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
.
|
|
|
|
|
- Anthem Blue Cross Policy denying certain E&M services California News
- MOASC Board & Officers install NEW Executive Director MOASC News
- USP Chapters <797> and <800> initial checklist available MOASC News
- Contact your lawmakers to urge them to pass HR913 National News
|
|
|
- The California Medical Association and the American Medical Association and other state and specialty societies continue to voice concerns with the recent implementation of the Anthem Blue Cross Policy denying certain evaluation and management services submitted with modifier 25. Learn more at
- Most patients don't argue when their health insurance won't cover treatment or medication, but they should: Consumers win about half of their appeals. The process can sometimes be overwhelming, but there are ways to prepare and get help. Did Your Health Plan Deny You Care? Fight Back.
- Last month, the California state legislature and Gov. Newsom signed the 2019 - 2020 State Budget, which includes $250 million for Value-Based Payments to Medi-Cal Providers with investment from Proposition 56 (Tobacco Tax) funds. Once approved, and matched by the federal government, the new investment will total more than $500 million. Although details are still rolling out, the Department of Health Care Services (DHCS) has established a website to share information about the Value Based Payment Program. The department also held a webinar in June to discuss the new program. Slides from the June webinar can also be found on the website. A full summary of the Health and Human Services portion of the budget is found here.
- A look at who is utilizing California's aid-in-dying law reveals a large racial gap that experts attribute to both issues with medical access and philosophical differences in what is considered suicide. Approximately 88 percent of people using California's physician-assisted death law are white, according to new data from the California Department of Public Health.
- SB 322, a bill that Gov. Newsom signed last week amends the state's Health Safety Code to encourage patients and health care workers to report unsafe patient care and conditions. The bill provides health care workers whistleblower protections when they issue a complaint or initiate an investigation about their employers. With the new law, health care workers have the right to voice their concerns privately to the California Division of Occupational Safety and Health without the presence of hospital management.
|
|
|
Publications:
October 2019 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing Files; Quarterly Update for Clinical Laboratory Fee Schedule and Laboratory Services Subject to Reasonable Charge Payment-Revised.
* MolDX: Decipher Biopsy Prostate Caner Classifier Assay for Men with Very Low or Low Risk Disease LCD-R1
* CLFS and Laboratory Services Subject to Reasonable Charge Payment-Quarterly Update-Revised CR11280
* Decipher Prostate Cancer Classifier Assay LCD-R6
* Quarterly ASP Medicare Part B Pricing Files and Revisions to Prior Quarterly Pricing Files-October 2019 CR11343.
Forthcoming Noridian JEMAC meetings/webinars/workshops
* Understanding National and Local Coverage Determinations Webinar (July 23)
* Using the Medicare Beneficiary Identifier (MBI) Webinar (July 23)
* Understanding the Basics of Medicare Secondary Payer (A/B) Webcast (July 24)
* Medicare Part A/B Revalidation Webinar (July 24)
* Computed Tomography of the Abdomen and Pelvis Webinar (July 31)
* What's New in the Third Quarter 2019-After Hours Webinar (August 1)
* Revocation, Caps and Appeals Webinar (August 7)
* Using the Medicare Beneficiary Identifier (MBI) Webinar (August 8)
* Submitting Your Enrollment Online-Part 1 (I&A) Webinar (August 21)
* Drugs and Biologics-Outpatient Billing Webinar (September 10)
|
|
|
- The Board of Directors & Officers of the Medical Oncology Association of Southern California have unanimously voted to award Nichole A. East, CAE, the position of Executive Director. Ms. East has served MOASC for more than 15 years, in various capacities. In January 2019, she
earned the prominent Certified Association Executive (CAE) credential from the CAE Commission of the American Society of Association Executives (ASAE). Accredited by the National Commission for Certifying Agencies (NCCA), she joins 4,300 association industry leaders worldwide who currently hold a CAE. Nichole will be honored, next month, during the 2019 ASAE Annual Meeting & Exposition in Columbus, Ohio. MOASC and her colleagues congratulate and celebrate her achievement and as the new MOASC Executive Director. Former Executive Director, Mariana S-B Lamb, M.S., will remain with MOASC as Executive Advisor.
-
Mark your calendar for MOASC's LunchTime Series presentation of, "Everything You Need To Know About USP Chapters <797> & <800>,"
Wednesday, July 31 at 12:00pm.
MOASC has been in receipt of calls from members regarding USP Chapters <797> & <800>.
Despite the national challenges, every medical practice that acquires, stores, mixes, or administers sterile and/or hazardous drugs, should review and consider their preparedness for inspection and being held to many of the pharmacy standards in USP Chapters <797> & <800>.
Dawn Holcombe,MBA FACMPE ACHE, President, DGH Consultingand Willis Triplett, PharmD, have madeavailableto MOASCan initial checklist that will guide you through your next steps. Please contact the MOASC Office moasc@moasc.org for handouts and call-in information.
- SAVE-THE-DATE for MOASC's Spotlight On Oncology, August 17, 2019 in Huntington Beach. MOASC awarded restricted grants to selected oncology fellows and faculty from the University of California, Irvine (UCI), to present the premier topics as a result of their attendance at the 2019 Annual ASCO Meeting. The presentations not only promote collegial discourse among colleagues along with networking in an informal setting but valuable clinical information. Contact the MOASC Office for more information at
moasc@moasc.org.
- Renew your MOASC Membership TODAY to continue your investment in your state association! MOASC continues to advance oncology in California with your support and membership in MOASC. In 2018, MOASC successfully worked to create the California Cancer Caucus in Sacramento. YOU, the California oncologist, are the reason for MOASC's existence. MOASC advocates diligently insuring your ability to serve the California oncology community.
You can renew your membership in two ways:
Print the application
HERE. With your check made payable to: Medical Oncology Association of Southern California, Inc., mail the completed application to: P.O. Box 161, Upland, CA 91785.
OR
We are looking forward to an exciting year ahead with benefits you will not want to miss.
If you have any questions, please contact the MOASC Office at 909-985-9061 ext.1 or at
moasc@moasc.org.
- MOASC Member, City of Hope CME presents: Multidisciplinary Approaches to Cancer Symposium on October 10-13, 2019 at the Waldorf Astoria, Las Vegas. 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.
- Mark your calendars for the "MOASC Educational Series Program" at the Waterfront Hotel, Huntington Beach on Thursday, November 14, 2019.
- Mark your calendars NOW for the 7th Annual MOASC Oncology Summit, March 14, 2020 at the Hyatt Regency Huntington Beach. From 2014 through 2019 the MOASC Oncology Summit has highlighted cutting-edge topics presented by world renowned physicians. From topics like: Decoding Molecular Medicine's "nibs" and "mabs" to Personalizing Cancer Care in the Era of Multiple Therapies and Diagnostic Tools to Harnessing the Power of Immunotherapy, and this year's Advancing Cancer Care in the Elderly; unlike any other, MOASC has brought to southern California physicians the most contemporary topics for presentation and discussion among colleagues. You will not want to miss our 2020 program!
|
|
|
- SAVE THE DATE for the ANCO Annual Professional Education Meeting 2019 in Berkeley on Saturday, October 17. Watch for a meeting announcement in late July.
- SAVE THE DATE for the ANCO-UCSF Precision Oncology Symposium in San Francisco on Saturday, November 2. Watch for a meeting announcement in mid July.
- Follow
ANCO on Twitter
at
@ANCO News
.
|
National News
- Medicaid patients need clinical trial access. ANCO, MOASC and more than 80 other organizations ask you to contact your lawmakers to urge them to pass HR913, the Clinical Treatment Act would guarantee coverage of routine care costs of clinical participation for Medicaid enrollees with life-threatening conditions. To contact your lawmakers, go to
https://asco.quorum.us/campaign/14280/
- CVS Health has brought eight more states into the fold of its direct-to-consumer MinuteClinic telehealth service, which brings its reach to 26 states and Washington, D.C. Residents in Arkansas, Connecticut, Hawaii, Indiana, Minnesota, Missouri, Oklahoma and Texas are the latest to be added to the program, which enables consumers to pay $59 to virtually reach a physician for minor ailments.
mHealth Intelligence
.
- Medical technology is continually evolving, and upskilling is critical to keep up with the changes, says Andrew Hajde, senior industry adviser at the Medical Group Management Association. Areas in oncology where training and upskilling will occur are in the areas of scheduling, registration, care coordination, remote patient monitoring and, eventually, AI-assisted clinical decision-making, amongst many other areas.
MGMA's Hajde: Upskilling is necessary to keep up with technology
- Medicare patient mortality, readmissions and costs were not significantly different when comparing data from, before and after, the Accreditation Council for Graduate Medical Education reduced maximum weekly and shift work hours for residents, according to research published in The BMJ. Sanjay Desai, M.D., of Johns Hopkins University, commented that the study "affirms for me that the discussion around the number of hours spent in the hospital during training is not an important discussion anymore." Medscape (free registration)
- Following the ASH Palliative Care Working Group finalization of the new ASH Statement in Support of Palliative Blood Transfusions in Hospice Setting, the OIG reported that one-third of all hospices that provided care to Medicare beneficiaries had complaints filed against them. ASH's statement outlines support for access to palliative blood transfusions, when appropriate, for individuals in the Medicare hospice benefit, to provide symptom relief. The OIG reported that from 2012 through 2016,nearly all hospices that provided care to Medicare beneficiaries were surveyed by either a State agency or accrediting organization. Over 300 hospices had at least one serious deficiency or at least one substantiated severe complaint in 2016, which the Office of Inspector General (OIG) considers to be poor performers. Over 80% of these hospices had at least one deficiency, with the most common types of deficiencies involving: Poor care planning; Mismanagement of aide services; and inadequate assessments of beneficiaries. Of the 80% of hospices having a deficiency, other deficiencies were found which posed risks to beneficiaries. These failings-such as improperly vetting staff and inadequate quality control-can jeopardize beneficiaries' safety and lead to poor care. Click Here to review and download the complete OIG report. ASH's full statement can be found on ASH's website.
- In past California Oncology Weekly publications, MOASC asked how you are faring with certain drug shortages. With ASCO and COA, ASH, too, is
concerned about the national shortage of intravenous immune globulin (IVIG) and has contacted the U.S. Food and Drug Administration's (FDA) Drug Shortage Office and Office of Compliance and Biologics Quality regarding the critical nature of this shortage. The FDA is directing all questions to individual manufacturers to resolve the shortage; manufacturers' contact information can be found online. ASH continues to monitor this shortage, and ASH members who are dealing with a critical case that requires this therapy and are encountering access issues should contact ASH Policy and Practice Coordinator, Katherine Stark.
|
CMS News
- Starting January 1, 2020, you must use the Medicare Beneficiary Identifier (MBI). CMS will reject claims you submit with the Health Insurance Claim Number (HICN), with a few exceptions and reject all eligibility transactions. Many providers are using the MBI for Medicare transactions. For the week ending July 5, providers submitted 76% of fee-for-service claims with the MBI. Protect your patients' identities by using MBIs now for all Medicare transactions. Don't have an MBI? Ask your patients for their card. If they did not get a new card, give them the Get Your New Medicare Card flyer in English or Spanish.
Use your Medicare Administrative Contractor's look up tool. Sign up for the Portal to use the tool. Check the remittance advice. CMS returns the MBI on the remittance advice for every claim with a valid and active HICN. For more information, see the MLN Matters Article.
- CMS will not be releasing any updates to the Hospital Compare star ratings this summer
. A CMS spokeswoman noted the next update won't happen until a panel of technical experts reviews the star ratings methodology and recommends changes, but the agency has yet to convene a panel.
CMS won't release updates to hospital star ratings this summer.
- America's Physician Groups (APG) is pleased to present a new complimentary webinar series this year for physicians and physician groups participating in the
Primary Cares Initiative, specifically the Direct Contracting Models. Through a co-branding agreement with the Centers for Medicare & Medicaid Services (CMS), the sessions combine the Innovation Center's expertise on the regulation content with APG members' knowledge of the competencies needed to be successful in the new direct contracting models. APG members will share the know-how necessary to operate risk-based contracts successfully. Subject matter experts from The Innovation Center (CMMI) will review the regulation content of the direct contracting models and provide additional relevant resources.
|
Affiliate Association News
- Get ready for the August Congressional recess! COA continues to make organizing a policymaker visit easy with the new and improved
Sit in My Chair
toolkit.
It offers everything your practice needs to curate a moving and memorable experience, from checking policymakers into your waiting room, walking them through diagnosis, having them sit in a chemotherapy chair for treatment, and more. It is important to put a human face on tough issues. That is what helps policymakers appreciate the important role of community oncology in patients' lives and our cancer care system. Is your practice ready to create a unique experience that will captivate members of Congress this summer? August is quickly approaching and calendars are filling up fast, which is why NOW is the time to plan a
Sit in My Chair
event.
- ASCO University has changed its name and upgraded the learning platform to ASCO eLearning. The ASCO eLearning platform now includes new personalize course collections to make content more digestible. Courses offer CE/CME/MOC credit and, on the new site, learners no longer have to complete all sections before obtaining credit. Visit ASCO eLearning at
https://elearning.asco.org/homepage.
- Applications are now being accepted for the 2020-2021 cycle of ASCO's Health Policy Leadership Development Program, a one-year program that gives ASCO members the opportunity to develop expertise in health policy, advocacy, and grassroots activity while learning valuable leadership skills. Learn more at
https://www.asco.org/advocacy-policy/asco-in-action/apply-now-ascos-health-policy-leadership-development-program.
- Present your research at the world's premier hematology event, the 61st ASH Annual Meeting and Exposition in Orlando, Florida. The best new scientific research in all areas of hematology will be presented. Researchers are encouraged to submit an abstract by August 1, 11:59 p.m. Pacific time.
- Start planning now for the meeting you can't miss!
The preliminary program for the 61st ASH Annual Meeting and Exposition, December 7-10, 2019, in Orlando, is now available online.
Take a look to start planning your meeting now and ensure you have access to the most up-to-date information on this year's exciting sessions, speakers, and events.
- The ASCO Oncology Practice Conference, September 5, in San Diego will focus on the business of cancer care addressing 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.
- 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. 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.
- 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. Top experts in the field, will present 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.
- Register for ASCO's Advocacy Summit, September 25 & 26, 2019 in Washington, D.C. this two-day conference will feature guest speakers and network opportunities that will empower you to advocate for policies that support cancer research, your practice and highest quality patient care in meetings with your lawmakers.
- Join the Inland Empire Oncology Nursing Society fundraiser event for The Leukemia & Lymphoma Society's Light The Night, on October 26, 2019 at the Auto Club Speedway of California in Fontana, money raised through Light The Night allows The Leukemia & Lymphoma Society (LLS) to fund treatments for patients who are suffering from all forms of blood cancers. In 2018, LLS helped advance 19 of 21 approved blood cancer therapies. Beating cancer is in our blood.
Donate NOW!
- ASCO's Quality Oncology Practice Initiative (QOPI) is an oncologist-led, practice-based quality assessment program for outpatient oncology clinics. Round 2 registration is now open and data submission will run from July 1 to December 3, 2019. Register for QOP at
https://myqopi.asco.org/registration/login.aspx.
- Conquer Cancer®, the ASCO Foundation, has awarded more than $126 million through nearly 2,100 grants and awards to medical students, trainees, young scientists, and oncologists at all stages of their careers. Many of ASCO's funding opportunities are currently accepting applications. While eligibility criteria differ for each award, all grants require that applicants be a member of ASCO to apply. Join ASCO and submit your grant application today!
Highlighted funding opportunities include: Young Investigators Award; Global Oncology Young Investigators Award; Career Development Award; Gateway Discovery Grant in Immunotherapy Research. For detailed information regarding eligibility criteria for each funding opportunity and its application process, please select the name of the grant above, or view all available funding opportunities through Conquer Cancer®.
|
|
|
- Genomic Health informs ANCO and MOASC that effective September 1, 2019, OncotypeDx in invasive breast cancer, Node +1-3 Nodes, is now included in UnitedHealthcare's medical policy coverage.
|
|
|
MOASC CALENDAR
July 31, 2019
|
(NCCN, San Francisco, September 27)
(NCCN, San Francisco, September 27-28)
ANCO Annual Professional Education Meeting 2019 (Berkeley, October 17)
ANCO-UCSF Precision Oncology Symposium (San Francisco, November 2),
|
|
|
|
|
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.org
|
|
| |
|
