July 20, 2021
This Weekly's Hot Topics
  • Today is last day to make your hotel reservation for ASH Annual Meeting. Affiliate Association News/ASH News
 
  • Tomorrow! The 2021 COA Patient Advocacy Network (CPAN) Advocacy Summit. Affiliate Association News/COA News
 
  • Tomorrow, 7/21! Contact COA to publish your PBM story. Affiliate Association News/COA News
 
  • New Oncology Medical Home (OMH) standards released. National News

MOASC News
MOASC Programs - Save the Dates - All Times are Pacific
July 28, Clinical Peer to Peer Discussion on Lung Cancer, 5:30pm – 7:00pm. 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; Jonathan Goldman, M.D., UCLA Hematology & Oncology.
The purpose of this meeting is multifaceted; to provide ongoing clinical education through community outreach, discuss new treatment options, side effect management and clinical trials. This will be a great opportunity to learn from key opinion leaders and network with colleagues. 
Benefits of Attending:
Submit questions and cases for discussion with KOL’s in the field;
Hear the latest clinical trial data and apply it to your patients; and
Consider real-world scenarios and how to mitigate barriers to treatment.
Target Audience:
This educational activity is directed toward medical oncologists, nurse practitioners, physician assistants, nurses and other professionals with an interest in hematology/oncology.
Registration is required. This event is complementary
July 28, Elizabeth Brem, MD, UCI, will moderate a virtual Roundtable Meeting on B-Cell Lymphoma: Third-Line Therapy for Relapsed/Refractory DLBCL. This program is for oncologists treating B-Cell Lymphoma: Third-Line Therapy for Relapsed/Refractory DLBCL. The virtual Case-Based Roundtable Meeting is a collaborative, small-group meeting designed around case-based clinical profiles and peer-dialogue led by an expert physician. This session offers practicing oncologists the perfect opportunity to sharpen their skills and expertise in treatment strategies. Attendees are paid $500 of compensation by Healthcare Research Analytics® for their attendance, participation & completion of the post-event HRA survey. Meeting specifics are outlined below, for reference.
July 29-31, Physicians Education Resource (PER) cordially invites all MOASC members to their 22nd Annual International Lung Cancer Congress (ILC), in Huntington Beach. The ILC has extended a discounted registration code for all MOASC members.
August 2, Rachel Salit, MD, Fred Hutchinson Cancer Research Center, will moderate a virtual Roundtable Meeting on GVHD: Acute & Chronic. This program is for oncologists treating GVHD: Acute and Chronic. The virtual Roundtable Meeting is a collaborative, small-group meeting designed around case-based clinical profiles and peer-dialogue led by an expert physician. This session offers practicing oncologists the perfect opportunity to sharpen their skills and expertise in treatment strategies. Attendees are paid $500 of compensation by Healthcare Research Analytics® for their attendance, participation & completion of the post-event HRA survey. Meeting specifics are outlined below, for reference.
August 11, 5:30-6:30 PDT, MOASC will host, a live Zoom meeting on Innovative Immunotherapy in Advanced Basal Cell Carcinoma. Evolving Science, Key Clinical Evidence, and Implications for Multidisciplinary Management. Karl D. Lewis, MD University of Colorado, Anschutz Medical Campus, University of Colorado Cancer Center, will chair & moderate the CME/MOC/NCPD/CPE presentation and discussions.
August 14, MOASC presents their virtual Spotlight On Clinical Oncology, 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.
August 25th at 12:30pm, MOASC LunchTime Series presents a zoom meeting Bradley Behrendt, Financial Consultant for the Tax & Financial, on California law requirements that force business with more than 5 employees to provide a qualified health plan to their employees. 
California News
August 3, is the deadline to apply for adopting value-based care in your practice with ACO Aledade. CMA is collaborating with Aledade Inc. to help independent physicians succeed in value-based care, ensuring practices and health centers are able to thrive while delivering the best possible patient care. As the top-rated, physician-led ACO in the country, Aledade’s proven process helps practices and community health centers quickly improve financial performance and get more from the data and technologies they have.
Health care providers who want to succeed in value-based care and other alternative payment models should consider embracing advanced analytics tools that can collect and analyze patient data such as socioeconomic status, housing security, and food access. Using advanced analytics, providers and health insurers can collaborate more effectively to improve the quality of care and reduce health care costs. 
The California Department of Public Health (CDPH) launched the CalVaxGrant program to help reach the state’s vaccination goals and keep Californians healthy. CalVaxGrants—administered by Physicians for a Healthy California (PHC)—is now accepting applications and will award eligible practices up to $55,000 in grant funding for COVID-19 vaccine administration.
Medicare News 
Noridian News
Noridian’s Medicare Part A and B Provider Outreach and Education (POE) team is providing their July 2021 latest news and updates.
August 19, Evaluation and Management 2021 Clarifications, After Hours Webinar.
This event includes: Evaluation and Management Codes 99202-99215, AMA Errata and Technical Corrections, Review Questions and Answers, Resources.
Noridian Programs
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.
CMS News
The Centers for Medicare & Medicaid Services (CMS) released the proposed 2022 Medicare physician fee schedule (PFS) rule, which includes proposed changes to the Quality Payment Program (QPP), Merit-based Incentive Payment System (MIPS) and alternative payment model (APM) participation options and requirements for 2022. The final 2022 PFS rule is expected by Nov. 1, 2021.
CMS Proposes Rule to Increase Price Transparency, Access to Care, Safety & Health Equity
CMS is proposing actions to address the health equity gap, ensure consumers have the information they need to make fully informed decisions regarding their health care, improve emergency care access in rural communities, and use lessons learned from the COVID-19 pandemic to inform patient care and quality measurements. CMS is further strengthening its efforts to increase price transparency, holding hospitals accountable and ensuring consumers have the information they need to make fully informed decisions regarding their health care.
COA has provided some preliminary summary comments/observations on the proposed 2022 Medicare physician fee schedule (PFS):
  1. CMS says oncology will see a 2% Medicare payment cut but that is very deceptive because it seems the comparison basis is not 2020, when Congress provided a 3.75% increase, but 2019. So, in effect, the cut is closer to 6%. And early internal estimates are the infusion code cuts may be as high as 14%.
  2. CMS issued the proposal on the Oncology Radiation Model, which will proceed starting 1/1/22. The model will save money for Medicare. Translation: It is a cut in radiation therapy payments. Of course, this announcement comes on the day that the HHS Secretary extends the pandemic public health emergency. So, how you go forward with a Radiation Oncology Payment Model at the same time you have a resurging pandemic with a new virus strain is beyond any rational comprehension.
  3. The 340B -22.5% Medicare payment cut stands for 2022.
  4. HHS proposing to increase hospital noncompliance with pricing reporting based on beds such that large hospitals will get hit with an annual penalty of upwards of $2 million per year. Problem is a hospital like Presbyterian in NY making over $300 million from 340B alone will pay the fine. It’s simply the cost of doing business.
An updated Patient Assistance Programs (PAP) User Guide is now available.
National News
First reporting deadline is September 30th. The U.S. Department of Health & Human Services Provider relief Fund reporting portal is now open for providers who need to report on the use of funds in Reporting Period 1. All recipients of PRF payments must comply with the reporting requirements. Providers who received one or more payments exceeding $10,000 in the aggregate, during a “payment received period” are required to report in each applicable “reporting time period.”
The American Society of Clinical Oncology (ASCO) and the Community Oncology Alliance (COA) jointly released new Oncology Medical Home (OMH) standards, which provide a comprehensive roadmap for oncology practices to deliver high-quality, evidence-based cancer care. These standards, which were published last week in the Journal of Clinical Oncology, Oncology Practice, establish core elements needed to deliver equitable, high-quality cancer care. In releasing the new standards, ASCO and COA seek to achieve a broad consensus among all stakeholders—including patients, clinicians, payers, purchasers, and employers—on what patients with cancer should expect and receive from their cancer care teams. 
The Information Blocking Rule became effective April 5, 2021, requiring Covered Entities to develop and implement policies and procedures consistent with the rule. The Coker Group provides information that may be used to develop your policy on exceptions.
Health care professionals frequently convey positive or negative feelings toward patients in clinical notes with words conveying approval or disapproval, according to a study in JAMA Network Open. Patients now have a legal right to see their medical records, including clinical notes, and health care professionals should review their notes to ensure they haven't used stigmatizing language, researchers wrote.
Prior authorization requests will be approved automatically in Texas when they are from clinicians with a 90% or better approval record for the medical order in question. The so-called gold-carding law, which is effective Sept. 1, will reduce delays in care and time spent on prior authorization requests, says oncologist Debra Patt, immediate past-chair of the Texas Medical Association's Council on Legislation.
United Healthcare has introduced their Comprehensive Medication Management (CMM) program, a patient-centered, interactive review of current medications that may include prescription and non-prescription medications, as well as herbal supplements. It is a pharmacist-led program that evaluates medication therapy for indication, effectiveness, safety and adherence, and includes data obtained through pharmacy claims, medical claims and patient reporting. This program is available to UnitedHealthcare Community Plan, commercial and Medicare & Retirement plan members.
Affiliate Association News
ANCO News
August 21, ANCO presents a hybrid meeting on the highlights of ASCO. ANCO’s ASCO21 Highlights will summarize the major research and treatment advancements presented at this year’s ASCO21 Virtual Meeting. The program will focus on breast, gastrointestinal, genitourinary, gynecologic, head and neck, lung cancers and sarcoma, as well as a Plenary: Equity: Every Patient. Every Day. Everywhere, and an Equity Panel. The faculty will place these developments in context as to their immediate clinical utility.
September 11, ANCO's Virtual Hematologic Malignancies Updates (part II of III) will be presented. Please register online no later than Thursday, September 9th.
ASH News

TODAY is the last day to make your hotel reservation, before registration opens to all ASH members for the 63rd ASH Annual Meeting and Exposition being held on December 11-14, 2021 virtually and at the Georgia World Congress Center in Atlanta, GA. MOASC members can register, by signing in with their ASH username (moasc@moasc.org) and password. If you have forgotten your password, you may reset it using the “Forgot Password?” link on the sign-in page. Register early and book one of the available hotels close to the convention center!
ASH is committed to educating its members on how to become effective advocates for hematology research and practice. The Society will be hosting a new series titled the ASH Advocacy Webinar Series to shed light on how Washington really works and how policy decisions at the federal level affect hematology research, practice, and patients.
City of Hope News
 
The Department of Radiation Oncology at City of Hope has created the Radiation Oncology Patient Assistance Fund to provide financial assistance to patients with financial hardship who are unable to afford much-needed over-the-counter products not covered by insurance. It’s making a profound difference to patients and their families — and has even grabbed the attention and support of a “rock solid” celebrity.
COA News
Tomorrow, July 21, join the free, virtual 2021 COA Patient Advocacy Network (CPAN) Advocacy Summit. 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 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.
Deadline is Tomorrow 7/21! COA has secured a reporter with MDedge/Medscape who is writing a story for oncology/rheumatology publications about bad experiences with PBMs. The article will address the COA filing of an Amicus Brief with the court in North Dakota supporting state regulation of PBMs, and as part of the story the reporter would like a few strong patient examples of PBMs impacting patient care. NO LATER THAN TOMORROW, 7/21, please contact Nick Ferreyros, Director of Communications, Phone: (713) 377-0689 Email: nferreyros@coacancer.org, if you are interested in talking to the reporter. Thank you
 
At the first in-person meeting in over 18 months, the COA Board of Directors came together outside of Washington, DC to work on a range of critical issues affecting patients and practices.  The COA Board decided on several strategic priorities, including voting unanimously to commit significant resources to stop destructive PBM actions at the federal and state levels; and to advance efforts to reform the 340B Drug Pricing Program so that discounts would flow directly to patients in need, rather than disproportionate share hospital profits. The Board also voted to establish a new standing task force on health disparities to plot a course towards meaningful action on this complex and difficult issue. 
UC Davis News
 
UC Davis is conducting a Medical Oncologist Survey. If you are a medical oncologist, UCD would like to invite you to participate in a survey about genetic counseling and for the chance to win an iPad. 
Industry News
G1 Therapeutics, Inc., announced that the FDA has granted Fast Track designation to COSELA™ (trilaciclib) investigation for use in combination with chemotherapy for the treatment of locally advanced or metastatic triple negative breast cancer (TNBC).
Janssen Pharmaceutical Companies of Johnson & Johnson announced:
1)      Primary results from the pivotal Phase 3 GLOW study (NCT03462719) evaluating fixed-duration IMBRUVICA® plus venetoclax (I+V) compared to chlorambucil plus obinutuzumab (Clb+O) for first-line treatment of elderly or unfit patients with chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL).
2)     The FDA approval of daratumumab and hyaluronidase-fihj (Darzalex Faspro, Janssen Biotech, Inc.) in combination with pomalidomide and dexamethasone for adult patients with multiple myeloma who have received at least one prior line of therapy including lenalidomide and a proteasome inhibitor.
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.