California Oncology Weekly
"An Oncologists’ Source for Timely Information"
A publication of the
Medical Oncology Association of Southern California, Inc.
December 08, 2020
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COA needs your information ASAP to respond effectively to the Most Favored Nation (MFN) “experiment.” Affiliate Association News/COA News
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Deliver a message to Congress: STOP THE MOST FAVORED NATION (MFN) EXPERIMENT ON CANCER CARE! Medicare News/CMS News
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Tomorrow, December 9, webinar on, “Upcoming Changes to Medi-Cal and Managed Medi-Cal for 2021 MOASC News/ Programs & Industry News
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Last month this publication presented Medical Oncology Association of Southern California (MOASC) and National Oncology State Network (NOSN) communiques with Anthem Blue Cross representatives regarding white-bagging of drugs from CVS Specialty Pharmacy. Clarification was received from Anthem specifically for PPO/EPO plans.
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There is an opportunity for those practices receiving the letter to comply with the white bagging policy, to communicate with their Anthem Agent, Anthem contract manager, or Anthem Network Relations staff, to be able to purchase drugs outside CVS Specialty.
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Practices who did not receive a letter to start white-bagging drugs may continue to proceed with purchasing drugs as they have always been and not required to go through CVS Specialty.
If you have continued questions, please contact the MOASC Office at moasc@moasc.org.
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Targeted Oncology is looking to highlight a MOASC physician member in their Targeted Therapies in Oncology publication. The article will be placed in the “Community Consult” column. This is an opportunity for you, as an oncologist, to share your insights on interesting cases with your peers. Share the cases in which your patients developed unique adverse events related to newly approved targeted therapies. Demonstrate how you and your team worked together to address these challenging cases, is of particular interest. Keep in mind, although this column lends itself to the case report format, the column doesn’t have to focus on a particular case. If you are facing a challenging clinical issue, Targeted Oncology can work with you to develop a two-page article addressing the clinical challenges. They are starting to plan for 2021 and will need a 4-month lead time to write something.
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Nominate your candidate(s) now for a MOASC Excellence Award. MOASC would like to recognize MOASC Members, and their staff, for their dedication to providing quality cancer care during the Pandemic of 2020. Frontline healthcare workers are the backbone of the health system. Selflessly, they take on significant personal risk, many times without adequate equipment to ensure that their patients continue to receive the care they need.
Nominate your colleagues (practice, physician, nurse or other healthcare worker) for their dedication, commitment and courage to continue providing care, thereby saving countless lives and making a difference in the community. Recognition are in the areas of Excellence in Leadership and Excellence in Healthcare. Please provide a brief summary of why you are nominating this individual or team. Awardees will be announced during the MOASC Annual Oncology Summit (Live/Virtual) on Saturday, March 27, 2021. Please submit your nominations by Friday, January 8, 2021. Thank you!
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MOASC Programs - Save the Dates -All Times are Pacific
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December 9, 12:00pm, MOASC Members are encouraged to attend the webinar, “Upcoming Changes to Medi-Cal and Managed Medi-Cal for 2021,” with Zu Afzal, PharmD, BCOP, Board Certified Oncology Pharmacist-Walgreens, presenting.
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MOASC, once again, is partnering with Neil Love, M.D., Founder, Research to Practice (RTP) for a virtual Clinical Summit, “Current Concepts and Recent Advances in Oncology,” tentatively scheduled for Saturday, March 6, 2021. This topic & event is CME-MOC/NCPD Accredited. RTP & MOASC are in search of 10-12 oncologists to participate in the case recording interviews. The disease types that will be presented are Breast Cancer, CLL and Lymphomas, GI Cancers, GU Cancers, Gynecologic Cancers, Lung Cancer, and Multiple Myeloma. Please contact the MOASC office neast@moasc.org by Monday, 12/21/20, of your interest in participating.
Honorarium, Case Requirements and project details can be found
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The MOASC ONCOLOGY SUMMIT, ANNUAL CLINICAL EDUCATION SYMPOSIUM – Exciting Advances in Oncology, is scheduled for March 27, 2021, 7:30am – 1:30pm, at the Hyatt Regency Huntington Beach. MOASC President, Ashkan Lashkari, M.D. will moderate topics presented by experts from City of Hope and UCLA highlighting advances in several areas of oncology including genitourinary, lymphoma, thoracic, colorectal and breast cancers. Please join us for another exciting opportunity to interact with colleagues and learn from recognized speakers.
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Thank you for your participation in the MOASC Clinical Webinar, Medicare Updates for Oncologists during the COVID Crisis and Changes in 2021, presented by Arthur Lurvey, M.D., Medicare Contractor Medical Director, Noridian.
In case you missed the presentation, you can listen to the recording by clicking onto the following link, enter passcode: 0=kVbEkG.
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In a continuing effort to improve the information, presentations, and content of future events, it is extremely important to us to obtain your feedback on the meeting you attended (live & recorded). Please take a few moments to answer these questions.
1. What was your overall opinion of this Presentation?
2. Was the information presented helpful?
3. Any suggestions for future topics?
Thank you in advance for your comments!
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California Legislature had an interesting year, passing a number of new laws in the midst of a pandemic that affect health care, resulting in considerable operational challenges. While the number of new laws overall is significantly reduced as compared to other years, there was a strong focus on the impacts of COVID-19 pandemic, allied health professionals, mental health, and workforce and labor issues. The CMS has culled through them and found many significant new California Laws of interest to physicians for 2021.
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Noridian News
2021 Evaluation and Management Change Preparation Webinars, Dec. 10 – 17, include: 2021 Change Summary, Office and Outpatient Services, Medical Decision Making, Time Component, and Resources.
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Physician Fee Schedule Final Rule: Understanding 4 Key Topics CMS Call
During this call, CMS experts will briefly cover provisions from the final rule and address your questions.
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Provider Enrollment Application Fee Amount for CY 2021
On November 23, CMS issued a notice: Provider Enrollment Application Fee Amount for Calendar Year 2021.
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Part A/B Quarterly Medicare Updates, Jan 5 & 14, 2021, include: CMS and Noridian Updates, January 2021 Quarterly Provider Updates, Change Requests (CR), Payment and Recurring Updates, Special Editions (SE), Resources and Educational Information.
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New Provider New Biller Review Entities and Appeals Webinar - January 14, 2021
This event includes: Appeals Process, Forms, Noridian Medicare Portal (NMP), Post Medical Review Programs, and Resources
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Region-specific events, webinars and training for December & January are found JEA, JEB, JAF and JFB.
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Locally-hosted coverage articles listed
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CMS News
Help deliver a message to Congress: STOP THE MOST FAVORED NATION (MFN) EXPERIMENT ON CANCER CARE! As you know, the MFN experiment is dangerous for patients and will devastate practices if implemented. You must let Congress know, in no uncertain terms, that it is bad policy and should not be pursued. Please step up and take action today by contacting Congress.
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CMS Takes Further Steps to Ensure Medicare Beneficiaries Have Wide Access to COVID-19 Antibody Treatment
The U.S. Food and Drug Administration issued an Emergency Use Authorization (EUA) for the investigational monoclonal antibody therapy, casirivimab and imdevimab, administered together, for the treatment of mild-to-moderate COVID-19 in adults and pediatric patients with positive COVID-19 test results who are at high risk for progressing to severe COVID-19 and/or hospitalization. Casirivimab and imdevimab, administered together, may only be administered in settings in which health care providers have immediate access to medications to treat a severe infusion reaction, such as anaphylaxis, and the ability to activate the Emergency Medical System (EMS), as necessary.
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Wednesday, December 16, 2020, CMS will conduct a live information session from 10:00am to 10:30am (PT). The session will provide a brief overview of the expanded reporting requirements going into effect on January 1, 2021 as a result of the SUPPORT Act and regulatory changes and share tips on how to prepare for successful compliance. Open Payments reporting entity system users and other compliance staff should attend. Once registered, you will receive an email with call access information.
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The Patients over Paperwork initiative has launched revisions, announced November 20, 2020 to modernize our health care system which updates the archaic “Stark Law” (Medicare Physician Self-Referral Law). The current Stark Law was enacted back in 1989 which generally prohibits a physician from sending a patient for many types of services to a provider that the physician owns, is employed by, or otherwise receives payment from—regardless of what that payment is for. The business of health care must be more streamlined and efficient. Revisions to the Stark Law will make it easier for this to happen and support the transition to Value-Based Care, especially in light of the COVID-19 pandemic and the Opioid Epidemic which challenge our health care system. The final rule sets forth, in a provision with considerable substantive significance, an effective date of 60 days after the date of display in the Federal Register (with the exception for all but one provision which is effective January 1, 2022).
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Affiliate Association News |
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ANCO News
Three part virtual series on Hematologic Malignancies Updates: Leukemias, Lymphomas, & Myelomas 2020 is scheduled for Saturday, December 19. The faculty will present the latest research on treatment modalities for hematologic malignancies—leukemias, lymphomas, and myeloma—along with case studies for these diagnoses. Register online no later than Thursday, December 17.
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Virtual Best of San Antonio Breast Cancer Symposium® – West, January 9, 2021
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21st Multidisciplinary Management of Cancers: A Case-Based Approach is taking place virtually on March 12-14, 2021.
COA News
In follow up to COA’s initial comments and a desire to respond effectively to the Most Favored Nation (MFN) “experiment,” COA needs the following information ASAP.
1) If you have contracts based on Medicare rates – meaning, a function of Medicare FFS rates, not a function of ASP + something – COA needs to see some language ASAP. Not looking for any specific rates (you can redact the language) but that indeed payment is based on Medicare FFS. The importance of this is that if you have any commercial contracts based on Medicare FFS, then payments from those plans would be based on MFN rates. And those payments, unlike the MFN payments that don’t get reported in ASP, would be reported in ASP. That means that ASP starts tanking.
2) COA needs a few practices that will produce an affidavit to be filed with their complaint (lawsuit) about the damage this will do to your practice. This may tie to the first point, if you do indeed have commercial contracts based on Medicare FFS rates. If you do this, COA may well need you as a witness (virtual) to testify. Obviously, if your practice has a large Medicare FFS population that is important. Please send your information, ASAP, to Ted Okon, Executive Director, Community Oncology Alliance (COA), tokon@COAcancer.org
This is very, very important. Time is of the essence. Thank you for your response.
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To help practices prepare for the E&M coding changes in 2021, COA is hosting a series of three in-depth webinars, What Administrators, Physicians, and Care Teams Can Expect in the New Year. Coding experts Bobbi Buell and Elaine Towle will join COA’s director of strategic practice initiatives Bo Gamble to discuss how the changes affect your practice and what you can do to start the year on the right foot.
TOMORROW, Wednesday, Dec. 9, administrators, coding, billing, and compliance personnel are invited to join at 12pm PT.
Physicians and care teams are invited to join on Thursday, Dec. 10th at 3:30pm PT or 5:30pm PT.
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LLS
Make a difference in your patients’ lives today! Tell them about the Co-Pay Assistance Program of the Leukemia & Lymphoma Society. If your patient has a confirmed blood cancer diagnosis, the co-pay assistance program may be able to help pay for medical expenses related to their blood cancer treatment.
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TOMORROW, December 9, 2020 at 12:00pm PT, Walgreens cordially invites MOASC Members to their webcast on Medi-Cal’s Transition to Fee For Service. Upcoming changes to Medi-Cal and Managed Medi-Cal for 2021. Highlights of changes to the program effective January 1, 2020, plus Q&A. Presented by Zu Afzal, PharmD, BCOP, Walgreens.
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AstraZeneca demonstrates growing leadership in breast cancer at San Antonio Breast Cancer Symposium (SABCS) with data from its innovative medicines and robust pipeline. New data from the DESTINY-Breast01 Phase II trial, which reinforce the durable efficacy seen with Enhertu (trastuzumab deruxtecan) in HER2-positive metastatic breast cancer following two or more prior anti-HER2 based regimens. New results from the SERENA-1 Phase I trial, which demonstrate strong efficacy and safety for a next-generation oral selective oestrogen receptor degrader (SERD), AZD9833 as a monotherapy and in combination with the CDK4/6 inhibitor, palbociclib, in HR-positive, HER2-negative advanced breast cancer
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Janssen announced the submission of a Biologics License Application (BLA) to the FDA for amivantamab, an investigational, fully-human epidermal growth factor receptor (EGFR) and mesenchymal epithelial transition factor (MET) bispecific antibody with immune cell-directing activity that targets tumors with activating and resistance EGFR and MET mutations and amplifications.
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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 material contained in the California Oncology Weekly is intended as general information for 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 accepts no liability for any statements or articles herein. CPT codes are owned and trademarked by the American Medical Association. All Rights Reserved.
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