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.
January 16, 2018
This Weekly's Hot Topics

  • The California Medical Association (CMA) has published a summary of the most significant new health laws of interest to physicians. (California News)
  • Effective February 5, Noridian/JEMAC will require providers to use the Enrollment Application Status Search self-service tool to access application related details. (Noridian News)
  • On January 9, CMS announced the launch of a new voluntary bundled payment model called Bundled Payments for Care Improvement Advanced (BPCI Advanced). (CMS News)
California News 
- The California Medical Association (CMA) 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 2018 at:
- Despite a projected $6.1 billion surplus, Governor Jerry Brown's proposed budget calls for only a modest increase in health care spending. The proposal contains $233 million for larger payments to doctors and dentists who treat Medi-Cal patients. It also uses revenue from California's recently-increased tobacco tax to boost pay for home-health providers. The budget says that most of the health programs that were cut during the recession have been restored.
- A five-year affiliation agreement between UC San Diego Health Eisenhower Health in the Coachella Valley expands cancer services in Coachella Valley. The two organizations aim to broaden the range of services that the Eisenhower Lucy Curci Cancer Center can offer in Rancho Mirage and in six oncology clinics throughout the valley. It also creates a new "concierge" service for patients who travel to UC San Diego's Moores Cancer Center in La Jolla when their conditions are severe enough that they can't be handled in the desert community.
Noridian News  
Noridian/JEMAC has posted more updates to its website:
* MLN Connects
Announcements--2018 EHR Incentive Program Payment Adjustment for Eligible Clinicians; Physician Compare: 2016 Performance Information Available; CMS Launches Data Submission System for Clinicians in the Quality Payment Program; Quality Payment Program: Qualified Registries and QCDRs; Quality Payment Program Resources; Hospice Compare Update   
Publications --Hospice Payment System Booklet-Revised; Medicare Overpayments Fact Sheet-Revised; Avoiding Medicare Fraud & Abuse: A Roadmap for Physicians Booklet-Revised; New Medicare Card Project Special Open Door Forum-January 23
* E/M Modifiers Education on Demand
* CLFS and Laboratory Services Subject to Reasonable Charge Payment-2018 Annual Update CR10409
* Chemotherapy Administration-R11
* MolDX: Molecular Diagnostic Tests (MDT) LCD-R4
* MolDX: Breast Cancer Assay: Prosigna LCD-R2
* Lymphedema Decongestive Treatment-R1
* January Webinars-Register Now
* 2018 Medicare Physician Fee Schedule Now Available
* MolDX-CDD: ProMark Risk Score LCD-R1
* Immune Globulin Intravenous (IVIg) LCD-R7
* Summary of Policies in the Calendar Year (CY) 2018 Medicare Physician Fee Schedule (MPFS) Final Rule, Telehealth Originating Site Facility Fee Payment Amount and Telehealth Services List, and CT Modifier Reduction List CR10393
* Laboratory NCD Edit Software Changes for April 2018 CR10424
* MolDX: NSCLC, Comprehensive Genomic Profile Testing LCD-R2
* Proper Use of Modifier 59-Revised SE1418
* Erythropoietin Stimulating Agents (ESA) LCD Retirement-Effective January 1, 2018
* MolDX: CHD7 Gene Analysis Billing and Coding Guidelines-R1
* MolDX: BRCA1 and BRCA2 Genetic Testing LCD-R1
* New Waived Tests CR10418
* ASP Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing Files for April 2018 CR10447
Upcoming Noridian/JEMAC webinars include
* Mammography, PapTest, Pelvic Exam, and Cervical Cancer with HPV Tests Webinar (January 17)
* Evaluation and Management Modifiers Webinar (January 24)
* Modifier 59, NCCI, and MUE Webinar (February 7)
Providers can also view the Evaluation and Management (E/M) Modifiers Education on Demand tutorial. 
To read the complete update  and for more information, visit:
- Effective February 5, Noridian/JEMAC will require providers to use the Enrollment Application Status Search self-service tool to access application related details. Visit the tool at . In addition, effective February 5, Noridian/JEMAC will require providers to use the Noridian Medicare Portal (NMP) and/or the Interactive Voice Response (IVR) for all eligibility inquiries. For more information, visit  and .
MOASC News  
On Saturday, January 27, 2018 join us at MOASC's Spotlight On® Hematology, in Huntington Beach. MOASC's Spotlight On series presentation brings highlights of the 2017 ASH annual meeting. MOASC awarded educational grants to 3 UCI Fellows who attended the ASH Annual in Atlanta, GA on December 9 - 12, 2017. They & UCI faculty will present their discoveries through interactive discussions on ASH highlights. For more information and to register please contact the MOASC office at .
-MOASC's LunchTime Series presentation of, Benchmarking and 2018 Updates, is scheduled for Wednesday, January 31st at 12:00pm. Presented by Roberta L. Buell, Principal onPoint Oncology, Inc. More details will be email soon. RSVP to or call 909-985-9061x1.
You are cordially invited to MOASC's 3rd Annual Oncology Summit®, Harnessing the Power of Immunotherapy. March 3, 2018 at the Waterfront Hilton, Huntington Beach. Topics & speakers: *Head and Neck Ezra Cohen, MD, UCSD *Colon Cancer Marvan Fakih, MD, COH *Lung Cancer Karen Reckamp, MD, COH *Breast Cancer Sara Hurvitz, MD, UCLA *Melanoma Omid Hamid, MD, The Angeles Clinic & Research Institute. Register at .  
Once you are registered for the MOASC Oncology Summit®, you are invited to participate in the Biocept Advisory Board Meeting, Saturday, March 3, 2018, 2pm - 5pm, immediately following the MOASC Oncology Summit®. Topic: Liquid Biopsies: The Future is Now. Register early as there is limited seating for the advisory board. Honorarium is provided. The purpose of the ad board is to:
1.        Compare the relative strengths and limitations of liquid biopsy against those of conventional tissue biopsies;
2.        Discuss current and emerging testing technologies with respect to sensitivity, specificity, and clinical applications for patients with cancer;
3.        Evaluate clinical evidence pertaining to specific testing modalities that may help to individualize treatment protocols for patients with cancer;
4.        Discuss which cancer types are best suited for liquid biopsy testing;
5.        Discuss the clinical value of plasma testing be used be used in conjunction with tissue testing;
6.        Discuss the value of doing targeted marker liquid biopsy testing vs. large panels for liquid biopsies.
MOASC member, UC Irvine, presents their 3rd Annual UCI Hematology Symposium on Saturday, April 21, 2018, will feature regional and national experts bringing you state-of-the-art updates on sickle cell disease, modern anticoagulants, CAR-T Cell therapy, and others.  New this year, we will feature a Case Conference segment with individual case presentations and interactive discussions.  We hope to see you at the 3rd Annual UCI Health Hematology Symposium.
- Oncology nurse urgently needed at MOASC Member practice in Long Beach, CA. For more information contact Ann at .
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ANCO News  
- The ANCO membership elected Bradley Ekstrand, M.D. (San Mateo, 2020), Joel Neal, M.D. (Stanford, 2020), Minggui Pan, M.D. (Santa Clara, 2020), and Thach-Giao Truong, M.D. (Vallejo, 2020) to the ANCO Board of Directors. ANCO thanks Dr. Kankipati for her service to the Board and Drs. Kankipati, Limvarapuss, and Marsland for standing for election.
ANCO, in association with the Organizing Committee of the San Antonio Breast Cancer Symposium and Encore Medical Education, is hosting the Best of San Antonio Breast Cancer Symposium San Francisco (Best of SABCS San Francisco) at The Claremont Hotel on Saturday morning, January 27, 2018. Hope S. Rugo, M.D., is the Regional Director for the Best of SABCS San Francisco. For more information and to register, visit
The 18th Multidisciplinary Management of Cancers: A Case-based Approach returns to the Silverado Resort and Spa in Napa on March 16-18, 2018. The meeting is sponsored by the Association of Northern California Oncologists, Stanford Cancer Institute, UC Davis Comprehensive Cancer Center, and UCSF Helen Diller Family Comprehensive Cancer Center. Go to for more information, to register, and arrange for housing.
National  News

Anthem Blue Cross recently announced that it would reduce the magnitude of its modifier 25 payment cut from 50% to 25% and would delay implementation until March 1, 2018. Anthem will be issuing formal guidance to network physicians communicating these changes.
The Anthem Blue Cross Network Update (December 2017) is now available online at .
UnitedHealthcare's Network Bulletin (January 2018) is now available online at > Tools & Resources > News & Network Bulletin and features articles on notification/prior authorization requirements for CAR-T therapy, change in advance notification and prior authorization requirements, new procedure codes for injectable medications (effective January 1, 2018).

CMS News 
- Register for the New Medicare Card Project Special Open Door Forum on Tuesday, January 23 from 11:00am to 12:00 pm PT. This call will educate State Medicaid Agencies, Medicaid providers, Managed Care Organizations, Medicaid partners, and other Medicaid stakeholders about the change from Social Security Number-based Health Insurance Claim Numbers to new Medicare Beneficiary Identifiers (MBIs). A question and answer session follows the presentation. This is the same presentation given on   November 9.  Dial -in number: 800-837-1935; conference ID#:8259057.
- As part of CMS Administrator Seema Verma's "Patients over Paperwork" initiative, CMS established an internal process to evaluate and streamline regulations to: Reduce unnecessary burden; Increase efficiencies and Improve the beneficiary experience.
CMS is committed to removing regulatory obstacles that reduce the time you spend with your patients.  Read about the Patients over Paperwork newsletter for the latest updates on burden reduction and regulatory reform. 
- On January 9, CMS announced the launch of a new voluntary bundled payment model called Bundled Payments for Care Improvement Advanced (BPCI Advanced). Under traditional fee-for-service payment, Medicare pays providers for each individual service they perform. Under this bundled payment model, participants can earn additional payment if all expenditures for a beneficiary's episode of care are under a spending target that factors in quality.
  • BPCI Advanced participants may receive payments for performance on 32 different clinical episodes
  • BPCI Advanced will qualify as an Advanced Alternative Payment Model (Advanced APM) under the Quality Payment Program
BPCI Advanced seeks to support and encourage participants who are interested in:
  • Continuously redesigning and improving care
  • Decreasing costs by eliminating care that is unnecessary or provides little benefit to patients
  • Encouraging care coordination and fostering quality improvement
  • Participating in a payment model that tests extended financial accountability for the outcomes of improved quality and reduced spending
  • Creating environments that stimulate rapid development of new evidence-based knowledge
  • Increasing the likelihood of better health at lower cost through patient engagement, education, and on-going communication between doctors and patients
- The Model Performance Period for BPCI Advanced starts on October 1, 2018 , and runs through December 31, 2023. For more information about the model and its requirements or to download a Request for Applications document, the application template, and attachments, visit the BPCI Advanced webpage. Applications must be submitted via the Application Portal, which will close on March 12, 2018, at 8:59 pm PT.
The CMS Innovation Center will hold a Q&A Open Forum on Tuesday, January 30 from 9 to 10 pm PT. Register in advance. See the full text of this excerpted CMS Press Release
Affiliate Association News 
ASCO has asked CMS to rescind its 340B reimbursement cut. The CY2017 Hospital Outpatient Prospective Payment System  final rule reduced 340B reimbursement for separately paid drugs to ASP minus 22.5%. Read ASCO's letter at .
ASCO submitted comments on CMS's Quality Payment Program Rule for 2018 urging CMS to remove Part B drug reimbursement from payment adjustments under MIPS and to reconsider the weighting of ASCO quality programs in the MIPS Improvement Activities (IA) category. Read ASCO's comments at .
The second annual  ASCO-SITC Clinical Immuno-Oncology Symposium,  January 25-27 in San Francisco , will feature more than 40 expert faculty discussing the latest clinical and translational advances in immuno-oncology. These specialists will facilitate in-depth discussions on cutting-edge research currently shaping the clinical application of immunotherapy, as well as provide insight into what this research means for future patient care.
ASCO seeks applications for volunteers at . Your application will be used for all upcoming Volunteer Corps opportunities and 2018 committee consideration. Apply by January 31, 2018 for 2018 committee consideration. 
- Attend the  2018 Community Oncology Conference! Reserve your seat for April 12-13, 2018 at the Gaylord National Hotel & Convention Center, right outside of Washington, DC. The discounted hotel room block will sell out. What are you waiting for?  Register today! 
You are invited to the  2018 ASCO Annual Meeting  in Chicago from June 1-5, 2018 . First,  reserve your hotel now to ensure the best accommodations and experience. Hotels book very quickly. When you visit the website, you will need to sign in. If you are an ASCO member or have previously created a guest account, at you should sign in using those credentials. If you are not a member, you will be asked to create a guest account. The process should not take long to complete. After you've signed in or created an account, you can reserve your hotel room.

2018 Highlights of ASH®. Get a synopsis of the top hematology research presented at the latest ASH annual meeting and learn how it can help improve your patient management and care strategies at Highlights of ASH. For more information or to register, click 
here .
ACCC's 2018 Patient Assistance and Reimbursement Guide is now available at .
NCCN has published updates to the below. For the complete updated versions, please visit Recent updates include: AIDS-Related Kaposi Sarcoma (V1.2018), bladder cancer (V1.2018), chronic myeloid leukemia (V3.2018), diffuse large B-cell lymphoma (V7.2017), distress management (V1.2018), follicular lymphoma (V7.2017), Hodgkin lymphoma (V1.2018), non-small cell lung cancer (V2.2018), palliative care (V1.2018), penile cancer (V1.2018), primary cutaneous B-cell lymphomas (V2.2018).
Industry News 

AMGEN informs ANCO and MOASC that the United States Food and Drug Administration has approved Xgeva for the prevention of skeletal-related events in patients with multiple myeloma.
Bristol-Myers Squibb Oncology informs ANCO and MOASC that the United States Food and Drug Administration has approved Opdivo for the adjuvant treatment of patients with melanoma with involvement of lymph nodes or in patients with metastatic disease who have undergone complete resection.
EMD Serono informs ANCO and MOASC that CMS has assigned HCPCS code J9023 to Bavencio (10mg) effective January 1, 2018.
Exelixis informs ANCO and MOASC that the United States Food and Drug Administration has approved Cabometyx for the treatment of patients with advanced renal cell carcinoma (RCC).
Genentech BioOncology informs ANCO and MOASC that the United States Food and Drug Administration (FDA) has approved Avastin for the treatment of adults with glioblastoma that progressed following prior therapy. In addition, the FDA has approved Perjeta, in combination with Herceptin and chemotherapy, for adjuvant treatment of HER2-positive early breast cancer at high risk of reoccurrence.
Lilly Oncology informs ANCO and MOASC that CMS has assigned HCPCS code J9285 to Lartruvo (10mg) effective January 1, 2018.
Novartis Oncology informs ANCO and MOASC that the United States Food and Drug Administration has updated the label for Tasigna to include information on its discontinuation, post-discontinuation monitoring criteria, and guidance for treatment re-initiation in patients taking Tasigna for Philadelphia chromosome positive (Ph+) chronic myeloid leukemia (CML) who have achieved a sustained molecular response (MR4.5).
In This Issue
Spotlight on Hematology 
 January 27, 2018
Huntington Beach, CA

LunchTime Series
January 31, 2018

Oncology Summit
March 3, 2018
Huntington Beach, CA

Highlights of ASH (San Francisco, January 12-13)

(San Francisco, January 13)

(San Francisco, January 18-20) 

(San Francisco, January 25-27) 

(Berkeley, January 27)

(San Francisco, February 8-10

(Napa, March 16-18)

(San Francisco, 
April 27-28)  
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 |