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 .
       
May 14, 2019
  
This Weekly's Hot Topics

  • Trump administration to require drug companies to include price of drug in television advertisementsNational News
  • Tomorrow is last day to review and dispute Open Payments. CMS News
  • ASCO invites your review of clinical guidelines, by May 16. Affiliate Association News


California News

Gov. Gavin Newsom's administration reversed course on his plan to divert public health dollars from several counties to help provide health coverage to young adults who are in the country illegally. The administration considered the concerns of Sacramento, Placer, Santa Barbara and Stanislaus counties, which had warned that the governor's plan would compromise their ability to cope with surging rates of sexually transmitted diseases and, in some cases, measles outbreaks. Newsom still plans to divert state money from 35 mostly small and rural counties, funds that currently pay for health services for uninsured residents, including undocumented immigrants. Legislators are working on their own budget proposals and have held dozens of hearings examining Newsom's plan. The governor and lawmakers have until June 15 to negotiate a final budget, so it is not yet clear which proposals will be included.
 
- The California Medical Association (CMA) will host a webinar entitled The Independent Dispute Resolution Process: How Physicians Can Appeal AB72's Interim Rate and How CMA Can Help Presented by Jodi Black, Vice President, CMA Center for Economic Services. Register at https://www.cmadocs.org/event
-info/sessionaltcd/CMA19_0529_IDRP
.
 
- MOASC & ANCO Members are invited to please join Californians Allied for Patient Protection (CAPP) for an evening reception in honor of Assembly Member Jesse Gabriel on Thursday, May 16th from 5:30 PM to 6:30 PM. The reception will be held at Woodland Hills Oral & Maxillofacial Surgery (6325 Topanga Canyon Blvd., Suite 435, Woodland Hills, CA 91367). Please click here to view the invitation. We ask that you share the invitation with your members and encourage them to attend. Please RSVP to Kristina Gelabert (kgelabert@micra.org). Thank you for your continued support of CAPP.



Noridian News  
 
- Noridian/JEMAC has the following updates on their website http://med.noridianmedicare.com/web/jeb
Announcements:
Open Payments: Review and Dispute Data by May 15; Proposed Rules on Interoperability: Comment Period Extended to June 3; Quality Payment Program: MIPS 2019 Call for Measures/Activities Ends July 1; Medicare Promoting Interoperability Program: Submit a Measure Proposal by May 28; New Part D Opioid Overutilization Policies: Myths and Facts; SNF Provider Preview Reports: Review Your Data by May 30; Medicare Shared Savings Program: Submit Notice of Intent to Apply Beginning June 11; Promoting Interoperability Programs: Submit Comments on Proposed Changes by June 24; Quality Payment Program Look Up Tool: Secure Access for APM Entities; Laboratory Blood Counts: Provider Compliance Tips
 
Events:
DMEPOS Competitive Bidding: Round 2021 Webcast Series
 
Publications:
AMCC Lab Panel Claims Payment System Logic; E/M Services of Teaching Physicians: Documentation; Medicare Physician Fee Schedule Database File Record Layout; Clinical Laboratory Fee Schedule: Quarterly Update; Medicare Physician Fee Schedule Database: Quarterly Update; Medicare Billing: Form CMS-1500 and 836 Professional Web-Based Training Course-Revised
 
* MolDX: ProMark Risk Score LCD-R2
* Medicare Physician Fee Schedule Database File Record Layout CR11191
* Documentation of Evaluation and Management Services of Teaching Physicians CR11171
* MPFS Database-July 2019 Update CR11293
* Re-Implementation of the AMCC Lab Panel Claims Payment System Logic CR11248
* MolDX: MammaPrint Billing and Coding Guidelines-R2
* ICD-10 and Other Coding Revisions to NCDs CR11229
* CLFS and Laboratory Services Subject to Reasonable Charge Payment-Quarterly Update CR11280
 
Forthcoming Noridian JEMAC meetings/webinars/workshops :
* Using the Medicare Beneficiary Identifier (MBI) Webinar (May 21)
* Duplicate Claims Webinar (May 22)
 * Modifier 59, NCCI and MUEs Webinar (May 28)
* Submitting Your Enrollment Online-Part 1 Webinar (I&A; May 29)
* Recoupment Webinar (May 30)
* Eligibility Claim Denials & Rejections Webinar (June 4)
* Using the Medicare Beneficiary Identifier (MBI) Webinar (June 13)
* Medicare Part A/B Revalidation Webinar (July 24)
* Submitting Your Enrollment Online-Part 2 Webinar (PECOS; June 26)
* Telehealth/Telemedicine Enrollment Only Webinar (July 10)
* 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  
 
- 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@moasc.org .
 
- MOASC Member, City of Hope CME presents: Multidisciplinary Approaches to Cancer Symposium onOctober 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:  https://cme.cityofhope.org/eventinfo_10946.html

  
    Like us on Facebook    Follow us on Twitter    View our profile on LinkedIn     
 
 
 
ANCO News  
 
- 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!

- The new ANCO website (www.anco.org) is now live!  ANCO physician members, their practice staff, and representatives from ANCO's corporate members must register to access password protected content at  https://anco.org/membership/already-a-member/ .
 
- Several new employment opportunities are now announced on the new ANCO website at https://anco.org/job-board/.

ANCO is now on Twitter; follow @ANCO News.
 


National News 
   
The drugs included everything from tablets and capsules to creams and ointments to treat conditions including cancer and more. U.S. states filed a lawsuit accusing Teva Pharmaceuticals USA Inc of orchestrating a sweeping scheme with other drug companies to inflate drug prices - sometimes by more than 1,000%, and stifle competition for generic drugs, state prosecutors said on Saturday. 20 drug companies engaged in illegal conspiracies to divide the market for drugs to avoid competing and, in some cases, conspired to prevent prices from dropping or to raise them, according to the complaint by 44 U.S. states, filed on Friday in the U.S. District Court in Connecticut. https://www.reuters.com/article/us-usa-drugs-lawsuit/u-s-states-accuse-teva-other-drugmakers-of-price-fixing-lawsuit-idUSKCN1SH0DP.
 
To inform a planned update to the methods that underpin ICER's evidence reports on new drugs and other health care interventions, the Institute for Clinical and Economic Review ( ICER) is opening a national call for suggestions on how to improve ICER's value assessment frameworkICER will welcome comments through Monday, June 10th. Based on the feedback received, draft revisions will be published to ICER's value assessment framework on August 16th, then go out to public comment on those proposed revisions through October 11th, and post the final updated framework on December 18th. This final framework will be applied to all assessments initiated in 2020 and beyond.
 
A federal D.C. district court judge is giving CMS the "first crack at crafting appropriate remedial measures" to fix the cut to hospitals' pay for 340B drugs included in both the 2018 pay rule and the 2019 rule, as the court on said CMS did not have authority to put forward the cuts in either regulation. The judge opted to give CMS a chance to fix the situation without vacating the pay rules, and points to concerns with the budget-neutral nature of pay rules and the presumption against retroactive rulemaking, which would complicate vacating the rules, in his explanation of that decision. "Plaintiffs express concern that the Secretary may use remand to 'further delay resolution of this matter' or even deny relief altogether," the opinion says. "But the Court will retain jurisdiction over this matter, and the Court may reconsider the remedy if the agency fails to fulfill its responsibilities in a prompt manner."
 
A study published in The Lancet Infectious Diseases ranked the top 50 US counties at greatest risk of measles outbreaks based on four factors: population, international air travel volume, nonmedical vaccine exemptions and measles incidence in countries people visit. The top five counties are Cook County, Ill.; Los Angeles County; Miami-Dade County, Fla.; Queens County, N.Y.; and King County, Wash. CNN ,   Becker's Clinical Leadership & Infection Control .

- A study by Kaiser Permanente Northern California (Study: Telemedicine satisfaction high among users) of patients who had a video visit with a primary care provider found that 93% were satisfied with the visit, and 90% expressed confidence about the quality of care they received. Ninety percent of people surveyed said they are open to future video visits. Reuters .
 
During Small Business Week last week, the Internal Revenue Service reminded small business owners and self-employed individuals to take deductions and credits that will help their bottom line. Publication 535, Business Expenses, has information about deductible business expenses, including employee related expenses such as employees' pay, retirement plans and insurance. Find more information about business tax credits on IRS.gov.
 

CMS News 
 
Tomorrow, May 15, is last day for U.S. physicians to review and dispute Open Payments data before it is made public on June 30. Review of the data is voluntary, but strongly encouraged to help improve the accuracy of the reported data. Learn more about Open Payments Review and Dispute here .
 
CMS finalized a rule, last week, which forces drug manufacturers to provide the list price for their products in direct-to-consumer ads, a policy aimed at increasing transparency and vehemently opposed by industry. The new policy will apply to drugs or biologics with list prices greater than $35 for a month's supply or the normal course of therapy, which HHS Secretary Alex Azar said is what consumers would be accustomed to pay because it's close to an insurance plan's average copayment for these drugs. First proposed in October, the rule will be going into effect in 60 days.
 
- CMS has reopened the National Coverage Determination (NCD) for Next Generation Sequencing (NGS). The reopening is limited solely to gremlin tests to identify those with hereditary cancer the may benefit from targeted therapies. As currently written, the NCD covers NGS tests approved by the USFDA for one-time use, on label, in patients with advanced cancer. For other one-time tests in advanced cancer, coverage may be provided through Local Coverage Determinations (LCDs), even if the test is not FDA-approved. Tests for patients with non-advanced cancer and tests for multiple uses, such as minimal residual disease, however are excluded from the NCD.



Affiliate Association News 
 
- Through May 16, ASCO invites key stakeholders to critically review and identify any errors in draft clinical practice guidelines prior to their finalization and publication. One draft clinical practice guideline or update is now open for comment--germline and somatic tumor testing in epithelial ovarian cancer Comment at  https://www.asco.org/practice-guidelines/quality-guidelines/guidelines-tools-resources/open-comment-guidelines .

Inland Empire Oncology Nursing Society is proud to announce the upcoming 5th Annual Education Fair for all medical professionals on May 18&19 at the Downtown Marriott in Riverside, CA. from 8:00am to 3:00pm. The Nursing Education agenda is geared toward oncology professionals - however the information is valuable in all aspects of nursing and care giving. Registration for ONS members is $55.00. Registration for NON-ONS members is $65.00. Your paid registration includes, breakfast, lunch, giveaways, parking and 5 CEU's.
 
Data abstraction for ASCO's QOPI Round 1 will close on June 3. Round 1 final reports will be available approximately two weeks after the round closes. Learn more at  http://practice.asco.org/quality-improvement/quality-programs/quality-oncology-practice-initiative?  In addition, The Doctor's Company, the nation's largest physician-owned medical malpractice insurer, offers up to a 10% premium discount to physicians whose practices have achieved QOPI Certification. Learn more at  https://www.thedoctors.com/qcp .
 
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  https://meetings.asco.org/opc/register .
   
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 .
 
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 .
 
- Improve your practice's business operations and clinical care delivery with help from ASCO Practice Consulting Services & Support. Learn more at 
https://practice.asco.org/practice-support/oncology-consulting-services . And, ASCO's Practice Engagement Program provides practices with a single point of contact to help you identify, navigate, and connect with the ASCO resources necessary to resolve outstanding challenges, prepare for pending changes, and succeed in an every-changing practice environment. Learn more at  https://practice.asco.org/practice-support/practice-engagement-program .
 
- ACCC's Spring update to the 2019 Patient Assistance & Reimbursement Assistance Guide is now available at  https://www.accc-cancer.org/home/learn/publications/patient-assistance-and-reimbursement-guide .
 
NCCN has published the following updates at  www.nccn.org : acute myeloid leukemia (V3.2019), breast cancer (V1.2019), diffuse B-cell lymphoma (V2.2019), gestational trophoblastic neoplasia (V2.2019), hepatobiliary cancers (V2.2019), Hodgkin lymphoma (V1.2019), kidney cancer (V4.2019), mantle cell lymphoma (V2.2019), neuroendocrine and adrenal tumors (V1.2019), smoking cessation (V2.2019).



Industry News
 
- Lilly Oncology informs ANCO and MOASC that the USFDA has approved Cyramza as a single agent for hepatocellular carcinoma (HCC) in patients who have an alpha fetoprotein (AFP) of  ≥ 400ng/ml and have been previously treated with sorafenib.
 
- Seattle Genetics cordially invites you to an educational program entitled Frontline Advancements: Clinical Data Overview of Echelon-1 and Echelon-2 with Caroline Behler, MD, California Pacific Medical Center, on May 16 at Mirimoto's in Napa. RSVP to rbelder@seagen.com.

- Stemline Therapeutics, Inc. informed MOASC and ANCO of their approval and subsequent commercial availability of ELZONRISTM (tagraxofusp-erzs; SL-401) for patients with blastic plasmacytoid dendritic cell neoplasm (BPDCN). For prescribing information on ELZONRISTM click HERE. To view a recent New England Journal of Medicine publication: "Tagraxofusp in Blastic Plasmacytoid Dendritic-Cell Neoplasm" go to https://stemline.com/pipeline/scientific-presentations/

 
 
 

 
In This Issue

















 
MOASC CALENDAR

Spotlight On Oncology
August 17, 2019












ANCO
CALENDAR
       
 
 
 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) 
 
 
 
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