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 .

J u n e 12 2 0 1 8
This Weekly's Hot Topics  
  • June is Men's Health Month. (National News)
  • CMA & Blue Shield of California announce project focusing on support of independent physicians (California News)
  • CMS to investigate Noridian 96402 denials (MOASC News)
California News 
- Gov. Jerry Brown and Democratic legislative leaders struck a $200 billion budget deal last Friday that rejected two proposals that would have expanded access to health care and tax breaks to undocumented Californians. The agreement puts the Legislature on track to meet its deadline to pass a budget by June 15. Democratic lawmakers also wanted to fill the reserves, but they also sought additional money for several programs, such as finding more money for expanding access to health care programs and providing more money to welfare programs for low-income Californians. $5 million to create a universal health care task force was on the table. The budget compromise generally avoids other new long-term health care commitments, rejecting Assembly-favored proposals that would have expanded Medi-Cal access to some undocumented immigrants. Health care advocates were frustrated that the budget did not include more money to reduce the cost of the health insurance premiums or expend access to Medi-Cal. "... It is deeply disappointing that this budget takes no new steps toward Californians getting coverage and care," said Anthony Wright, executive director of Health Access California.
- NEXT Tuesday, June 19th CAPP/MICRA Supporters are invited for an evening reception, to mix and mingle with California Republican Caucus members, including Senate Republican Leader Patricia Bates and Assembly Republican Leader Brian Dahle. The reception will be held at the California Dental Association's 15th Floor Rotunda, 1201 K Street, Sacramento, from 5:00 p.m. - 6:30 p.m.  Please click here  to view the invitation. Please share the invitation with your staff and colleagues and encourage them to attend. Please RSVP to Tina de Vere White Thank you for your continued support of CAPP.
- The California Medical Association (CMA) and Blue Shield of California announced a multi-year collaboration to develop and support a new health care model that gives Californians access to quality, comprehensive and sustainably affordable care that improves the health of individuals and their communities. The goal is for CMA and Blue Shield to scale the projects statewide with a focus on supporting independent physicians.
Blue Shield will invest $30 million to support the initiative, beginning with two pilot projects in Monterey and Butte counties designed to bring health care into the digital age, tie pay to value, and create a patient-centered experience through home- and community-based services. To achieve this, a new technology infrastructure will be built to help physicians focus their attention on care delivery, rather than administrative work.
The nonprofit health plan will work closely with CMA's leadership and physicians in those local communities to build new models of care that will:
Bring health care into the digital age; Tie pay to value; Create a patient-centered experience, and Improve physicians' ability to practice.
Noridian News  
Noridian/JEMAC has the following updates on their website
* MLN Connects Provider eNews
Announcements: New Medicare Card Project-Card Mailing Update; Provider Minute Video: The Importance of Proper Documentation; New Medicare Card: MBI Look-up Tool Available through your MAC; 2017 Quality Payment Program Year 1 Submission Results; View Your MIPS Preliminary Performance Feedback Data
Claims, Prices & Codes: FY2019 ICD-10-PCD Procedure Codes; July 2018 Average Sales Price Files
Events: MIPS Promoting Interoperability Performance Category Webinar-June 12; CMS Quality Measures: Development, Implementation, and You Webinar-June 13 or 14
- Publications: New Medicare Beneficiary Identifier: Get It, Use It MLN Matters Article-New; Quarterly Update to Medicare Physician Fee Schedule Database MLN Matters Article-New; Quality Payment Program Call: Audio Recording and Transcript-New; Claim Status Category and Claim Status Codes Update MLN Matters Article-New
* Immune Globulin Intravenous (IVIg) LCD-R8
* MBI Look-Up Tool Available on the Noridian Medicare Portal
* MolDX: APC and MUTYH Gene Testing LCD-R1 Read the complete update
* MolDX: ConfirmMDx Epigenetic Molecular Assay LCD-R4 Read the complete update
* Off-label Drug Indications Read the complete update
* Claim Status Category and Claim Status Codes Update CR10777 Read the complete update
- Upcoming Noridian/JEMAC webinars include: 
* Medical Review Findings of Care Plan Overview (CPO) Webinar (June 19)
* Modifier 59, NCCI and MUE Webinar (June 21)
* Mammography, Pap Test and Pelvic Exam Webinar (June 26)
* Beneficiary Forms: When and Why Providers Issue Them Webinar (June 26) 5 p.m. Pacific Read the complete update
* Part B, Home Health & Hospice Collaborative Webinar (June 27)
Visit for more information and to register.
MOASC News  
- MOASC has communicated with Noridian regarding 96402 denials. The most recent response from Noridian is, "...Claims are being adjusted.  Noridian does not have the timeframe on this.  Noridian would suggest calling the call center in case they have more information. It takes a while to get these processes done.  Noridian expects that any claims submitting going forth should process correctly, but physicians and providers may want to test a few before submitting a batch..." MOASC still waits for a Production Alert to be posted, but it has not been at this time.
Not satisfied with Noridian's response, MOASC has now communicated with Neal E. Logue, Health Insurance Specialist, Division of Financial Management and Fee for Service Operations, Centers for Medicare & Medicaid Services (CMS), CMS San Francisco Regional Office, who requests that MOASC & ANCO members please send, by FAX (443) 380-6310 to his attention, two or three specific claim examples including the name of the beneficiary, the beneficiary's Medicare number, date of service, name of provider, and the provider's national provider identifier (NPI).  Upon receipt of the requested information, CMS will review the reason for the denials.  Please do not send the requested information by email, but you may submit the information by FAX which is secure.  Thank you.
- MOASC Member, Cedars Sinai in Los Angeles, is the first U.S. hospital system to incorporate CancerAid's self-reporting information into a dashboard system for doctors. CancerAid, a self-reporting and symptom monitoring tool for cancer patients, has scored its first major coup in the U.S. healthcare market with its integration into Epic Systems electronic health records and an integration with Apple's HealthKit. (TechCrunch)
- MOASC continues to support fixing the 340B program. As you know, the 340B drug discount program was created by Congress in 1992 with the best intentions but the program is not reaching the very individuals it set out to serve: vulnerable or uninsured populations across the United States. MOASC has signed on to a group letter asking HHS Secretary Alex Azar for his continued efforts to fix the 340B program so that it serves those who need it most.
We're encouraged by the actions that the Department of Health and Human Services (HHS) has already taken on the 340B program and request that HHS continue using its authority to fix the 340B program so patients are benefiting. Please join a letter to HHS Secretary Alex Azar encouraging HHS to provide increased oversight of the 340B program and clarify the program's rules so that it operates in the best interests of patients.
MOASC and ANCO are jointly conducting a 2018 staff salary survey. The survey will be USPS mailed, e-mailed/FAXed to all MOASC members in mid-May and is available online at A $50 Visa gift card for respondents is included in this year's survey. Return your completed survey no later than September 30; results will be analyzed and reported in 4Q2018.
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ANCO News  
- Congratulations to ANCO Member, Timothy T. Ferng, M.D., University of California, San FranciscoDr. Ferng was awarded the 2018 Conquer Cancer Foundation of ASCO/ANCO Young Investigator Award at the 2018 ASCO Annual Meeting for his research entitled Identifying Synthetic Lethal Interactions in FLT3-mutant Acute Myeloid Leukemia Using Dynamic BH3 Profiling.
ANCO and MOASC are jointly conducting a 2018 staff salary survey. The survey will be USPS mailed, e-mailed/FAXed to all ANCO members in mid-May and is available online at A $50 Visa gift card for respondents is included in this year's survey. Return your completed survey no later than September 30; results will be analyzed and reported in 4Q2018.
ANCO is organizing a series of Hematologic Malignancies Updates in 2018. The first Update takes place on June 16 at the Sacramento Hyatt Regency with Gabriel Mannis, M.D., University of California, San Francisco, Joseph Tuscano, M.D., University of California, Davis, Jeffrey Wolf, M.D., University of California, San Francisco, and Naseem Esteghamat, M.D., University of California, Davis. The latest research on novel treatment modalities for hematologic malignancies--leukemias, lymphomas and myeloma--along with case studies for these diagnoses will be presented. These updates are supported by AMGEN, Janssen Oncology, Jazz Pharmaceuticals, Novartis Oncology, and Seattle Genetics. Download the meeting announcement and registration form at 
- SAVE THE DATE: ANCO'S ASCO Highlights 2018 will take place on August 25 at The Claremont Resort in Oakland. Watch for an announcement and registration form in late June.
National News

- June is Men's Health Month. This month-long observance is an opportunity for men to take command of their health. According to the Centers for Disease Control and Prevention, the leading causes of death among men in the U.S. include heart disease, cancer, respiratory diseases, and stroke. Check out a few tips for men to improve their health. Read the full article here.  
- The AMA, voted 56-44 percent, yesterday, to keep studying its current guidance on medically-assisted deaths. The guidance currently states that medically-assisted deaths are "fundamentally incompatible with the physician's role as healer." A recommendation that the AMA maintain its opposition to medically assisted death was rejected, with delegates at the AMA's annual meeting in Chicago instead voting for the organization to continue reviewing its guidance on the issue. Following a debate on whether the AMA should revise its Code of Medical Ethics, the House of Delegates voted by a margin of 56 to 44 percent to have the AMA's Council on Ethical and Judicial Affairs keep studying the current guidance. That position, adopted a quarter-century ago, labels the practice "physician-assisted suicide" and calls it "fundamentally incompatible with the physician's role as healer."

- Yesterday, Congresswoman Doris Matsui (D-CA) introduced the Stretching Entity Resources for Vulnerable (SERV) Communities Act, legislation that clarifies the intent of the 340B Program, enhances program integrity, and protects and expands the program to meet the needs of the opioid crisis.  This legislation makes clear the importance of preserving the program so safety net providers can continue to serve low-income and vulnerable patients, while expanding it to help address the opioid crisis.
A section-by-section on the legislation can be found  here . A fact sheet on the legislation can be found  here . The legislative text can be found  here . Statements of support for the legislation can be found  here .
- The American Cancer Society announced last week that the organization is launching a public health campaign to eliminate vaccine-preventable HPV cancers, starting with cervical cancer see press release. Their goal is to reach an annual vaccination rate of 80% of young people by 2026. It's a daunting goal - but with the combined support of all the organizations working to improve HPV vaccination, it is possible.
UnitedHealthcare's Network Bulletin (June 2018) is now available online at > Tools & Resources > News & Network Bulletin and features articles entitled Reminder on Clinical Laboratory Improvement Amendments Identification Requirements Policy, Will Be Retired Soon, Quick Access to Policies and Protocols on, Addition to National Drug Code Requirement Policy, Changes to Advance Notification and Prior Authorization Requirements, Reminder: Denosumab (HCPCS code J0897) Requires Prior Authorization, Prescription Drug List Updates.

- The International Myeloma Foundation presents Living Well with Myeloma Teleconference Series, The Importance of Bone Health and Treatment Updates: What Patients & Caregivers Need to Know, Wednesday, June 20, 2018. Faculty:
Noopur S. Raje, MD,Massachusetts General Hospital Cancer Center, ad
Beth Faiman, PhD, RN, MSN, APRN-BC, AOCN, Cleveland Clinic Taussig Cancer Institute Wednesday, June 20, 2018   4pm Pacific/5pm Mountain/6pm Central/7pm Eastern Duration: 60 Minutes (includes Q&A). Click here to Save the date and Register!
CMS News 
- Clarifying documentation requirements when performed by Medical Students in a teaching situation, the Centers for Medicare & Medicaid Services (CMS) issued a MLN Matters article ( MM10412 Revised) on May 31 with a retroactive effective date of January 1, 2018. Read more & comment
- The CMS will host a national webinar for Emergency Preparedness (EP) Providers on topics and questions related to the new CMS EP Rule, the 1135 waiver and Lessons Learned (observations) within the past year. Please ensure only EP Providers participate in the webinar on Tuesday, June 19, 2018 at 10:00-11:30 pm, PT.
Please use the following link to register for this upcoming webinar:
For questions related to content:  Please submit Emergency Preparedness (EP) questions in advance to
- By FRIDAY, June 29, submit your ideas to CMS! CMS is accepting proposed measures for inclusion in the Medicare Promoting Interoperability program, formerly known as meaningful use. Stakeholders may that focus on the improvement of health data exchange and interoperability, advanced use of 2015 edition certified EHR technology, patient safety, outcomes measurement, and streamlined program effectiveness, efficiency and flexibility. EHR Intelligence.
Affiliate Association News 
- COA and their Pharmacist group, COPA, are needing your help to send to them ANY & ALL PBM delay stories, as well as any other stories where patient care is compromised.  
Several fronts, including legislative (federal and state levels) and legal are being tapped into!  The message MUST go out far and wide. Below are some quick links to a couple of projects that COPA board members have been working on. There are links to two articles and one podcast below that are very well done regarding the challenges that we all face surrounding PBMs and them restricting our ability to care for our patients. 
Please send your stories to Ricky Newton at COA. Thank you.
- ASCO invites all practices to participate in the 2018 ASCO Practice Census, an annual survey of the entire U.S. oncology practice community that aims to capture keep information on what is happening in oncology practice today and that is chronicled as part of ASCO's State of Cancer Care in America initiative. Complete the Census at
ASCO has published an ASCO in Action podcast on biosimilars that presents its recent statement on biosimilars published in the Journal of Clinical Oncology ( Listen to the podcast at

ASCO has published several new Policy Issue Briefs:
* Oncology Clinical Pathways (

ASCO has published several new guidelines, as follows:
* Practical Assessment and Management of Vulnerabilities in Older Patients Receiving Chemotherapy (
* Update on Selection of Optimal Adjuvant Chemotherapy and Targeted Therapy for Early Breast Cancer (
* Human Epidermal Growth Factor Receptor 2 Testing in Breast Cancer (
- Help steer the meeting discussion by providing input today, for the   ASH Summit on Emerging Immunotherapies for Hematologic DiseasesJuly 12 & 13, 2018. The Summit will feature interactive breakout sessions aimed at addressing important topics relevant to the design and application of immunotherapies. These small-group sessions will create a unique opportunity for attendees to steer the conversation and help chart the course for the field. Please complete a short pre-meeting survey to help facilitate scientific discourse during the breakout sessions.
- NCCN has published the following updates at
Anal carcinoma (V2.2018), Antiemesis (V3.2018), Noninvasive Breast Cancer (V1.2018), Hepatobiliary cancers (V2.2018), Lung Cancer Screening (V1.2019), Primary Cutaneous B-cell Lymphomas (V2.2018).
Industry News 
- AbbVie informs MOASC and ANCO about U.S. FDA Approval of VENCLEXTA┬« (venetoclax tablets) in Combination with Rituximab as a Fixed Duration Treatment for Chronic Lymphocytic Leukemia or Small Lymphocytic Lymphoma Patients Who Have Received One Prior Therapy. The full U.S. prescribing information, including Medication Guide, for VENCLEXTA can be found here. Globally, prescribing information varies; refer to the individual country product label for complete information. Patient Assistance: For those who qualify, patient assistance options are available for people taking VENCLEXTA in the U.S. If people cannot afford their medication, they should contact for assistance.
- AMGEN  informs ANCO and MOASC that the United States Food and Drug Administration's Risk Evaluation and Mitigation Strategy  (REMS) program has issued a safety update regarding Blincyto addressing potential risks for (1) cytokine release syndrome which may be life-threatening or fatal, (2) neurological toxicities which may be severe, life-threatening, or fatal, and (3) preparation and administration errors. More information is available at

Genentech BioOncology informs ANCO and MOASC that the United States Food and Drug Administration has approved Venclexta in combination with Rituxan for the treatment of people with chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL), with or without 17p deletion, who have received at least one prior therapy.
Helsinn Oncology informs ANCO and MOASC that the United States Food and Drug Administration has approved Akynzeo for injection in the new intravenous formulation in combination with dexamethasone in adults for the prevention of acute and delayed nausea and vomiting associated with initial and repeat courses of highly emetogenic cancer chemotherapy.
Lilly Oncology informs ANCO and MOASC that the United States Food and Drug Administration has expanded the approved indications for Alimta to include its use in combination with carboplatin and Keytruda for the initial treatment of patients with metastatic nonsquamous non-small cell lung cancer (NSCLC), irrespective of PD-L1 expression status.
Novartis Oncology informs ANCO and MOASC that the United States Food and Drug Administration has expanded the approval of Kymriah to include the treatment of patients with relapsed or refractory large B-cell lymphoma after two or more lines of systemic therapy (including diffuse large B-cell lymphoma-DLBCL, high-grade B-cell lymphoma, and DLBCL arising from follicular lymphoma).
Pharmacyclics informs ANCO and MOASC that in addition to the one pill, once daily formulation, it has decided to continue to offer Imbruvica in the 140mg capsule formulation at the current price. Learn more at .

In This Issue

LunchTime Series

( Sacramento, June 16)

ANCO's ASCO Highlights
(Oakland, August 25) 
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 |