshops
* Evaluation and Management Modifiers Webinar (June 13) 
* Using the Medicare Beneficiary Identifier (MBI) Webinar (June 13)
* Clinical Lab Basics (June 18)
* Completing Appeals through the Noridian Medicare Portal (NMP) Webinar (June 19)
* Advanced Beneficiary Notice of Non-coverage (ABM) Webinar (June 21)
* Modifier 59, NCCI, and MUEs Webinar (June 26)
* Submitting Your Enrollment Online-Part 2 Webinar (PECOS; June 26)
* New Provider New Biller Review Entities and Appeals Part 2 of 2 Webinar (June 28)
* Reopenings Webinar (July 9)
* Telehealth/Telemedicine Enrollment Only Webinar (July 10)
* What's New in the Third Quarter 2019 Webinar (July 11)
* Understanding National and Local Coverage Determinations Webinar (July 23)
* Understanding the Basics of Medicare Secondary Payer (A/B) Webcast (July 24)
* Medicare Part A/B Revalidation Webinar (July 24)
* Revocation, Caps and Appeals Webinar (August 7)
* Submitting Your Enrollment Online-Part 1 (I&A) Webinar (August 21)
For more information and to register, visit: http://med.noridianmedicarecom/web/jeb/education/training-events  

MOASC News  
- Renew your MOASC Membership TODAY! Continue your investment in your state association.  MOASC will be able to continue to advance oncology in California, with your continued support and membership in MOASC. In 2018, MOASC successfully worked to create the California Cancer Caucus in Sacramento. YOU, the California oncologist, are the reason for MOASC's existence. MOASC advocates diligently to insure your ability to serve the California oncology community. 
You can renew your membership in two ways:

Print the application HERE mail it along with your check made payable to: Medical Oncology Association of Southern California, Inc., P.O. Box 161, Upland, CA  91785.

Go to and pay via PayPal.
We are looking forward to an exciting year ahead with benefits you will not want to miss.
If you have any questions, please contact the MOASC Office at 909-985-9061 ext.1 or at
- SAVE-THE-DATE for MOASC's Spotlight On Oncology, August 17, 2019 in Huntington Beach. Through a restricted grant from MOASC, selected oncology fellows and faculty from the University of California, Irvine (UCI), present the premier topics from their attendance at the 2019 Annual ASCO meeting. The presentations promote collegial discourse among colleagues along with networking in an informal setting.  Contact the MOASC Office for more information at
- MOASC Member, City of Hope CME presents: Multidisciplinary Approaches to Cancer Symposium on October 10-13, 2019 @ Waldorf Astoria, Las Vegas, Nevada. This intensive program will provide participants with an enhanced ability to interpret and apply best treatment options into their individual cancer practices. For more information click HERE. To register go to:

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ANCO News  
-   ANCO members may register with a discounted rate using code ILC19ANCO for the 20th Annual International Lung Cancer Congress taking place on July 25-27 at the Hyatt Regency Huntington Beach. Visit  for more information.

- SAVE THE DATE: ANCO's ASCO Highlights 2019 will take place on Saturday, August 17 at The Claremont Resort in Berkeley. Watch for an official announcement in June!

- Several new employment opportunities are now announced on the new ANCO website at

- The new ANCO website ( is now live!  ANCO physician members, their practice staff, and representatives from ANCO's corporate members must register to access password protected content at .
ANCO is now on Twitter ; follow  @ANCO News .

National News 

GET YOUR ENTRY IN TODAY! Teen Cancer America and If Only has teamed up with the legendary rock band, The Who, to offer a once in a lifetime rock 'n' roll adventure at Wembly Stadium in London. The sweepstakes is now live and runs through June 11th at The lucky winner and a guest will be flown to London to experience The Who's Moving On tour and meet Roger Daltry, Pete Townsend and Eddie Vedder backstage, plus airfare, hotel accommodations and exclusive tickets to sit in the Royal Box area. Each entry counts as a donation that benefits Teen Cancer America! ENTER TO WIN

Didn't get your sweepstakes entry in on time? The Who 'Moving On' Tour dates and locations can be found by emailing . California dates and places are:
Oct 11   Hollywood Bowl, Los Angeles, CA - Tickets
Oct 13   Hollywood Bowl, Los Angeles, CA -
Oct 16   Viejas Arena at Aztec Bowl San Diego State University, San Diego, CA -
Oct 24   Hollywood Bowl, Los Angeles, CA -
- The United States Food and Drug Administration (FDA) has announced a project to have the agency become the middleman for physicians seeking unapproved cancer drugs for their patients. Rather than having physicians plead their case first to companies and then to the FDA if the company agrees to provide the drug, the FDA will become the initial step and will assign a staffer to quickly do the paperwork so that when a company gets a request, it knows the FDA already considers it appropriate.
- ASCO has highlighted concerns surrounding the lack of interoperability of EMRs and the challenges it poses to cancer care to the Senate Health, Education, Labor & Pensions Committee. Read ASCO's letter at .
- ASCO submitted comments to a House Energy & Commerce health subcommittee focused on several bills aimed at increasing transparency around drug prices and lowering out-of-pocket costs for patients. ASCO's comments offer the oncology community's perspective on several of the bills discussed during the hearing and focus on improving access to affordable cancer care. Read ASCO's comments at .
- ASCO has endorsed the Improving Seniors' Timely Access to Care Act of 2019(HR3107) that would improve the prior authorization process in Medicare Advantage plans by requiring "real time" authorizations for routinely approved services. Learn more about HR3107 at .

- ANCO, MOASC, and ASCO urge all members to contact their Congressional Representatives to ask them to co-sponsor the Clinical Treatment Act (HR913) that would provide for coverage of routine care costs of Medicaid beneficiaries enrolled in clinical trials. Use the ASO ACT Network at  to contact your Representatives.
The National Institutes of Health has published their Annual Report to the Nation: Overall cancer mortality continues to decline . Special section on adults ages 20 to 49 shows higher cancer incidence and mortality for women than men. 

CMS News 
CMS has been asked to help amplify the CDC Guideline for Prescribing Opioids and related social media messaging.  Centers for Disease Control and Prevention (CDC) Guideline for Prescribing Opioids. The CDC is raising awareness of the risk to patient health and safety due to misapplication of the Opioid Guideline for chronic pain.  Please read the recent commentary in the New England Journal of Medicine, where authors of the 2016 CDC Guideline for Prescribing Opioids for Chronic Pain advise against misapplication of the Guideline that can put patients' health and safety at risk. Link to CDC Opioid Guideline and specific resources:   CDC Guideline for Prescribing Opioids for Chronic Pain.
Over the past two years, CMS has made a concerted effort to reduce clinician and provider burden, working across multiple CMS programs to reduce burden through regulatory changes, documentation simplification, and policy updates. According to latest information, savings to providers and clinicians are estimated to be $5.7 billion and 40 million burden hours through 2021.
Using the information gained from CMS' intensive outreach, changes, such as allowing patient notes written by medical students to count for billing purposes when the supervising clinician signs off, and allowing clinicians to focus their notes on what had changed since the last time they saw a patient.
Most recently, CMS made changes to the Medicare appeals process in an effort to reduce burden and simplify processes. Specifically, the appeals process that Medicare beneficiaries, providers, and suppliers must follow to appeal denials, has been streamlined. Most savings is coming from removing the requirement that providers must sign appeal requests, technical corrections to remove outdated and redundant terminology, and adopted additional changes to further reduce regulatory burden and make it easier for beneficiaries and providers to navigate the appeals process.
CMS has been working hard to reduce burden through the local coverage process and concerns around transparency and notifications. CMS also continues to work with providers and clinicians to modernize documentation requirements and billing codes, which in turn, will free up more time for patients, lessen clinician burnout, and bolster the doctor-patient relationship.
CMS continues to listen to providers, clinicians, and patients through our Patients over Paperwork email address:
CMS, last week issued The Request for Information on Reducing Administrative Burden to put Patients over Paperwork. The RFI invites patients and their families, the medical community, and other healthcare stakeholders to recommend further changes to rules, policies, and procedures that would shift more of clinicians' time and our healthcare system's resources from needless paperwork to high-quality care that improves patient health. Comments are due August 12, 2019 and can be submitted here:

Affiliate Association News   

- ABIM and ASCO have created a new assessment option for oncologists entitled the ABIM/ASCO Medical Oncology: Learning & Assessment. The new option will become available in 2020 as an alternate to the traditional long-form MOC exam and includes shorter assessments that are reflective of physician practice with topic-focused exam modules and related educational materials provided before, during, and after exams. Learn more at .
- Unable to attend the ASCO Annual Meeting? With the 2019 ASCO Annual Meeting Videos & Slides you can watch 1,200+ Annual Meeting presentations, download and use over 1,000 high-resolution PowerPoint slides, and access, 2,500 posters and abstracts. ASCO members save 20% at .

-The 2019 Best of ASCO® Bellevue Meeting will be held on July 19-20. This meeting will highlight the most cutting-edge science and education from the ASCO Annual Meeting, the world's premier oncology event. To register or for more information click HERE.

ASCO's Oncology Practice Conference takes place in San Diego on September 5. Focused on the business of cancer care, this conference will address the needs of practice administration and operations, with timely and practice strategies for the challenges faced by all those involved in the business of cancer care. Learn more and register at .
The ASCO Quality Care Symposium, September 6-7 in San Diego, encompasses the latest strategies and methods for quantification of patient experience, provider efficiency, clinical outcomes, and quality and safety in the cancer care field. The Symposium will include a variety of sessions that will cover the latest science in precision and personalized medicine. Oral abstract presentations will feature the highest-quality science submitted to the Symposium and Poster Walks will allow for networking while exploring the presentation of the newest science. This meeting will bring leaders in quality improvement science together to participate in stimulating conversation with opportunities for networking among physicians, nurse practitioners, physician assistants, and others. ASCO Quality Care Symposium .
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 highlight 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 .
- Present your research at the world's premier hematology event. The best new scientific research in all areas of hematology will be presented at the 61st ASH Annual Meeting and Exposition in Orlando, Florida. We encourage researchers to submit an abstract by August 1, 11:59 p.m. Pacific time.
NCCN has published the following updates at :
central nervous system cancers (V1.2019), cutaneous melanoma (V2.2019), gastric cancer (V2.2019), head and neck cancers (V1.2019), kidney cancer (V1.2020), non-small cell lung cancer (V5.2019), prostate cancer early detection (V2.2019), survivorship (V2.2019),  thymomas and thyme carcinomas (V2.2019), thyroid carcinoma (V1.2019).

Industry News

-Astellas Pharma US, Inc. informs MOASC and ANCO that the Prescribing Information for XOSPATA® (gilteritinib) was updated on May 30, 2019. XOSPATA is indicated for the treatment of adult patients who have relapsed or refractory acute myeloid leukemia (AML) with a FMS-like tyrosine kinase 3 (FLT3) mutation as detected by an FDA-approved test.¹ For more information, please visit and click here for the Full Prescribing Information including BOXED WARNING for additional safety information. 

Bristol-Myers Squibb Oncology  will host a webinar for ANCO and MOASC entitled Pursuing Precision Medicine through Oncology Biomarkers on Tuesday, June 18 at 12PM. The speaker will be Tony Wang, PharmD, JD, Health Systems Liaison, Medical Affairs, Associate Director, Health Systems (Northwest Region), Bristol-Myers Squibb Oncology. The call-on number is (866) 217-3840; the conference code is 1630309; and, the webcast address is .
- Genentech BioOncology informs ANCO and MOASC that the United States Food and Drug Administration has approved Polivy, a CD79b-directed antibody-drug conjugate indicated in combination with bendamustine and rituximab product for adult patients with released or refractory diffuse large B-cell lymphoma (DLBCL), not otherwise specified, after at least two prior therapies. . The Genentech press release including Important Safety Information is linked here and a press release issued by the FDA about the approval is linked here.

- Merck informs ANCO and MOASC that the United States Food and Drug Administration has approved Keytruda for the first-line treatment of patients with metastatic or unresectable recurrent head and neck squamous cell carcinoma (HNSCC).

In This Issue


LunchTime Series 
June 18, 2019

Spotlight On Oncology
August 17, 2019


 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) 
Supportive Care in Oncology
(ASCO, San Francisco, October 25-26) 

Kaiser Permanente National Oncology Symposium (Los Angeles, November 8-9)
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 |