California Oncology Weekly
"An Oncologists’ Source for Timely Information"
A publication of the
Medical Oncology Association of Southern California, Inc.
January 12, 2021
|
|
"I have a dream that my four little children will one day live in a nation where they will not be judged by the color of their skin but by the content of their character." Martin Luther King, Jr.
|
|
-
California labor law changes that took effect on January 1, 2021. California News
-
CMS final rule requires Medicare Part D prescription drug plans to enable technology allowing providers to see whether a drug requires prior authorization Medicare News/CMS News
-
Support the Multi-Cancer Early Detection Screening Coverage Act National News
|
|
MOASC Programs - Save the Dates - All Times are Pacific
|
|
MOASC’s LunchTime Series presents Bobbi Buell bringing an “Update on 2021 Medicare Regulations and E/M Coding,” scheduled for January 27 at 12:30pm. The new year brought many changes to the healthcare industry, specifically to Medicare and E/M policies. But what are these changes and how will your practice be impacted? These questions (along with several more) will be addressed in this webinar for MOASC members by Codemisstress Bobbi Buell.
Other topics include:
- Final Physician Fee Schedule Rule for 2021
- Final Hospital Outpatient Payment Program Rule 2021
- E/M Updates for 2021.
|
|
On January 8, 2020, Governor Gavin Newsom released his state budget proposal for the fiscal year. Below is a link to a memo summarizing this budget as it pertains to healthcare. Please feel free to use the information contained within for any government/legislative updates you may wish to use. Please note this is the Governor’s initial budget proposal, as you will see in the “Next Steps” section of the memo, budget subcommittees in the State Senate and State Assembly will debate the proposed budget leading into the May Revise.
|
|
As mentioned, here, last Fall, California has several labor law changes and amendments that took effect on January 1, 2021. These include: increased minimum wages and exempt employee salaries, mandatory child abuse reporting, expanded crime victim leave
On January 1, California’s minimum wage increased to $14 per hour for employers with 26+ employees. The new minimum wage for employers with 25 or fewer employees is $13 per hour.
The minimum salary threshold for exempt employees increased to $1,120 per week ($58,240 per year) for employers with 26+ employees, and $1,040 per week ($54,080 per year) for employees with 25 or fewer employees. Additionally, the minimum rate for exempt computer software employees increased to $47.48 per hour. Finally, the minimum rate for exempt licensed physicians and surgeons paid on an hourly basis increased to $86.49 per hour.
The minimum wage also increased in certain cities. Keep in mind, you should always pay employees per the highest applicable wage. (Whether federal, state, or local!)
The California Department of Labor & Industrial Relations updated their Minimum Wage notice. The updated notice reflects an adjustment of the state minimum wage to $13.00/hour for employers with 25 or fewer employees and to $14.00/hour for employers with 26 or more employees, effective January 1, 2021. Additionally, upcoming minimum wage rates through January 2023 have been added to the notice. The poster revision date is December 24, 2020.
|
|
The California Department of Labor & Industrial Relations has updated their Safety and Health Protection on the Job notice. The updated notice reflects a new safety rule requiring employers to provide employees with access to their written Injury and Illness Prevention Plan. The poster revision date is December 24, 2020.
|
|
California has added employees who supervise and directly interact with minors, as well as “HR employees,” to its list of “mandated reporters.” However, these employees are only mandated reporters if the organization has 5+ employees and employs at least one minor. Mandated reporters must report known or suspected child abuse and neglect, and/or sexual abuse, to any of several state or county agencies. Failure to report is a crime. The state provides compliant online training. Time spent taking the training is considered hours worked and must be paid. Employers must also collect a signed acknowledgment form related to these duties from each employee who is a mandated reporter. The law does not say when the training must be completed. However, since the duty to report takes effect immediately on January 1 and failure to report can have significant penalties, we would recommend training current employees as soon as possible and including this training as part of any new “HR employee” onboarding.
|
|
Previously, employers of all sizes were required to provide job-protected leave to victims of stalking, domestic violence, and sexual assault. Now, this law also includes victims of any crime that caused physical or mental injury or a threat of physical injury. The law entitles employees who are victims to take time off from work to “obtain any relief.” For example, taking steps to ensure their or their child’s health, safety, or welfare, such as by trying to get a restraining order. Employees are also entitled to leave if their family member has died because of a crime. As with the current California crime victim leave law, employers may require reasonable advance notice of the need for leave, if notice is feasible. And if the employee isn’t able to give advance notice, the employer can require documentation. However, the law now states that a signed statement from the employee that their absence was for a covered reason is acceptable documentation. Finally, employers with 25+ employees must now provide leave to all crime victims for reasons similar to those previously required only for sexual assault and domestic abuse victims. For example, medical attention, counseling, or safety planning.
If you haven’t already, it is recommended that you update your policies with these changes as soon as possible.
Significant amendments to the California Family Rights Act took effect on January 1, 2021. Most notably, this California law will now apply to employers with just 5+ employees. CFRA requires covered employers to provide up to 12 weeks of unpaid, job-protected leave to eligible employees for specified reasons. (For example, baby bonding). Additionally, employers must post a notice about employees’ CFRA rights. A compliant notice is provided by the Department of Fair Employment and Housing (DFEH)
|
|
Employers with 100+ employees must begin reporting pay data annually to the DFEH. The first deadline is March 31, 2021. To help employers with this new requirement, the DFEH has created an FAQ.
|
|
Noridian News
Billing and Coding: Chemotherapy Administration Retirement - Effective December 31, 2020 under contractor numbers: 01112 (NCA), 01182 (SCA), 01212 (AS, GU, HI, NMI), and 01312 (NV).
|
|
Stereotactic Body Radiation Therapy LCD/Billing and Coding: Stereotactic Body Radiation Therapy LCA Retirement - Effective January 15, 2021 under contractor numbers: 01112 (NCA), 01182 (SCA), 01212 (AS, GU, HI, NMI), and 01312 (NV).
|
|
2021 Medicare Parts A & B Premiums and Deductibles
Medicare Part B Premiums/Deductibles: The standard monthly premium for Medicare Part B enrollees will be $148.50. The annual deductible for all Medicare Part B beneficiaries will be $203.
Medicare Part A Premiums/Deductibles: The Medicare Part A inpatient hospital deductible that beneficiaries will pay when admitted to the hospital will be $1,484. The Part A inpatient hospital deductible covers beneficiaries’ share of costs for the first 60 days of Medicare-covered inpatient hospital care in a benefit period.
|
|
Addition of the QW Modifier to HCPCS Codes 87811 and 87428
CR 12093 informs you of the addition of the QW modifier to the following CMS Healthcare Common Procedure Coding System (HCPCS) codes: 87811 and 87428.
|
|
Quarterly Update to the NCCI PTP Edits, Version 27.1, Effective April 1, 2021 CR12110
CR 12110 provides the quarterly update to the National Correct Coding Initiative (NCCI) Procedure-to-Procedure (PTP) edits.
|
|
Part A/B Quarterly Medicare Updates on January 14, will include: CMS and Noridian Updates, January 2021 Quarterly Provider Updates, Change Requests (CR), Payment and Recurring Updates, Special Editions (SE), Resources and Educational Information.
|
|
Webinar COVID-19 Telehealth Services for Part B Providers
|
|
New Provider New Biller Review Entities and Appeals Webinar on January 14, will include: Appeals Process, Forms, Noridian Medicare Portal (NMP), Post Medical Review Programs, and Resources.
|
|
Provider Enrollment Live Chat Webinar - January 27, 2021, will include: Provider Enrollment Live Chat, Provider Enrollment Basics, Provider Enrollment Applications.
|
|
Region-specific events, webinars and training for January are found JEA, JEB, JAF and JFB.
|
|
CMS News
A finalized CMS rule will require Medicare Part D prescription drug plans to enable technology that allows health care professionals to see at the point of care whether a drug they are prescribing is subject to prior authorization restrictions. Pharmacy benefit managers may begin implementing the new transaction standard now; compliance is required by Jan. 1, 2022.
|
|
CMS released the annual Physician Fee Schedule (PFS) final rule, prioritizing CMS’ investment in primary care and chronic disease management by increasing payments to physicians and other practitioners for the additional time they spend with patients, especially those with chronic conditions.
|
|
There has been quite a bit of legislative activity over the past month in order to support access to multi-cancer early detection, MCED. As a result, the Prevent Cancer Foundation has created an letter to convey support for the Multi-Cancer Early Detection Screening Coverage Act (S. 5051 and H.R. 8845). You and your organization are encouraged to sign on to the letter, thus adding your credible voice to this important matter. The letter discusses the many reasons why this is critical to cancer prevention and be able to quickly go on record in support of the legislation.
|
|
Have you heard about this campaign? Concerns about COVID-19 have led some patients to delay necessary screens, scans, vaccinations, and treatments. The #ReturnToCare Coalition is a group of patient advocacy organizations and medical societies working together to encourage patients to seek the care they need in consultation with their healthcare providers. In areas where COVID-19 conditions allow reopening, the group encourages patients to consult their doctors to discuss getting necessary imaging, treatment and other care postponed due to the pandemic.
Seeking necessary care can prevent progression of disease to more advanced stages, where it becomes less treatable. The Coalition wants to promote public health by helping patients #ReturnToCare in a safe, timely fashion. Including MOASC, currently, the #ReturnToCare Coalition includes 18 medical and imaging societies, patient advocacy groups, and industry trade group.
|
|
The ongoing COVID-19 Vaccine Study protocol excluded “immunocompromised individuals with known or suspected immunodeficiency, as determined by history and/or laboratory/physical examination.” Individuals who have a history of cancer, including breast, colon prostate and other cancers, and are in remission were eligible to participate and are part of the trial population. A future clinical trial focused specifically on the immunocompromised population is planned for next year. Vaccination is an important topic for cancer patients to talk about with their doctor about. For information about the Pfizer-BioNTech COVID-19 vaccine, visit www.cvdvaccine.com. Healthcare professionals can also visit www.PfizerMedInfo.com to find information about the vaccine or to submit an inquiry. Below is a link to a list of COVID-19 vaccine informational resources. The links provided are for informational purposes only.
|
|
Once the COVID-19 vaccine becomes available to you, know that:
You will need 2 doses of the COVID-19 vaccine for it to be effective. When you receive your first dose, make sure to schedule your second dose. Most insurances and Medicare cover the COVID-19 vaccine, so there should be no cost to you. State governments are handling the distribution of COVID-19 vaccines. Look for updates from your state and local officials as more doses of the vaccine become available for additional priority groups. Besides visiting CDC.gov for additional trustworthy information on the COVID-19 vaccines.
|
|
Puma Biotechnology, Speaker Program invites you to their Post-SABCS Web Series for NERLYNX® (neratinib) on January13 & 14. Click on preferred date below to register.
|
|
SeaGen cordially invites MOASC members to their upcoming ADCETRIS® (brentuximab vedotin) National Broadcast event. This broadcast will be an engaging event featuring the Chair, Scott Smith, MD, PhD, FACP, LUMC and Panelists: Elizabeth Brém, MD, UCI and Aaron Goodman, MD, UCSD, on Thursday, January 21, 2021, with 2 sessions. To register contact Stacey Dominguez at 310-560-1104 or email sdominguez@seagen.com.
|
|
Incyte presents three live disease education webinares for patients diagnosed with a myeloproliferative neoplasm (MPN), on January 13, 20 & 28. Please share with your patients and peers.
|
|
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.
|
|
|
|
|
|
|
