June 29, 2021

This Weekly's Hot Topics

MOASC President, Ashkan Lashkari, MD, will join ANCO President, Thach-Giao Truong, MD, on ANCO Connections, Thursday, July 15, 12:00pm-1:00pm. The title of the program is, Connecting with MOASC: Re-opening of California, and what it means for Oncologists.

MOASC continues their Membership drive. Your Membership in MOASC is an investment in your patients. MOASC has advanced oncology in California, and influenced national dialogue for the past 31 years. MOASC provides you access to California oncology colleagues, clinical education and support for delivery of oncology patient care, no matter the setting or the stage of your career.

Contact the MOASC Office at moasc@moasc.org, or 909-985-9061 ext. 1, for more information on how MOASC benefits you.

MOASC Programs - Save the Dates - All Times are Pacific

Clinical Peer to Peer Discussion on Lung Cancer, Wednesday, July 28, 5:30pm – 7:00pm-PDT. MOASC Secretary, Joshua Mansour, M.D., City of Hope will host moderator Hatim Husain, M.D., UCSD in a panel discussion of case presentations and discussion of various treatment options with; Munveer Bhangoo, M.D., Scripps MD Anderson Cancer Center; Misaqh Karimi, M.D., City of Hope; Jonathan Goldman, M.D., UCLA Hematology & Oncology.

This event is complementary registration is required. 

Mark Your Calendar for the MOASC virtual Spotlight On Clinical Oncology Saturday, August 14, 8am – 12pm. Topics to be discussed are on breast cancer, GU cancers, upper GI and lower GI cancers, lung cancer and melanoma/sarcoma. Renowned speakers from UCI, UCSD, Cedars-Sinai and more are being lined up to present a most valuable program for you.

Coverage for low-income people 50 and older who are living in the country illegally, will cost California taxpayers about $1.3 billion per year. This is money that’s part of the new state operating budget that Gov. Gavin Newsom and state legislative leaders unveiled Friday night. Yesterday’s late Monday floor votes satisfy a 72-hour disclosure rule after deals on some of the most stubborn issues, including an expansion of Medi-Cal to older low-income undocumented immigrants, were not announced until Friday night. Lawmakers will wait until at least Thursday to approve the Medi-Cal plan and other bills that will carry out the rest of the budget. The payment of health care bills of illegal aliens is part of an expansion of Medicaid that aims to inch the nation’s most populous state toward Democrats’ goal of making sure everyone has health insurance.

California has launched a website, myvaccinerecord.cdph.ca.gov, that will allow residents to download or view a digital copy of their COVID-19 immunization records. A tool is planned to allow verification of the records by scanning a QR code.

California's Comprehensive Cancer Control Plan, 2021-2025 is almost ready for posting. In the meantime, you can download the goals and objectives of the plan to inform your work.

Noridian’s Medicare Part A and B Provider Outreach and Education (POE) team is providing their latest news and updates.

There will be Common Working File (CWF) “Dark” days on Friday, July 2 through Sunday, July 4, 2021 for all CWF hosts. This means the CWF online Health Insurance Master Record (HIMR) inquiry will not be available on those days. Due to July 5th being observed as the July 4th holiday, there will be no claim cycles. Updated claim data will be available on Tuesday, July 6th. 

Effective July 23, 2021, the Billing and Coding: Complex Drug Administration Coding, R5 coverage article has been revised and published for notice under contract numbers: 01112 (NCA), 01182 (SCA), 01212 (HI and Territories), and 01312 (NV).

July 6, 2021 Quarterly Medicare Updates is intended for Medicare Part A/B Providers and will include: • CMS and Noridian Updates • July 2021 Quarterly Provider Updates • Change Requests (CR) • Recurring Updates • Special Editions • Resources. 

July 8, 2021 Quarterly Medicare Updates After Hours webinar is intended for Medicare Part A/B Providers and will include: • CMS and Noridian Updates • July 2021 Quarterly Provider Updates • Change Requests (CR) • Recurring Updates • Special Editions (SE) • Resources. 

July 13, 2021 Telehealth Services webinar is intended for Medicare Part B Providers and will include: • Overview • Eligible Providers • Covered Services • Coding and Billing • Virtual Services • Resources.

July 14, 2021 Prior Authorization for Certain Hospital Outpatient Department (OPD) Services webinar is intended for Medicare Part A/B Providers and will include: • Overview • Authorization Process • Submitting Prior Authorization Request (PAR) • Services Requiring Prior Authorization • Advance Beneficiary Notice of Noncoverage (ABN) • Resources.

July 22, 2021 Modifier 59, National Correct Coding Initiative and Medically Unlikely Edits webinar includes: National Correct Coding Initiative (NCCI), Modifier 59, Procedure to Procedure (PTP) CCI Edits, Medically Unlikely Edits (MUEs), CCI Examples, Resources.

July 29, 2021 Noridian Medicare Portal (NMP) Functionality webinar includes: NMP Functionality for Eligibility and MBI Lookup Tool, Claim Status, Financial, Appeals Status and Submission, Remittance Advices, Provider Enrollment, Message Center. 

July 2021 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing Files are found in CR12244. The revision informs you about the ASP methodology, which is based on quarterly data manufacturers submit to CMS. CMS gives the MACs ASP and Not Otherwise Classified (NOC) drug pricing files for Medicare Part B drugs on a quarterly basis. Payment allowance limits under the Outpatient Prospective Payment System (OPPS) are in the Outpatient Code Editor (OCE) through separate instructions in Chapter 4, Section 50 of the Medicare Claims Processing Manual. Please make sure your billing staffs are aware of these updates.

It is CRITICAL to please reach out to ALL the Representatives from districts where you treat patients to cosponsor the TACT Act (72-hour bill) H.R. 3258. Representatives Offices need to hear from constituents – that’s you. Contact COA for materials at nferreyros@COAcancer.org.  This should be a very easy lift as it is a patient empowerment bill. Let’s beat the PBMs on this!!!

Senate Finance Committee Chairman Ron Wyden, D-Ore., has released a set of principles designed to stimulate legislative action on drug pricing. The plan calls for a cap on out-of-pocket costs for Medicare beneficiaries, limiting Medicare price increases to the rate of inflation and allowing Medicare to negotiate lower prices, which would also apply to private insurance enrollees.

Congressional leaders introduced a bipartisan follow-up to 2016's 21st Century Cures Act, dubbed Cures 2.0. The proposal would create a new federal research agency, expand Medicare coverage and diversify clinical trials. The legislation aims to establish the $6.5 billion Advanced Research Projects Agency for Health to study cancer, Alzheimer's disease and other illnesses, expand Medicare coverage for new health care technologies, and require the FDA to expand collection and use of real-world data, among other provisions.

TRICARE reminds providers and beneficiaries of their formulary search tool to assist patients and physicians to know if the prescribed drug is something that TRICARE covers.

Past healthcare venture promises to lower costs have gone bust. This time, five Blue Cross Blue Shield health plans are leveraging patient data on drug efficacy. These five Blues have created a new company, Evio, which aims to assess prescription drug efficacy and match a drug's cost to performance. The goal of the value-based initiative is to reduce prescription drug costs.

Connecting with MOASC: Re-opening of California, and what it means for Oncologists. Thursday, July 15, 2021 12:00pm-1:00pm, Speakers - Dr. Truong, ANCO President and Dr. Lashkari, MOASC President.

ANCO is in the beginning stages of planning for their Professional Education Conference for the Fall of 2021. Please take a few moments and help with their planning by completing this very short, 4-question survey. Thank you!

Earn CME or CE credit through a virtual course on the applications of genomics. The free virtual course, developed by ASH, LLS and TFF, is the second installment of GENOM (Genomics Essentials in Hematologic Malignancies). The latest "Applications" series features disease-specific, case-based modules exploring relevant biomarkers, available tests and therapies, patient communication strategies, and emerging research. As a reminder, the first "Foundation" series featured content on genomics, followed by disease-specific activities covering major hematologic malignancies and relevant premalignant conditions. These activities are intended for hematologists, hematologist-oncologists, medical oncologists, nurses, physician assistants, and nurse practitioners caring for patients with blood cancers.

Watch and read 2020-2021 ASCO president Dr. Lori J. Pierce’s presidential address, delivered at the ASCO21 Opening Session. “I want us all to imagine what this world could and will be like when we can deliver the right care to every patient, every day, everywhere,” Dr. Pierce said. “I firmly believe success is within our reach. In other words, it is our time.”

If you want a law or regulation to change, you’ve got to make your voice heard. Saying it loud and proud is one of the themes of the free, virtual 2021 COA Patient Advocacy Network (CPAN) Advocacy Summit on Wednesday, July 21. The power to create a better cancer care system rests with the physicians, patients, survivors, and advocates of community oncology. You'll hear from advocacy, legal, clinical, and communications experts who will help you and your patients hone your advocacy skills.

CURE® | Targeted Oncology™ have confirmed another virtual roundtable for the southern California region.

B-Cell Lymphoma: New Approaches for Relapsed/Refractory DLBCL will be moderated by Dr. Elizabeth Budde (City of Hope) on Wednesday, July 14^th at 7:00-8:30pmPDT.

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.