California
Oncology
Weekly
"Where California Oncologists Go For Answers!"
A collaborative publication of the
Medical Oncology Association of Southern California, Inc.
and the
Association of Northern California Oncologists, Inc
.
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- This Sunday, June 2! Celebrate National Cancer Survivors Day®. National News
- Congress to limit out-of-pocket spending on prescription drugs in Medicare Part D. National News
- Need some Hospira/Abbott Plum A+ infusion pumps? MOASC News
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- Please join Californians Allied for Patient Protection (defenders of MICRA) for an evening reception in honor of Assembly Member Sabrina Cervantes on Thursday, June 6th from 5:30 PM to 6:30 PM. The reception will be held at PrimeCare, part of OptumCare (2275 Sampson Ave. Ste. 111, Corona, CA 92879). Please click here to view the invitation.
Please share this invitation with your colleagues and encourage them to attend. Please RSVP to Kristina Gelabert kgelabert@micra.org. Thank you for your continued support of CAPP.
- The 2019 Patient Conference on Prostate Cancer presented by the California Prostate Cancer Coalition and the Helen Diller Family Comprehensive Cancer Center of UCSF will be held Saturday, June 8, 2019 from 8-5 at UCSF. There are a small number of complimentary tickets available for this event. If you are unable to pay the registration fee and would like a ticket, please send your name and email address to
hdfcccoce@gmail.com. Please include Prostate Conference in the subject line. To download the flyer, click here. To register, click here.
- The 2019 California Dialogue On Cancer Regional Stakeholder Meetings held in Sacramento and Los Angeles on April 29, 2019, were a success and will inform cancer plan developments in the coming months. Presentations from both the Sacramento and Los Angeles meetings are linked below.
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Announcements:
Proposed Rules on Interoperability: Comment Period Extended to June 3; Quality Payment Program: MIPS 2019 Call for Measures/Activities Ends July 1; SNF Provider Preview Reports: Review Your Data by May 30; Medicare Shared Savings Program: Submit Notice of Intent to Apply Beginning June 11; Promoting Interoperability Programs: Submit Comments on Proposed Changes by June 24; No Shortcuts for Safer Opioids Prescribing: CDC Commentary; CMS Takes Action to Lower Prescription Drug Prices and Increase Transparency; Promoting Interoperability Program: 2015 Edition CEHRT Required; April - June Quarterly Provider Update; Provider Minute Video: The Importance of Proper Documentation
Events:
Hospice Quality Reporting Program: Review and Correct Report Webinar-June 11
Publications:
Claims Status Category and Claim Status Codes Update; Quarterly Healthcare Common Procedure Coding System (HCPCS) Drug/Biological Code Changes-July 2019 Update; Remittance Advice Remark Code (RARC), Claims Adjustment Reason Code (CARC), Medicare Remit Easy Print (MREP) and PC Print Update; Reporting the HCPCS Level II Modifiers of the Patient Relationship Categories and Codes; Proper Use of Modifier 59-Revised; Medicare Basics: Commonly Used Acronyms-Reminder
* MolDX Draft LCDs (DL38131, DL38151, DL38135)-Published for Review and Comments
* Reporting the HCPCS Level II Modifiers of the PRC CR11259
* Open Public Meeting Announcement-June 4, 2019
* MolDX: Targeted and Comprehensive Genomic Profile Next-Generation Sequencing Testing in Cancer-R3
* MolDX: EndoPredict Breast Cancer Gene Expression Test LCD-R2
* RARC, CARC, MREP, and PC Print Update CR112252
* Modifier Education on Demand Tutorials Available
* Claim Status Category and Claim Status Codes Update CR11292
* Proper Use of Modifier 59-Revised SE1418
* Quarterly HCPCS Drug/Biological Code Changes-July 2019 Update CR11296
Forthcoming Noridian JEMAC meetings/webinars/workshops
* Submitting Your Enrollment Online-Part 1 Webinar (I&A; May 29)
* Recoupment Webinar (May 30)
* Eligibility Claim Denials & Rejections Webinar (June 4)
* Using the Medicare Beneficiary Identifier (MBI) Webinar (June 13)
* Completing Appeals through the Noridian Medicare Portal (NMP) Webinar (June 19)
* Advanced Beneficiary Notice of Non-coverage (ABM) Webinar (June 21)
* Modifier 59, NCCI, and MUEs Webinar (June 26)
* Submitting Your Enrollment Online-Part 2 Webinar (PECOS; June 26)
* New Provider New Biller Review Entities and Appeals Part 2 of 2 Webinar (June 28)
* Telehealth/Telemedicine Enrollment Only Webinar (July 10)
* Understanding National and Local Coverage Determinations Webinar (July 23)
* Medicare Part A/B Revalidation Webinar (July 24)
* Revocation, Caps and Appeals Webinar (August 7)
* Submitting Your Enrollment Online-Part 1 (I&A) Webinar (August 21)
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- Renew your MOASC Membership TODAY! Continue your investment in your association.
We will continue to advance oncology in California, with your continued support and membership in MOASC. We truly appreciate your devotion to serving the California oncology community.
You can renew your membership in two ways:
- Print the application HERE mail it along with your check made payable to: Medical Oncology Association of Southern California, Inc., P.O. Box 161, Upland, CA 91785
- Go to www.moasc.org and pay via PayPal.
We are looking forward to an exciting year ahead with benefits you will not want to miss.
If you have any questions, please contact the MOASC Office at 909-985-9061 ext. 1.
MOASC is pleased to introduce two new physicians that have joined the Board of Directors.
Anthony Nguyen, M.D., is a first year Hematology/Oncology Fellow at Loma Linda University. He is very eager to get
involved with MOASC and advocate for patients.
 Joshua Mansour, M.D.,
is a board-certified Hematologist/Oncologist. He works at the City of Hope and The Southern California Permanente Group. He specializes in Bone Marrow Transplantation & Cellular Immunotherapy. He prides himself on being a healthcare advocate and is excited to get involved with MOASC.
- SAVE-THE-DATE for MOASC's Spotlight On Oncology, August 17, 2019 in Huntington Beach. Through a restricted grant from MOASC, selected oncology fellows and faculty from the University of California, Irvine (UCI), present the premier topics from their attendance at the 2019 Annual ASCO meeting. The presentations promote collegial discourse among colleagues along with networking in an informal setting. Contact the MOASC Office for more information at
moasc@moasc.org.
- MOASC Member, City of Hope CME presents: Multidisciplinary Approaches to Cancer Symposium on October 10-13, 2019 @ Waldorf Astoria, Las Vegas, Nevada. This intensive program will provide participants with an enhanced ability to interpret and apply best treatment options into their individual cancer practices. For more information click
HERE. To register go to: https://cme.cityofhope.org/eventinfo_10946.html
INFUSION PUMPS for SALE:
- MOASC Member has 32, never used, in the box, Hospira/Abbott Plum A+ infusion pumps. Sold as is. Warranty is not transferrable. If interested, please contact Laura Volpini at 661-616-1650 or lvolpini@cbccusa.com
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- SAVE THE DATE: ANCO's
ASCO Highlights 2019
will take place on Saturday, August 17 at The Claremont Resort in Berkeley. Watch for an official announcement in June!
-
ANCO is now on Twitter
; follow
@ANCO News
.
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National News
- Cancer survivors, in local communities, will celebrate National Cancer Survivors Day® this Sunday, June 2. With more than 15.5 million people living with and beyond cancer in the U.S. today - and more than 32 million cancer survivors worldwide - everyone knows someone whose life has been touched by cancer. Communities around the world will unite to recognize these cancer survivors, and to raise awareness of the challenges of cancer survivorship, as part of the 32nd Annual National Cancer Survivors Day® Celebration of Life. To find the one nearest you, contact the American Cancer Society office. Or you can host an event of your own using the resources available through the National Cancer Survivors Day® website, ncsd.org.
- The leaders and ranking members of the House Ways and Means Committee and the Energy and Commerce Committee released the discussion draft of legislation meant to limit beneficiaries' out-of-pocket spending on prescription drugs in Medicare Part D and reduce the government's portion of catastrophic coverage from 80% to 20% over a four-year period. The Senate health committee also unveiled its 165-page discussion draft of provisions to lower healthcare costs. The Senate Finance Committee is aiming to release its slate of drug pricing bills related to Medicare Parts B and D and Medicaid shortly after recess, with a mark-up in mid-June. Stakeholders are invited to submit input on the proposals by June 6.
- Last week the Senate health committee released draft legislation to reform how hospitals and insurers use contracts and bill patients. Critics claim the current practices allow providers to dominate their competitors, consolidate business and surprise patients with high bills.
On the most visible level, this package is the Senate vehicle for the much-debated ban on surprise medical bills. However, the discussion draft doesn't settle the contentious question of how Congress should implement the ban and instead addresses three ideas that the committee still needs to decide upon:
*Require hospitals to guarantee patients that, for practical purposes, all its physicians are in-network. Physicians could either contract with the hospital's insurers or stay out of network but submit their charges through the hospital.
*Let insurers, hospitals or physicians choose arbitration to resolve disputed charges higher than $750.
*Have insurers pay the surprise bill at the median contracted rate for that region to the hospital or doctor in question, which is similar to a House Energy and Commerce Committee proposal.
The American Hospital Association strongly opposes any proposal that would impose arbitrary rates on providers, along with untested proposals such as bundling payments, which would be unworkable and would do nothing to solve the issue of surprise billing. The association's preferred approach is to ban balance billing for emergency services or services performed at an in-network facility. The AHA also opposed a provision that would ban "all-or-nothing" clauses where hospitals force insurers to contract with all their facilities by saying if they do not contract with all of them they cannot contract with any.
The Senate Health Committee also proposes to ban gag clauses that some hospitals include in their insurer contracts, meaning hospitals could no longer prevent patients or any other party from seeing all hospitals' cost and quality data. Insurers would be able to access and share anonymous claims data to monitor the quality of their contracted providers.
- ANCO, MOASC, and ASCO urge all members to contact their Congressional Representatives to ask them to co-sponsor the Clinical Treatment Act (HR913) that would provide for coverage of routine care costs of Medicaid beneficiaries enrolled in clinical trials. Use the ASO ACT Network at
https://asco.quorum.us/campaign/14280/
to contact your Representatives.
- ICER will welcome comments through Monday, June 10th. The Institute for Clinical and Economic Review (
ICER
) is opening a national call for suggestions on how to improve ICER's
value assessment framework
to the methods that underpin ICER's evidence reports on new drugs and other health care interventions.
Based on the feedback received, draft revisions will be published to ICER's value assessment framework on August 16th, then go out to public comment on those proposed revisions through October 11th, and post the final updated framework on December 18th. This final framework will be applied to all assessments initiated in 2020 and beyond.
- Our connected world brings many advantages, but it also introduces new threats like ransomware. Healthcare organizations are especially vulnerable given the proliferation of data (collecting devices, wearables, and apps). Here is an interactive site that provides recommendations on how to mitigate ten common security challenges, from data availability and legacy applications to hospital decentralization and the skills shortage. DOWNLOAD NOW!
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CMS News
- Some oncology practices may be forced to drop out of CMS' bundled-payment program to avoid financial loss. CMS' Oncology Care Model, beginning in July, will push practices to move from one-sided to two-sided risk where they would be responsible for paying the difference if they do not meet a target price for services. Approximately 70% of oncology practices participating in the program would owe CMS money, according to new research released last week by Avalere Health.
Started in 2016, the Oncology Care Model is a five-year, voluntary bundled-payment model developed to give providers incentives to improve care quality and care coordination to lower costs. Oncology practices participating in the model receive a combination of both regular fee-for-service payments as well as the potential to earn more through a performance-based payment when certain quality and financial measures are met over a six-month performance period.
Currently, practices can generate revenue by providing care below the target price set by CMS without incurring penalties if they exceed cost targets. Starting in July, practices that have yet to achieve performance-based payment could be transitioned to the two-sided risk model, putting them on the hook for financial losses if they don't meet cost targets.
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Affiliate Association News
- ASCO Clinical Affairs is your one-stop shop for the operations side of cancer care, providing the educational tools, training programs, services and resources you need to deliver high-quality, high-value care to your patients. Subscribe to receive email updates on how Clinical Affairs can help maintain and improve your practice health at
https://practice.asco.org/subscribe-clinical-affairs-updates
.
- Data abstraction for ASCO's QOPI Round 1 will close on June 3. Round 1 final reports will be available approximately two weeks after the round closes. Learn more at
- ASCO's Oncology Practice Conference takes place in San Diego on September 5. Focused on the business of cancer care, this conference will address the needs of practice administration and operations, with timely and practice strategies for the challenges faced by all those involved in the business of cancer care. Learn more and register at
https://meetings.asco.org/opc/register
.
- Join ASH on September 6-7, 2019, at the Fairmont Chicago, Millennium Park for the 2019 ASH Meeting on Hematologic Malignancies to gain knowledge that can help you make an immediate impact in your practice. The meeting will feature top experts in the field, comprehensive clinical content, the latest clinical research, and opportunities to interact with colleagues in an intimate, small group setting with no competing sessions. The program content will be structured as "How I Treat" presentations, which will highlight each speaker's evidence-based treatment approaches, present cutting-edge scientific data that can be translated into new strategies for diagnosis and treatment, and address what to do in cases where there is no data. For more details, or to register, please visit the
ASH Website
.
- The ASCO Quality Care Symposium, September 6-7 in San Diego, encompasses the latest strategies and methods for quantification of patient experience, provider efficiency, clinical outcomes, and quality and safety in the cancer care field. The Symposium will include a variety of sessions that will cover the latest science in precision and personalized medicine. Oral abstract presentations will feature the highest-quality science submitted to the Symposium and Poster Walks will allow for networking while exploring the presentation of the newest science. This meeting will bring leaders in quality improvement science together to participate in stimulating conversation with opportunities for networking among physicians, nurse practitioners, physician assistants, and others.
ASCO Quality Care Symposium
.
- NCCN has published the following updates at
www.nccn.org
: xxx (V2x.2019).
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- Incyte informs ANCO and MOASC that the United States Food and Drug Administration has approved Jakafi for steroid-refractory acute graft-versus-host disease (GVHD) in adult and pediatric patients12 years and older.
- Pfizer Oncology informs ANCO and MOASC that the United States Food and Drug Administration has approved Bavencio (IO) + Inlyta (TKI) as a new, first-line combination therapy for patients with advanced renal cell carcinoma (RCC).
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MOASC CALENDAR
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(NCCN, San Francisco, September 27)
(NCCN, San Francisco, September 27-28)
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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
Association of Northern California Oncologists
(ANCO) is an association of hematologists/oncologists dedicated to promoting high professional standards of cancer care by providing a forum for the exchange of ideas, data, and knowledge.
The material contained in the
California Oncology Weekly
is intended as general information for ANCO and 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 or ANCO accepts no liability for any statements or articles herein.
CPT codes are owned and trademarked by the American Medical Association. All Rights Reserved.
MOASC: P.O. Box 161, Upland, CA 91785 | P (909) 985-9061 | F (909) 804-5006| www.moasc.org
ANCO: P.O. Box 151109, San Rafael, CA 94915 | P (415) 472-3960 | F (415) 472-3961 | www.anco-online.org
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