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Tomorrow! 7am PT, Watch House Committee on Oversight forum on the impact of PBMs. Affiliate Association News/COA News
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Thursday! ACS CAN California Virtual Policy Forum California News
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Thursday! CMS Innovation Center Strategy Listening Session Medicare News/CMS News
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Thursday, November 18, is the ACS Great American Smokeout® National News
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MOASC supports Debra A. Patt, M.D. for the ASCO Board. Please take time to vote, and encourage your partners to vote, in the ASCO election. The voting period closes on Tuesday, December 7, 2021, at 12:00pm PST, all ballots must be received by this time.
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MOASC Programs - Save the Dates - All Times are Pacific
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The University of California San Diego cordially invites you to their Great Debates in Advanced Cutaneous Squamous Cell Carcinoma (CSCC), December 4, 8:30am. This virtual meeting will provide a multidisciplinary management approach for patients with advanced CSCC. Topics will focus on updates in risk assessment, pathology, radiation therapy medical & surgical management, featuring case presentations alongside plenary sessions followed by a question and answer opportunity. Target audiences include: dermatologists; medical, radiation and surgical oncologists; otolaryngologists; plastic surgeons; pathologists, and physicians and allied health professionals caring for patients with cutaneous squamous cell carcinoma.
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Career News
City of Hope Medical Group Seeks Medical Oncologists to Join our Main Campus in Duarte and Our Expanding Network:
Duarte (main campus) | Women’s Health (Breast) Medical Oncology 60-80% clinical effort
Antelope Valley | General Medical Oncology 95% clinical effort
Corona | General Medical Oncology 95% clinical effort
Glendale | General Medical Oncology 95% clinical effort
West Covina/Glendora | General Medical Oncology 95% clinical effort
Simi Valley | General Medical Oncology 95% clinical effort
Interested candidates must submit an official application via the City of Hope Physician Careers Internet site: Physician Careers. Additionally, applicants can forward a curriculum vitae and letter of interest to MDRecruitment@coh.org.
Thank you!
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This Thursday! Join the 2021 ACS CAN California Virtual Policy Forum, Cancer Research Through A Health Equity Lens, on November 18, 5:00pm–6:30pm PST. This event will feature presentations from cancer researchers on cutting-edge science at the forefront of breakthroughs in diagnosis, treatment, care and survivorship coupled with policy proposals that ensure these advancements are available for all. Esteemed panelists will share how their work contributes to health equity in cancer research. A moderated panel and Q&A to follow.
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A new California law requires health insurance companies to notify consumers how much remains on their deductibles and how close they are to their annual out-of-pocket spending limits.
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The Doctors and Clinicians Preview Period is officially open. You can now preview your 2020 Quality Payment Program (QPP) performance information before it will appear on clinician and group profile pages on Medicare Care Compare and in the Provider Data Catalog (PDC). You can access the secured Preview through the QPP website.
Please refer to the resources below on how to preview your information:
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November 18 - The National Correct Coding Initiative and Medically Unlikely Edits.
This webinar will assist Part B providers with navigating tables for the National Correct Coding Initiative and the medically unlikely edits. It will also review proper modifiers to use to avoid denials.
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November 23 - How to Avoid Duplicate Claim Denials
Duplicate denials continue to be one of the top billing errors. Unnecessary duplicate filing of Medicare claims cost the provider's office valuable time and resources as well as Medicare's time and money to process them. Join this webinar for tips on how to avoid them.
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November 30, 2021 - Modifier 59, National Correct Coding Initiative (NCCI) and Medically Unlikely Edit (MUE).This event includes: National Correct Coding Initiatives (NCCI), Procedure to Procedure (PTP) CCI Edits, Modifier 59, Medically Unlikely Edits (MUEs), Correct Coding Initiative (CCI) Examples, Resources.
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December 1, 2021 - Noridian Medicare Portal (NMP) Eligibility Webinar. This event includes: Noridian Medicare Portal, Hours of Availability, Eligibility, MBI Look Up
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December 3, 2021 - Medicare Secondary Payer (MSP) Part B Billing Webinar.
This event includes: Part B MSP Billing, Payments and Calculations, Forms and Noridian Medicare Portal (NMP), Scenarios and Avoiding Delays, and Resources.
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December 8, 2021 - Medicare 101 - New Providers/New Billers: Beneficiary Forms Webinar. This event includes: Important Message from Medicare, Advanced Beneficiary Notice of Noncoverage, Medicare Outpatient Observation Notice, and Hospital Issued Notice of Noncoverage.
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Thursday, November 18, 1:00 – 2:30 p.m., ET/10-11:30am PST, join CMS’ first CMS Innovation Center Strategy Listening Session, as part of CMS’ ongoing commitment to public-private partnership. Today, CMS Innovation Center published an At-A-Glance with highlights from their Driving Health System Transformation - A Strategy for the Innovation Center’s Second Decade, white paper, which details its vision for attaining a health system that achieves equitable outcomes through high-quality, affordable, patient-centered care. Attendees may submit written comments during the session or via email to CMMIStrategy@cms.hhs.gov using the subject line “LISTENING SESSION #1.” Some written comments will be read aloud during the listening session; please indicate if you prefer your comments not be shared.
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CMS recently released Part II of an interim final rule (IFR) to the No Surprises Act (NSA) of 2020, providing more detailed implementation requirements for last year’s highly publicized surprise medical bill legislation. It is critically important for physicians providing out-of-network (OON) services to prepare for the administrative and financial impacts of the IFR next year. We focus on evaluating the potential financial and administrative effects on physicians in this article. Download the article for an overview of the recent rule, the possible financial ramifications for providers, and mitigating strategies.
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CMS recently announced that this year, they will again, be granting automatic exceptions from reporting requirements for clinicians and providers participating in Medicare quality reporting programs due to the ongoing disruptions the Covid-19 public health emergency is having on physician practices.
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December 1 & 2 – HCPCS Public Meeting. The purpose of the Public Meetings is to provide a forum for the general public to present information regarding specific Healthcare Common Procedural Coding System (HCPCS) coding requests for new products, supplies, and services. The meeting also provides an opportunity to obtain industry and public reaction to the preliminary coding recommendations of the CMS HCPCS Workgroup, as well as CMS' preliminary recommendations regarding payment methodology. Coding decisions related to the Medicare and Medicaid programs internal operating procedures are reviewed internally, and are not included in this forum.
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Tomorrow, Wednesday, November 17 at 10:00am ET/7:00am PST, House Committee on Oversight and Reform Ranking Member James Comer (R-Ky.) and lawmakers will hold a forum on the impact of pharmacy benefit managers (PBMs) in pharmaceutical markets with experts, pharmacists, physicians, and PBMs.
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Relating to the Build Back Better bill and the harmful drug pricing provisions, COA has prepared a one-pager to use with congressional offices to summarize the problem and provide a legislative fix.
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The U.S. Food and Drug Administration is taking several important actions to support ongoing nationwide COVID-19 testing efforts. These actions are aimed at further increasing access to accurate and reliable COVID-19 tests, particularly diagnostic tests that can be performed at home or in places like doctor’s offices, hospitals, urgent care centers and emergency rooms without having to be sent to a central lab for testing.
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The immune system can be trained to spot and attack distinctive proteins on cancer cells, killing them and leaving healthy cells potentially untouched, as the Pfizer and Moderna mRNA vaccines protect humans from COVID-19. While these precision cancer vaccines remain experimental, researchers continue to make basic discoveries that move the field forward. That includes a recent NIH-funded study in mice that helps to refine the selection of protein targets on tumors as a way to boost the immune response [1]. To enable this boost, the researchers first had to discover a possible solution to a longstanding challenge in developing precision cancer vaccines:
Tcell exhaustion.
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The CEO of BioNTech, says the company is interested in improving chimeric antigen receptor T-cell therapies for cancer patients by harnessing the same type of mRNA technology used in making COVID-19 vaccines.
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This Thursday, November 18, is the ACS Great American Smokeout®. A new CDC feature article highlights the event. Smoking remains the single largest preventable cause of death and illness in the world and causes over 8 million deaths per year world-wide. Cigarette smoking causes nearly 1 in 5 deaths in the United States each year. In a continued effort to reduce smoking-related death and disease, CDC encourages people to use evidence-based treatments to help them quit smoking, including quit-smoking medicines and behavioral counseling.
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Affiliate Association News |
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You are invited to Make the Connection! Work-Life Balance for a New Generation of Oncologists. Thursday, November 18, 12:15pm PST
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ASCO News
Please take time to vote in the ASCO election. Please encourage your partners to vote in the ASCO election. The voting period closes on Tuesday, December 7, 2021, at 12:00pm PST, all ballots must be received by this time.
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A collaboration between ASH and The Leukemia & Lymphoma Society’s Clinical Trial Support Center (CTSC) can help you provide this free, critical clinical trial resource to your patients. ASH member physicians and their care teams, along with patients and caregivers, receive one-on-one support from CTSC Nurse Navigators, who provide personal assistance throughout the entire clinical trial process. These Nurse Navigators are specially trained in blood cancers, clinical trials, and patient education/support. ASH member physicians, their care teams, and their patients and caregivers have direct access to their CTSC Nurse Navigator for the duration of the search and enrollment process, and while patients are on the trials.
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TOMORROW! COA Executive Director, Ted Okon, will be testifying at the House Committee on Oversight and Reform (see article above in National News). COA continues to pull out all stops for you and your practices on PBMs. Mr. Okon will be touching on DIR fees, mandatory mail order, etc. The forum hearing on PBMs is tomorrow, Wednesday, 11/17 on Capitol Hill starting at 7:00AM PST. It will be another effort to let Congress know that they need to address PBMs. Please tune in to watch your advocates in action.
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COA Urges Technical Fixes to Remove Doctors from Middle of Negotiations, Stop Unintended Collateral Damage of BBB to U.S. Cancer System.
COA Asks CMMI to Extend Oncology Care Model (OCM) Through December 2022. Oncologists say OCM has helped practices transform care delivery for patients, and seek extension until a successor model is named. In the letter to leadership at CMS and CMMI, COA notes that beginning to wind down the OCM starting at the end of this year without any clear reasons, or a successor model, will waste millions of taxpayers’ dollars and the successes of participating practices in transforming cancer care for patients across the country. The tremendous financial and resource investment in the OCM, and the dramatic successes of many independent community oncology practices participating in the OCM in enhancing patient cancer care while lowering treatment costs, should be clear reasons why the OCM should not be discontinued. Rather, the model should be refined and re-envisioned based on what is working, says the letter. These practice transformations have led to many new initiatives and arrangements with payers to enhance the quality of cancer care while lowering costs.
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Merck would like to remind of the Importance of Screening for Lung Cancer. Lung cancer is the deadliest form of cancer. Early detection through screening may help improve your patients’chances of survival1. Please see attached resource that provides information about the importance of lung cancer screening.
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Janssen Biotech cordially invites you to their 7th Fall IDEA Healthcare Summit, December 2, 2021. Attendees will explore what providers, caregivers, advocates, employers, payers, and pharmaceutical companies can do to elevate the patient voice. Panelists will discuss the elements of effective self-advocacy in health care and how we can cultivate those practices. Our goal is a health care system that is responsive to needs and centered around access, affordability, and innovation. Panelists will explore barriers to health self-advocacy, with a focus on underserved communities, and what can be done to overcome these barriers and help people be heard and better served.
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Just 2 weeks away from the 2021 Premier Alternate Site Programs Virtual National Meeting taking place virtually on Thursday, December 2 and Friday, December 3. With keynote speaker headliner Captain Chesley “Sully” Sullenberger, “Miracle on the Hudson” Pilot and Safety Expert, featured session speakers will cover trending topics in four unique tracks: Clinical and Compliance Outcomes, Legislative & Regulatory Updates, Business Management and Operations, and Supply Chain Strategies. There is an updated agenda and Business Track speakers below, that reflect the informative and engaging virtual program. Please register today to secure your spot!
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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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