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.
November 15, 2016
California News

- The California Supreme Court today ruled that health plans cannot absolve themselves of the responsibility to pay claims for emergency care by non-contracted providers by negligently delegating that responsibility to a risk bearing organization that it knows-or should have known-to be financially insolvent. Read More

- The California Medical Association has published a summary of the most significant new health laws of interest to physicians. For more details, see "Significant New California Laws of Interest to Physicians for 2017." 

Noridian News

- Noridian/JEMAC has posted the following updates to its website :
* MLN Connects Provider News
Announcements--2017 PQRS Results: Submit an Informal Review by November 30; Value Modifier: Informal Review Request Period Open through November 30; Quality Payment Program Presentations Available
Claims, Pricers, and Codes --
--Quality Payment Program Final Rule Call-November 15; CMS 2016 Quality Conference-December 13-15 
Publications --PECOS for Physicians and Non-Physician Practitioners Fact Sheet-Revised
* New Physician Specialty Code for Hospitalist CR9716.
* Self-Service Reopenings Available Through Noridian Medicare Portal
* ASP Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing Files-January 2017 CR9843
* Open Enrollment Participation Program
* CCI Edits, Version 23.0, Effective January 1 2017-Quarterly Update CR9847
* 2017 MPFS Available Soon.

DHCS/Medi-Cal News
- The Department of Health Care Services (DHCS) will hold its first Access Assessment Advisory Committee meeting on Friday, November 18, 2016, from 9 am - 3 pm in Sacramento. California's Medi-Cal 2020 1115 Waiver Special Terms and Conditions require DHCS to conduct an Access to Care Assessment (Assessment). DHCS is working with its External Quality Review Organization to conduct the Assessment, which will evaluate primary, core specialty, and facility access to care for Medi-Cal managed care beneficiaries. As a part of the Assessment process, the State established an Advisory Committee that includes representatives from consumer advocacy organizations, providers/provider associations, health plans/health plan associations, and legislative staff. The Committee will provide input into the assessment structure, including network adequacy requirements and metrics that should be considered, as well as provide feedback on the Assessment's initial draft report. Please visit the Access Assessment Webpage for more information. For questions or comments, please contact

  MOASC News
- Results from the ANCO/MOASC 2016 Staff Salary Survey are now available. Read the report, review the results, and download the raw data at .

- MOASC is proud to present their 2017 Oncology Summit: How Personalized Medicine fits into your treatment pattern for Lung cancer, Prostate cancer and Multiple Myeloma. Saturday, March 11, 2017, 7:30am to 3:30pm at the Hyatt Regency Huntington Beach. The confirmed speakers for Non-Small Cell Lung Cancer are: Edward Garon, MD, Associate Professor Medical Oncology, UCLA and Karen Reckamp, MD, MS, Associate Professor Medical Oncology, City of Hope; for Prostate Cancer, Przemyslaw Twardowski, MD, Associate Professor Medical Oncology, City of Hope and David I Quinn, MD, Associate Professor Medical Oncology, USC, and for Multiple Myeloma, James R. Berenson, MD, and Amrita Krishnan, MD, FACP,
Director, Judy and Bernard Briskin Center for Myeloma, City of Hope.
For complete information on this superb program, please contact the MOASC Office at 909-985-9061 ext.1 or or .
- "...attended both days and took away a lot of useful information, Thank you MOASC for putting together great speakers..." IF YOU MISSED IT.... THERE'S ALWAYS NEXT YEAR! MOASC's Fall Clinical Staff, Billing and Administrator Programs, held last week were a resounding success. Discussions highlighted were: Ron Culberson, MSW, CSP, CPAE, Speaker, Author, Humorist, presented Do It Well, Make It Fun! The Key to success in Oncology.Cheryl Bradley, Associate Director, CMA discussed  MACRA and what you need to know!Seth Eisenberg, RN, ASN, OCN, BMTCN, Professional Practice Coordinator, Infusion Services, Seattle Cancer Care Alliance Ambulatory Clinic, presented Self Advocating for Protection Against Hazardous Drugs. Stephanie L. Jackson, MSN, RN, AOCNS, BMTC, Oncology Clinical Nurse Specialist, Hematology/Stem Cell Transplantation, Ronald Reagan UCLA Medical Center and Pattie Jakel, MSN, AOCN, Oncology Clinical Nurse Specialist, Solid Tumor Program Santa Monica UCLA Medical Center discussed  Chemotherapy and Biotherapy Clinical Hot Topics in 2016.Edwina Rains, CPC, Associate Consultant, Oncology Management Consulting Group, President, ER's HealthCare Consulting presented Oncology Billing Overview. Kristy McGowan, Business Practice Consultant, Innovation Cancer, AmerisourceBergen discussed Mitigating financial risk in the practice and Payer Contracting/Negotiations.
"...A lot of applicable information, always a good reminder, excellent speaker, great suggestions..."

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- Results from the ANCO/MOASC 2016 Staff Salary Survey are not available. Read the report, review the results, and download the raw data at
- UC San Francisco's Thomas Martin, M.D., will present Back to Basics: Tenets of Testing in Myeloma Diagnostics--A Webinar with Live Q&A  on November 16 and December 12. The webinars are organized by MediCom Worldwide . Go to  for more information and to register.
- ANCO's Medicare Reimbursement for Oncology 2017 with Bobbi Buell takes place January 4 in San Jose and January 5 in Sacramento. Learn the latest information impacting Medicare's oncology reimbursement for 2017. These meetings are supported by ARIAD Pharmaceuticals, Exelixis, Helsinn Oncology, and Merck. Download the meeting announcement and registration form at
- ANCO is pleased to announce the 17th Multidisciplinary Management of Cancers: A Case-based Approach on March 17-19, 2017 at The Silverado Resort and Spa in Napa. Sign up for more information at
- ANCO seeks nominations to its Board of Directors. Four seats on the Board are up for election in 2016. This year's election will be conducted via mail ballot in December. Candidates with the top four vote totals will serve for three years (i.e., from 2017-2019, inclusive). The ANCO Board of Directors governs the Association, developing advocacy strategies and policies, approving education meeting proposals and activities, and considering membership benefits. The Board meets in person approximately once each year in the San Francisco Bay Area and via bimonthly teleconference. Expenses associated with attending Board meetings are reimbursed. Communication with the Board is also conducted via FAX broadcast and e-mail. You may nominate an ANCO member (including yourself) to stand for election to the Board via FAX to the ANCO office at (415) 472-3961 or e-mail to no later than November 18, 2016.

- ASCO has announced its roster of candidates for open leadership positions. Amongst the candidates are two ANCO members--Eric Small, MD, UCSF, and A. Dimitrios Colevas, MD, Stanford University. ASCO members will be able to vote for their chosen leaders through December 2, 2016. Go to for more information.

National News

- Bipartisan lawmakers hope to continue funding for the Precision Medicine Initiative and Cancer Moonshot by passing the 21st Century Cures legislation in the lame-duck Congress. The 21st Century Cures Act would provide $9 million in funding for new medical research, including provisions to support the Cancer Moonshot and Precision Medicine Initiative. It would also accelerate biomedical research under the National Institutes of Health (NIH) by creating the NIH and Cures Innovation Fund, which would receive $1.86 billion every year through 2020. See more at:
- CMA informs ANCO and MOASC that the effective November 1, Anthem in partnership with AIM Specialty Health expanded its Pre-service Review to the medical necessity of coverage requests for all not otherwise classified (NOC) oncology and biologic drugs. Pre-service clinical review will be based on specific medical policy or clinical guideline when available. In instances where a specific policy or guideline is unavailable, then Clinical Guideline CG-DRUG-01, Off-Label Drug and Approved Orphan Drug Use, will be used for HCPC codes J9999 and J3590. If the drug is not reviewed pre-service then Anthem will conduct a post-service review based on the same clinical criteria and may request records as part of that review. This pre-service clinical review program apples to commercial, local ASO, national accounts and Medicare Advantage members. Please contact (800) 676-2583 to verify any pre-service review recommendations or requirements for BlueCard business. Ordering physicians may submit a request for services to AIM through the AIM ProviderPortal, through the Availity Web Portal, or by calling the AIM call center at (877) 291-0360.
- UnitedhHealthcare Network Bulletin (November 2016) is now available online and features articles about eligibilityLink and claimsLink Rollout, Virtual Card Payment Option for Electronic Payments and Statements, Treatment for Members with Substance Abuse Disorder. Go to for more information.

CMS News

- Read Bobbi Buell's summary of the CY2017 Medicare Physician Fee Schedule at .
- The HHS Office of Inspector General "will review Medicare incentive payment data to identify payments to providers that should not have received incentive payment" and "assess CMS's plans to oversee incentive payments for the duration of the program and corrective actions taken regarding erroneous incentive payments," according to the agency's work plan for 2017. The agency will also evaluate the security of certified EHR technology and audit covered entities that have received these payments from the CMS, the work plan stated.
CMS has released information that physicians can consult to determine whether they will be subject to 2017 payment penalties associated with the Physician Quality Reporting System (PQRS) and the Value Modifier. Practices that have concerns about the findings in their report have until November 30 to file for an informal review of their data. Go to for instructions on how to access your Quality and Resource Use Report (QRUR).
Information on physicians having until November 30 to dispute 2015 PQRS and QRUR findings; MACRA will not create new reporting burdens, and the last day to change your Medicare participation status for 2017 (December 31) can be found at .

Affiliate Association News  
-  ACCC is hosting a webinar on the CY2017 Medicare Physician Fee Schedule and Hospital Outpatient Prospective Payment System on November 16 at 11AM PST. Register for this webinar at .
-AML webinar series explores the changing landscape of clinical decision making. From emerging molecular and cytogenetic alterations to treatment timing to improving outcomes for older patients, the landscape of treatment decision-making in AML is changing.
*On Thursday, Nov. 17, Fred Appelbaum, M.D., James Foran, M.D., Laura C. Michaelis, M.D., will discuss patient co-morbidities, disease factors and assessment tools that influence treatment decision-making for patients with AML over age 60. All webinars are scheduled from 2-3 p.m. Pacific Time. Find full details on CME and the activities at . Whether you see a few patients a year with AML or dozens, the free webinars will present information you can apply to your clinical practice. Register for the webinars, or select the ones that fit your schedule. This series is being sponsored by The National Marrow Donor Program®/Be The Match®.
- The American Medical Association (AMA) is providing free educational programs to help physicians understand the new Quality Payment Program under MACRA. Webinars have been scheduled for November 21 (register at ) and December 6 ( ). In addition, two  in-person meetings have been scheduled in Atlanta and San Francisco (on December 10; ).
- ASCO's Annual Election of leaders is now open through December 2. Go to  to learn about the candidates and vote.
- The 58th ASH Annual Meeting and Exposition is only a month away. Be sure to register . Learn about the most significant scientific discoveries in hematology and how these discoveries impact clinical practice, at the 58th ASH Annual Meeting & Exposition. December 3-6, 2016 in San Diego. Advance registration is open for a limited time. Register today to secure the best rates available for this year's event and to book your housing. ASH Registration and Housing Center, 888-273-5704 (U.S. toll free). Email:
- ASCO will present a webinar entitled MACRA Rules are Final: Time to Implement on December 5 at 1PM PT. For more information and to register, go to .
- ACCC and the Nevada Oncology Society will present a webinar entitled MIPS--The Final Rules Under MACRA on December 6 at 12PM PST. Register at .
- ASCO is accepting applications for its prestigious Health Policy Fellowship, a one-year Fellowship opportunity designed to give early-career oncologists the unique skills necessary to monitor and shape the regulatory and legislative policies that directly affect the practice environment and impact patients with cancer and their care teams. The deadline for submitting applications is December 30 at .
- ASH's 2017 Highlights of ASH in North America will take place in Seattle on January 27-28. Go to for more information and to register.
- Register for the inaugural ASCO Oncology Practice Conference, an educational meeting focused on the business of cancer care, being held March 2, 2017 in Orlando. Learn more and register at .
- Read the various summaries of the CMS Final MACRA rule :
ASH's summary focuses on how the MACRA rule will affect hematologists based comments it submitted under the proposed rule .
Bobbi Buell's analysis of the final rule is at .
- Comments on the proposed Medicare Physician Fee Schedule for CY2017 have been submitted by:
- ASCO and Innovative Oncology Business Solutions (IOBS) have announced a new collaboration, ASCO COME HOME--an oncology medical home program designed to transition community oncology practices from volume-based to value-based care by structuring reimbursement around the full range of services needed by patients with cancer. ASCO COME HOME will also prepare oncology practices for full implementation of the Quality Payment Program under MACRA and will be available across the country starting on January 1. ASCO is now recruiting practices for the fee-based 2017 ASCO COME HOME program. For more information, please contact Elaine Towle ( ). Learn more about ASCO's physician payment reform efforts at .
- Free PQRS reporting is now available through ASCO's QOPI. All users will be able to use the QOPI system to fulfill the Oncology Measures Group set of seven measures for PQRS reporting. Learn more at .
- ASCO is conducting a very brief (three-question) AMA survey on in-office drug compounding at
- ASCO is accepting applications for its 2017 Quality Training Program. In 2017, the Program is shifting its model of in-person sessions at ASCO headquarters in Alexandria to regional settings, including Portland. The comprehensive six-month program brings oncology teams together to create and facilitate an improvement project. Each team selects a project that will solve a problem in its own clinical setting, so the learning experience is simultaneously fostering a solution or best practice. For more information about the Quality Training Program, visit .
- View the 2016 ASH Meeting on Hematologic Malignancies Webcast with more than 13 hours of exclusive educational content. The webcast provides access to 21 sessions and 8 panel discussions featuring top experts in hematologic malignancies. The content is available online as video recordings of the speakers synced with slides from their presentations. Free previews from the 2015 meeting are available for viewing. Order Now
Want to see what a webcast looks like? View a free session from the 2015 meeting .
- Starting in November, join select 2017 ASH Meeting on Hematologic Malignancies (MHM) Program Planning Committee members and speakers for a free, five-part series previewing content from the core malignant hematology themes covered during the meeting--leukemia, lymphoma, myelodysplastic syndromes, myeloma, and myeloproliferative neoplasms. Learn more and register at .
- ACCC is hosting a webinar on USP800 where attendees will learn how to develop strategies to improve worker safety, talk about community-based care, and hear about the newest treatment issues. Register at .
- ACCC is hosting a series of interactive webinars on the hottest topics in oncology (from oral oncolytics and immunotherapy to new guidelines for NSCLC).  For the Oral Oncolytics Webinar Series, go to
for the Imuno-Oncology Webinar Series, go to .
- NCCN has published updated NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) with NCCN Evidence Blocks™ for Bone Cancer (V2.2017). For the complete updated versions of the NCCN Guidelines, NCCN Guidelines with NCCN Evidence Blocks™, the NCCN Compendium®, the NCCN Chemotherapy Order Templates (NCCN Templates®), and the NCCN Imaging Appropriate Use Criteria (NCCN Imaging AUC™), please visit .
- As part of its mission to improve the quality, effectiveness, and efficiency of cancer care so that patients can live better lives, the National Comprehensive Cancer Network® (NCCN®) has announced the launch of Just Bag It: The NCCN Campaign for Safe Vincristine HandlingThis campaign encourages health care providers to adopt a policy to always dilute and administer vincristine in a mini IV-drip bag to prevent a deadly medical error.  Attached is the Flash Update detailing the Chemotherapy Order Templates that are affected by this policy.

Industry News

- AMGEN informs ANCO and MOASC up 2017 coding updates for Neulasta. Effective January 1, a new drug administration CPT code (93677) will be available for use with the Neulasta Onpro Kit (J2505). For the Neulasta Prefilled Syringe for Manual Injection use CPT code 96372.
- Astellas Oncology will host a webinar on Xtandi on November 16. Go to for more information.
- AstraZeneca is a sponsor of the upcoming 2016 American Cancer Society Cancer Action Network, Personalized Medicine Roundtable on November 16th, in Los Angeles, and invites the members of Medical Oncology Association of Southern California to attend the event as AstraZeneca's guest. There a total of 4 seats left. Please don't register, but let Silvina Martínez, , 916.813.1252,know if you and/or others would like to attend, and she will submit your names to ACS as AstraZeneca's guests. For details of the event go to 2016 ACS CAN Los Angeles.  
- Bristol-Myers Squibb Oncology informs ANCO and MOASC that the United States Food and Drug Administration has approved Opdivo for the treatment of patients with recurrent and metastatic squamous cell carcinoma of the head and neck (SCCHN) with disease progression on or after a platinum-based therapy.
- Genentech launched the cancer immunotherapy Centers of Research Excellence (imCORE) Network, which will bring together many of the world's leading scientific and clinical experts in cancer immunotherapy to collaborate in the investigation of promising new treatment approaches. The imCORE research network is made up of scientists from 21 leading academic centers. The goal is to access and share technology, data and expertise to rapidly initiate pre-clinical and clinical research based on the latest discoveries and identify approaches to expand the number of people who may benefit from cancer immunotherapy. Genentech is working in collaboration with the network on existing and new investigational medicines, diagnostic technologies and emerging data. To learn more visit the Genentech cancer immunotherapy topic page.
- Johnson & Johnson Health Care Systems shares their 2017 MACRA Final Rule Highlights and Q&A documents that the legal team at Johnson & Johnson pulled together.  This gives a concise summary of the 2017 MACRA Final Rule ~ Please note~ CMS is accepting comments until December 13, 2016.
- Merrimack Pharmaceuticals informs ANCO and MOASC that Onivyde has been assigned J-code 9205 (1mg).

In This Issue
LunchTime Series
  October 26th

Oncology Roundtable Teleconference 
November 30th 
ASCO State Affiliate  
Meeting in Virginia, VA
October 26th - 28th


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 |