January 25, 2022
This Weekly's Hot Topics
  • Tomorrow! January 26, 2022, Management of Metastatic EGFR Mutated Non-Small Cell Lung Cancer MOASC News/MOASC Programs
  • California oncology sends letter to California Department of Public Health MOASC News
 
  • Save MICRA! California News
 
  • USP 795 and 797 standards analysis National News
 
  • Thank You to those who support oncology in southern California! Industry News
MOASC News
MOASC and the Association of Northern California Oncologists (ANCO), are preparing a joint letter for the California Department of Public Health (CDPH) to encourage them to amend AFL 21-08.7, to protect California’s patients with cancer who are more vulnerable to complications from infection with SARS-CoV2. The current active CDPH policy allows health facilities in the state at critical staff shortage to have health care providers return to work with patients without isolation after testing positive for COVID if asymptomatic. 
MOASC Programs - Save the Dates - All Times are Pacific
Tomorrow! January 26, 2022, 6:00pm- PST, MOASC presents their Lung Cancer Series Webinar on the Management of Metastatic EGFR Mutated Non-Small Cell Lung Cancer. This lively discussion on the management of metastatic EGFR mutated non-small cell lung cancer will provide a great opportunity to learn from key opinion leaders and network with colleagues. Submit your questions and cases, in advance, for discussion with key opinion leaders in the field. Hear the latest clinical trial data, apply it to your patients, consider real-world scenarios and how to mitigate barriers to treatment.
February 9, 2022 at 12:30pm PST, join in MOASC’s LunchTime Series, Encore Presentation, Improving the Patient Collections Experience. PayGround’s Patient-First platform enables patients (and their dependents) to manage ALL bills in one place from across ALL their providers, helping them understand their responsibility while providing multiple payment methods to fulfill that responsibility. This leads to an average 23% patient collections improvement and 6.7 days average reduction in A/R days.
PayGround has already been adopted by multiple MOASC members and the average yearly savings is estimated to be just over $10,000 in the first year.
Career News 

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Clinical Trials News
MOASC Clinical Trial Database is on the MOASC website at www.moasc.org
California News
With less than one year until Californians head to the ballot to vote on the so-called Fairness for Injured Patients Act (FIPA), the coalition of Californians to Protect Patients and Contain Health Care Costs have an update on the campaign and how they are preparing to defeat this dangerous initiative. With funding assistance from The Doctors Company, California Association of Hospitals and Health Systems and the California Medical Association, the campaign team has built a strong coalition of physicians, nurses, dentists, hospitals, clinics, and many other health care organizations who recognize the irreparable harm and loss of care that FIPA would cause to millions of seniors, low-income populations, and disadvantaged communities. Working with members of local media to educate reporters on the nuances of MICRA, stories have been placed in local publications that highlight the devastation FIPA would cause to California’s health care system. The campaign to protect MICRA is in a good position and will continue to build the coalition needed to reach each and every voter with our message so we can defeat this misguided measure. The trial attorneys are taking it to the voters! Please consider becoming a Community Ambassador and sign up for the Community Ambassador Training series. These trainings educate coalition members about FIPA and provide them with the tools to serve as leaders and educators within their own organizations and circles of influence. 
The California Department of Justice (DOJ) recently awarded the contract for prescription data collection services for the Controlled Substance Utilization Review and Evaluation System (CURES) to Bamboo Health. Dispensers who are required to report dispensation data to CURES must begin reporting through Bamboo Health’s PMP Clearinghouse on 2/9/2022. If you have not yet registered with PMP Clearinghouse, please refer to The Data Submission Guide for Dispensers, which explains the process to register and transmit data. The CURES transition of data collection services to the PMP Clearinghouse does not impact users who are accessing data in CURES.
AB 933 Prescription Drug Cost Sharing is held under submission in Appropriations Committee as of last Thursday, 1/20/22. This is a rebate reform bill that will lower medication costs for California patients. If you haven't already, be sure to get your letter of support in ASAP. Please reach out to Brooke Witzelberger with any questions.
The California State Board of Pharmacy is aware there may be misinformation and misunderstanding among licensees regarding the e-prescribing requirements established by Assembly Bill (AB) 2789 (Wood, 2018). Beginning January 1, 2022, Business & Professions Code section 688 requires health care practitioners authorized to issue prescriptions to have the capability to transmit electronic data transmission prescriptions and requires pharmacies to have the capability to receive an electronic data prescription sent by a prescriber on behalf of a patient. Pharmacies that do not have the capability to receive electronic data transmission prescriptions on behalf of a patient may be in violation of pharmacy law, provided the electronic data transmission prescription complies with legal requirements, including electronic data transmission prescriptions for a controlled substance. There are exceptions when prescribers do not have to transmit a prescription electronically. The Board also cautioned that a pharmacist should consider the impact on the patient and continuity of care when deciding whether to fill a legally valid written, oral or faxed prescription if the only issue is that it was not received electronically. 
Placerville’s Marshall Medical Center announced that it is entering into an affiliation with UC Davis Health to allow its patients access to the nationally recognized cancer treatment that the academic health system provides. “It’s exciting to expand and elevate cancer services in a way that will also preserve our standing as a nonprofit, independent hospital,” said Siri Nelson, Marshall’s chief executive officer. “Under the agreement, our cancer center will stay under the Marshall umbrella, with the hospital retaining ownership, licensure, and clinical oversight for patient care.”
Effective January 1, 2022, with poster revision date of January 5, 2022, the California Department of Labor & Industrial Relations has updated their Minimum Wage notice. The updated notice reflects an adjustment of the state minimum wage to $14.00/hour for employers with 25 or fewer employee and to $15.00/hour for employers with 26 or more employee., Questions about enforcement should be directed to the Labor Commissioner's Office. For the address and telephone number of the office nearest you, information can be found on the internet at www.dir.ca.gov/DLSE/dlse.html or under a search for “California Labor Commissioner's Office” on the internet or any other directory.
Medicare News
Billing and Coding: MolDX: Molecular Testing for Solid Organ Allograft Rejection (A58168) - R1 - Effective November 25, 2021
This coverage article has been revised and published for notice under contract numbers: 01112 (NCA), 01182 (SCA), 01212 (AS, GU, HI, NMI), and 01312 (NV).
Billing and Coding: MolDX: Minimal Residual Disease Testing for Hematologic Cancers (A58996) - Effective December 26, 2021. This coverage article has been revised and published for notice under contract numbers: 01112 (NCA), 01182 (SCA), 01212 (AS, GU, HI, NMI), and 01312 (NV).
Billing and Coding: MolDX: Predictive Classifiers for Early Stage Non-Small Cell Lung Cancer (A57329) - R1 - Effective January 06, 2022. This Billing and Coding Article has been revised and published for notice under contract numbers: 01112 (NCA), 01182 (SCA), 01212 (AS, GU, HI, NMI), and 01312 (NV).
MolDX: Plasma-Based Genomic Profiling in Solid Tumors DL39230 proposed Local Coverage Determination (LCD) was published January 20, 2022, for review and comments due by March 5, 2022 for contract numbers: 01112 (NCA), 01182 (SCA), 01212 (AS, GU, HI, and NMI), and 01312 (NV).
MolDX: BRCA1 and BRCA2 Genetic Testing (L36161) - R8 - Effective April 29, 2021
This Local Coverage Determination (LCD) has been revised under contractor numbers: 01112 (NCA), 01182 (SCA), 01212 (AS, GU, HI, and NMI), and 01312 (NV). 
Noridian Programs
Evaluation and Management Updates Webinar - February 17, 2022
This event includes: Evaluation and Management Codes 99202-99215, AMA Errata and Technical Corrections, and Resources.
National News
Last month, COA contracted with Avalere to review the proposed updates on USP 795 and 797 standards to see if there is any impact on oncology practices. Below is their summary.
Avalere found that the updates may impact community practices in the following ways: Personnel, Process, Waste, or Financial Burdens:
1. Personnel: Number of staff and additional training required to complete an added task.
2. Process: A revision requiring a change in standard operating procedure (SOP), more paperwork/documentation, and additional training for staff to carry out the SOP.
3. Waste: When a product intended for use is wasted. For example, in USP <795>, once removed from the original container, any component not used in compounding should be discarded and not returned to the original container.
4. Financial Burden: personnel burden, process burden, and increased waste of resources all cause an increase in financial burden (supplies, expenses, staffing).
One-quarter (25 percent) of 340B DSH hospitals provide charity care that represents less than 1 percent of their total operating costs. Only 38% of DSH hospitals – and less than one third of their “child” sites and affiliated contract pharmacies – are located in MUAs. Despite their mission of “serving a significantly disproportionate number of low-income patients.” (Source: Avalere Health analysis of FY 2017 Medicare cost report data). While the 340B program has the unique opportunity to advance health equity by supporting safety-net providers in underserved communities, misguided eligibility standards have allowed DSH hospitals to expand into affluent areas, antithetical to the program’s goal. This new report is further evidence that the program is not working for the low-income and vulnerable patients it should be benefiting. During the eight years since Alliance for Integrity & Reform (AIR340B) first released an analysis of hospital charity care, the 340B program has more than quadrupled in size (from $9 billion in 2014 to $38 billion in 2020) and yet most 340B hospitals continue to provide relatively low levels of charity care, as a percent of their operating costs.
The Department of Health and Human Services is providing $103 million in American Rescue Plan funding to promote mental health and alleviate stress and burnout among health care staff in the US. The agency said $28.6 million will be awarded to 10 organizations that provide evidence-based programs for employee wellness, $68.2 million will go to 34 organizations that offer mental health and resiliency training, and about $6 million will fund a new Health and Public Safety Workforce Resiliency Technical Assistance Center.
Affiliate Association News
ANCO News
ANCO, with the organizing committee of the San Antonio Breast Cancer Symposium and Encore Medical Education, will host the Best of San Antonio Breast Cancer Symposium Northern California (Best of SABCS West Coast) at The InterContinental San Francisco on Saturday morning, February 12, 2022. Hope S. Rugo, M.D., UC San Francisco, is the Regional Director for Best of SABCS West Coast. Live Streaming option is available.
The 22nd Multidisciplinary Management of Cancers: A Case-based Approach returns to the Silverado Resort and Spa in Napa on March 11-13, 2022. The meeting is sponsored by the Association of Northern California Oncologists, Stanford Cancer Institute, UC Davis Comprehensive Cancer Center, and the UCSF Helen Diller Family Comprehensive Cancer Center. Registration is now open for HCP for in person and virtual attendance.
ASCO News
ASCO released standards on using telehealth for cancer care. In short their recommendation is, that when using telehealth for cancer care, providers should conduct initial patient assessments, provide education about the technology and use virtual platforms for clinical trials.
COA News
The Community Oncology Alliance has announced the promotion of Nicolas Ferreyros to Managing Director for Policy, Advocacy, and Communications. In this newly created role, Mr. Ferreyros will oversee the integration of state policy, patient advocacy, and all communications functions at COA, a national non-profit dedicated solely to community oncology practices and the patients they serve.
CURE News

CURE’s sister franchise, Physician’s Education Resource (PER) has an upcoming CME opportunity. As MOASC is a partner, PER is offering 35% discounted registration for MOASC physicians to their 19th Annual Winter Lung Cancer Conference on February 4 – 6, 2022, 4am – 9am PST. The meeting will be held in-person at Eden Roc Miami Beach, Miami Beach, FL and Virtually. Program chairs: Rogerio C. Lilenbaum, MD, Mark A. Socinski, MD, Julie R. Brahmer, MD, MSc, FASCO.
National Survivors Day® 2022 News

The 35th Annual National Cancer Survivors Day® Celebration of Life will be held on Sunday, June 5, 2022. On this day, people across the globe will come together to acknowledge cancer survivors, raise awareness of the ongoing challenges cancer survivors face because of their disease, and – most importantly – celebrate life. It is a day for everyone who is living with a history of cancer to connect with other cancer survivors, celebrate milestones, and recognize those who have supported them along the way. It is also a day to draw attention to the ongoing challenges of cancer survivorship, with the aim of promoting more resources, research, and legislation to improve cancer survivors’ quality of life.
Industry News
MOASC is pleased to acknowledge and thank the following companies for their generous support of your association. Please welcome and thank them when they call, e-mail and come to your office.
Daiichi Sankyo, Inc. (DSI) (Diamond Sponsor) is primarily focused on developing novel therapies for people with cancer as well as other diseases with high unmet medical needs.
Daiichi Sankyo, Inc. medicines approved in the U.S. are outlined below and include therapies for metastatic breast and gastric cancer, tenosynovial giant cell tumor, metastatic melanoma, hypertension, dyslipidemia, diabetes, thrombosis, stroke risk reduction, acute coronary syndrome, and IV iron therapy. ENHERTU® (fam-trastuzumab deruxtecan-nxki), INJECTAFER® (ferric carboxymaltose injection), TURALIO® (Pexidartinib), ZELBORAF® (vemurafenib).
Astellas Pharma, US (Silver Sponsor) has established a Focus Area Approach for its research and development strategy. Specifically, their Focus Area Strategy is defined as combinations of three components: (1) biologies with high disease relevance, (2) versatile modalities/technologies, and (3) diseases with high unmet medical needs that are expected to be tackled by the first two components. We view this strategy as a way to build a sustainable, expandable drug discovery approach to develop new platforms, leverage expertise and create innovative products. XTANDI® (enzalutamide), XOSPATA® (gilteritinib), PADCEV® (enfortumab vedotin), Evrenzo® (roxadustat). 
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.