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.
 
 
March 28, 2017
 
 
This Weekly's Hot Topics
  • Need HELP with your health plan? (DMCS News)
  • The NIH is working towards a nationwide single IRB model. (National News)
  • March 31st is deadline to submit 2016 EHR data via QRDA. (CMS News)

California News 
 
Follow the link below for a summary of the outcome and next steps for the American Health Care Act (AHCA) - the House Republican plan to repeal and replace the Affordable Care Act. CMA expressed serious concerns about the floor version of the AHCA and urged the Republican leadership to rework the bill so that millions of Californians did not lose insurance coverage, it increased Medi-Cal payment rates to improve access to care, and there were adequate tax credits to make insurance affordable for low-moderate income families.  

 As the California Dialogue On Cancer (CDOC) continues to strengthen its Policy, Systems, and Environmental (PSE) change efforts as a means to effectively reduce the burden of cancer, the CDOC would like to hear from you on what your PSE needs may be. CDOC has created a short survey to help them gauge interest in learning more about, and implementing PSE interventions in your work. Please help by following the link and completing the short survey. It takes only a few minutes to complete. 
Please respond by next Wednesday, April 5th . Thank you in advance for your time.   http://bit.ly/PSEsurvey .
 
With a dramatic shake-up happening in Washington, D.C., the  Western Health Care Leadership Academy  is the right place and time for physician leaders  who want to stay on top of policy and political changes to shape the future of health care.   Register today  and join your colleagues, May 5 -7 in San Diego  for the West Coast's premier health care leadership confe rence!


 
Noridian News

- Multi-Factor Authentication Required on Noridian Medicare Portal - Beginning April 1, 2017.    Beginning April 1, 2017 the Noridian Medicare Portal (NMP) will require a multi-factor authentication (MFA) process for users each time you need to log into NMP. MFA adds a second layer of security to your NMP account.  Read the complete update . 
 
There will be Common Working File (CWF) "Dark" days on Friday, March 31 through Sunday, April 2, 2017 for all CWF hosts. The CWF online Health Insurance Master Record (HIMR) inquiry will not be available on those days. Read the complete update .
 
Noridian/JEMAC has posted the following updates to its website
* MLN Connects Provider News
Announcements --Revised CMS-855O Application: Enrollment Solely to Order, Certify, or Prescribe; Connected Care: New Educational Initiative to Raise Awareness of Chronic Care Management; Quality Payment Program: New Materials
Claims, Pricers, and Codes --Chronic Care Management Payment Correction for RHCs and FQHCs
Events --Open Payments: Prepare to Review Reported Data Call-April 13
Publications --Provider Enrollment Revalidation: Cycle 2 MLN Matters Article-Revised; Medicare-Required SNF PPS Assessments Educational Tool-Revised; Items and Services Not Covered under Medicare Booklet-Revised
* ASCO Payment System-April 2017 Update CR9998
* Self-Service Reopenings Through Noridian Medicare Portal-More Options Available
* DMEPOS Fee Schedule-April 2017 Update
* Controlled Substance Monitoring and Drugs of Abuse Testing-R1
* Provider Enrollment Revalidation-Cycle 2-Revised SE1605
* Appealing Demand Letters
* Claim Denied for Duplicate or Bundling? Noridian Medicare Portal Has the Answer
* Positron Emission Tomography Scans Coverage-R9
 
Forthcoming Noridian/JEMAC webinars 
* Noridian Medicare Portal Registration for Part B Providers (April 4)



  DHCS/Medi-Cal News 
 
Need help with your health plan? Call the California Department of Managed Health Care's Help Center at 888-466-2219 or file a complaint online:  http://bit.ly/2kUcCL9 .
The Help Center educates consumers about their rights, resolves consumer complaints, helps consumers to navigate and understand their coverage and ensures access to health care services.



  MOASC News

DON'T MISS TOMORROW's MOASC Lunchtime Series presentation on the Oncology Care Model, with a bonus update on USP Pharmacy Regulations on Oncology. On Wednesday, March 29th at 12:00pm Pacific time,  Dawn Holcombe, FACMPE MBA ACHE, President, DGH Consulting, Director, NAMCP Medical Directors Oncology Institute, and Executive Director, Connecticut Oncology Association, will be discussing; lessons learned from those who have broken ground with the OCM, changes in the MIPS Final Rule that affect oncology physicians, specifics about MIPS, decisions you need to make, and actions you want to take to start preparing for beyond 2017. Please RSVP to [email protected] or by calling 909-985-9061 ext. 1.
 
JOB BOARD:
Hematology-Oncology Physician Opportunity- Bakersfield, CA
Comprehensive Blood & Cancer Center (CBCC) has an immediate opening for a Hematology-Oncology specialist.
Requirements: California medical license in good standing with no past negative actions. BC/BE in Hematology/Oncology and authorized to work in the United States.
CBCC is a 100,000 ft outpatient comprehensive cancer center with 200+ team members providing support.  CBCC is one of approximately 200 physician group practices nationwide participating in the OCM project, a model designed to support higher quality and more coordinated cancer care. Please see our website  www.cbccusa.com  for a detailed listing of services offered.
Our comprehensive team of experts includes:
6 hematology and medical oncologists; 2 radiation oncologists; 2 dermatologist/Mohs surgeons
1 ENT surgeon; 1 Pain management physician; 1 Infectious Disease specialist; 1 Naturopathic physician; 7 mid-levels; 1 onsite Radiologist with offsite support; 1 LCSW; Mind-Body medicine
Certified patient navigators and genetic counselor; Onsite physician dispensary.
Please submit all inquiries to:
Anthony LaMacchia, Comprehensive Blood & Cancer Center, 6501 Truxtun Avenue,
Bakersfield, CA 93309   [email protected]



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ANCO News
 
ANCO is organizing a series of Hematologic Malignancies Updates in 2017. The first Update will take place on May 6 at the Sacramento Hyatt Regency on May 6 with Mehrdad Abedi, M.D., University of California, Davis, Sandy Wong, M.D., University of California, San Francisco, and Julian Davis, M.D., University of California, Davis. The latest research on novel treatment modalities for hematologic malignancies, myeloma, and amyloidosis, along with case studies for these diagnoses, will be presented. These updates are supported by Janssen Biotech, Merck, Pfizer Oncology, and Pharmacyclics. Watch for a meeting announcement in late March.

- ANCO's ASCO Highlights 2017 will not take place in 2017 in lieu of our encouragement of members to attend ASCO's Best of ASCO in San Francisco (
http://west-boa.asco.org ; June 16-17). However, ANCO will host an event on June 15 entitled The State of Cancer Care with Margaret Tempero, M.D., University of California, San Francisco, at the San Francisco Marriott Marquis. Watch for a meeting announcement in April.



National  News
 
The National Institutes of Health is leading policy and programmatic initiatives to streamline and accelerate the overly cumbersome process of developing and conducting multisite clinical trials. The Clinical & Translational Science Awards (CTSA) Program paves the way for nationwide single IRB model. NIH's National Center for Advancing Translational Sciences (NCATS) announced today that all CTSA Program sites have signed on to the NCATSStreamlined, Multisite, Accelerated Resources for Trials (SMART) IRB authorization agreement. This agreement, which now includes a total of more than150 medical research institutions, will enable all participating study sites to rely on the ethics review of one IRB for each study, making it possible to initiate multisite studies within weeks instead of months. For patients waiting to enroll in a study, this could make a life-saving difference.
The SMART IRB authorization agreement serves as a model to help investigators adhere to the NIH's policy on single IRB use for multisite studies. This policy was designed to improve IRB efficiencies while ensuring the protection of research participants so that research can proceed expeditiously. The SMART IRB authorization agreement will provide the foundation for NCATS' Trial Innovation Network central IRBs. The Trial Innovation Network is a collaborative CTSA Program initiative designed to address critical roadblocks in clinical research, and to optimize and streamline the clinical trial and studies process. Next steps for the NCATS SMART IRB Platform include the development of education, training and harmonization of best practices for a single IRB review. Learn more at https://ncats.nih.gov/expertise/clinical/smartirb and https://smartirb.org(link is external).
 
There is a continued call on Congress to repeal the Independent Payment Advisory Board (IPAB) . Many of you have activated on IPAB repeal and the efforts are appreciated.  There was a successful messaging blitz effort earlier this month, but need everyone to keep up the hard work!  In case you missed it, a Hill briefing was last week on the topic, and was aired on CSPAN2.   With the Independent Payment Advisory Board (IPAB) likely to be triggered next month, we need Congress to hear loud and clear that IPAB will lead to billions of dollars in Medicare cuts and reduce healthcare access to beneficiaries.  Now is the time to repeal IPAB and ensure healthcare decisions are made by seniors and their doctors.
  • 179 more cosponsors are needed, in the House(H.R. 849, the Protecting Seniors' Access to Medicare Act of 2017).
  • 20 more cosponsors are needed in the Senate(S. 260, Protecting Seniors' Access to Medicare Act of 2017 and S. 251, Protecting Medicare from Executive Action Act of 2017).
To view a list of IPAB repeal legislation cosponsors from last Congress who have not yet  cosponsored IPAB repeal legislation this Congress click: IPAB Repeal Dear Colleague 115th Congress.pdf (233KB): 114th COS IPAB Repeal not 115th COS.pdf (120KB):

PLEASE:
Submit an op-ed from your leadership to a newspaper and/or Submit pro-repeal letters to the editor to local publications (the public relations experts at McCabe Message Partners stand at the ready to assist with placing these);
E-mail the health legislative assistants to members of Congress where your organization/practice has a presence, and your own voting district representative.
Post on your Facebook page about the need for IPAB repeal; and
Use your Twitter feed to discuss IPAB, using individual MOC Twitter handles.
Follow us on Twitter at @MyDrAndMe.
Thanks again for your participation in this important effort, and keep up all your hard work!  Please don't hesitate to reach out with questions or needs.



CMS News
 
- Physicians and Providers now have until, THIS FRIDAY, March 31 to submit their 2016 EHR data via QRDA. CMS has extended the data submission deadline for the EHR reporting mechanism of the 2016 Quality Reporting Document Architecture (QRDA) for the Physician Quality Reporting System (PQRS) program. Individual eligible professionals (EPs), PQRS group practices, qualified clinical registries (QCDRs), and qualified EHR data submission vendors (DSVs) are included in this extension . Go to  www.asco.org/advocacy-policy/asco-in-action/2016-pqrs-data-submission-deadline-ehr-reporting-mechanism-extended for more information.
 
With an anticipated completion date of, NEXT MONDAY, April 3, as a reminder, CMS is now phasing out the Road to 10 site. CMS has merged all up-to-date content from their Road to 10 website to the main ICD-10 site,  cms.gov/ICD10, to streamline access to resources. In preparation for the merge, please be sure to update all bookmarks and links for Roadto10.org to point to cms.gov/ICD10 Keep Up to Date on ICD-10.Visit the CMS ICD-10 website for the latest news and official resources. Sign up for CMS ICD-10 Email Updates and follow us on Twitter.
 
- With the deadline of July 1, CMS has announced that it is now accepting hardship exceptions from the meaningful use requirements of the EHR incentive payment program for the 2016 reporting year. Physicians who can show that demonstrating meaningful use would result in a significant hardship can apply for a one-year exception and avoid a negative payment adjustment in 2018. For more information and applications, go to  www.cms.gov/Regulations-andGuidance/Legislation/EHRIncentivePrograms/PaymentAdj_Hardship.html .
 
As the CMS works to remove Social Security numbers from millions of Medicare ID cards, providers are calling on the agency to increase physician outreach efforts to alert them how billing under the program may change.  Last week, HHS' Advisory Panel on Outreach and Education told the CMS that it needs to ensure that providers know they must update their electronic health record systems to accept new Medicare ID numbers created to curb fraud and abuse. Since the beginning of the Medicare program, Social Security numbers have been used as the beneficiary identifier for administering services. But the CMS has mandated Social Security numbers be removed from Medicare cards because of identity theft and fraud risks.
Per the law, the CMS will issue Medicare cards with a new ID number to approximately 60 million beneficiaries by April 2019. The new cards will begin being shipped out in April 2018, and the CMS is developing an outreach effort to notify the public about the change. Doctors will need to update their EHR systems to accept the new ID numbers or risk losing their ability to bill Medicare once the old ID numbers are phased out in 2020. 



Affiliate Association News 
 
TOMORROW, March 29th, is the deadline for ASCO members, who are participants in the survey that will examine the specific roles and responsibilities of APPs within the cancer care delivery, to complete and return it to ASCO as instructed. Read more about the survey at: www.asco.org/advocacy-policy/asco-in-action/new-survey-advanced-practice-providers-oncology-launched.  
 
- The United States cancer care delivery system is undergoing profound changes to better meet the needs of people with cancer, but persistent hurdles threaten to slow progress, according to ASCO's fourth annual State of Cancer Care in America report. 
The report is published in the Journal of Oncology Practice and was presented at a briefing on Capitol Hill. A summary of the report is available at  www.asco.org/advocacy-policy/asco-in-action/us-cancer-care-system-poised-transformation-challenges-loom-large .
 
The 2017 Community Oncology Conference on April 27 & 28, 2017 at the Gaylord Hotel, National Harbor, MD (just outside Washington DC), will comprehensively cover the issues that are critical to community practices being able to succeed and thrive in the coming year. The packed agenda features national experts discussing the Oncology Care Model (OCM), biosimilars, cancer policy, resolving coding denials, pharmacy operations, PBM challenges, and much more. The conference also allows for lots of networking opportunities, where you can meet other oncology professionals and learn what they are doing to be successful. 
 
Have you or your colleagues worked to implement appropriate use strategies in your practice, institution, or hospital system? If so, ASH encourages you to submit a nomination to be one of this year's three ASH Choosing Wisely Champions .  Presented in cooperation with the ABIM Foundation, the Choosing Wisely Champions initiative was created to recognize the efforts of practitioners who are working to eliminate costly and potentially harmful overuse of common tests and procedures, and to provide annual meeting attendees with an opportunity to learn about projects that might be translated to their own practices. Three nominees will be selected to present their successful utilization strategies during the Choosing Wisely session at the 59th ASH Annual Meeting and Exposition in Atlanta. Clinicians, researchers, or trainees at all levels in both academic and community settings are encouraged to apply by June 1.
 
ASH is now accepting nominations for members to participate in its seventh annual Advocacy Leadership Institute that will take place September 27-28, 2017, in Washington, DC. This two-day workshop is an exciting opportunity for ASH members who wish to learn about legislation and health policy affecting hematology research and practice. The first day of the Institute will include sessions featuring guest speakers from Congress and the Administration. On the second day, participants will visit their congressional delegation on Capitol Hill to apply what was learned on the first day. Nominations are being accepted through June 16. Self-nominations are welcome, and individuals may nominate more than one colleague. To submit a nomination or to learn more about this opportunity, visit the ASH website.
 
- To support clinical decision-making around the use of radiation therapy in patients with cancer, NCCN has launched the NCCN Radiation Therapy Compendium. The radiation therapy recommendations contained in the Compendium are derived directly from the library of NCCN Clinical Practice Guidelines in Oncology which document evidence-based, consensus-driven management to ensure that all patients receive care most likely to lead to optimal outcomes. Learn more at  www.nccn.org/about/news/newsinfor.aspx?NewsID=851 .
 
- NCCN has published updates to the NCCN Clinical Practice Guidelines in Oncology   (NCCN Guidelines®), the NCCN Drugs & Biologics Compendium (NCCN Compendium®), and NCCN Imaging Appropriate Use Criteria (NCCN Imaging AUC™)   for breast cancer (V1.2017); chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL; chemotherapy order templates); colon and rectal cancers (V2.2017 and V3.2017); hepatobilliary cancers (V1.2017); non-small cell lung cancer (V5.2017); palliative care (V1.2017); and, penile cancer (V2.2017).   NCCN has, also, published updates to the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Smoking Cessation. These NCCN Guidelines® are currently available as Version 1.2017. 
For the complete updated versions of the NCCN Guidelines, NCCN Guidelines with NCCN Evidence Blocks™, the NCCN Compendium®, the NCCN Biomarkers Compendium®, the NCCN Templates®, and the NCCN Imaging Appropriate Use Criteria (NCCN Imaging AUC™), please visit  NCCN.org .To view the NCCN Guidelines for Patients®, please visit  NCCN.org/patients . Free NCCN Guidelines apps for iPhone, iPad, and Android devices are now available! Visit  NCCN.org/apps .



Industry News 
 
Novartis Oncology informs ANCO and MOASC that the United States Food and Drug Administration has approved Kisqali in combination with an aromatase inhibitor as initial endocrine-based therapy for the treatment of postmenopausal women with hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative advanced or metastatic breast cancer.
 
EMD Serono informs ANCO that the United States Food and Drug Administration has approved Bavencio for the treatment of adults and pediatric patients 12 years and older with metastatic Merkel cell carcinoma (MCC).


In This Issue

MOASC CALENDAR

 

LunchTime Series
March 29, 2017
 
NCCN Meeting in Florida 
March 23-25, 2017

COA Annual Meeting 
  April 27-28, 2017

ASCO National Meeting in Chicago
June 2-6, 2017
 
 


 
ANCO  
CALENDAR
   
2Q2017 Hematologic Malignancies Updates
(Sacramento, May 6) 
 
The State of Cancer Care (San Francisco, June 15)

 
 
 
 
 
 
 
 
 
 
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