California Oncology Weekly
"An Oncologists’ Source for Timely Information"
A publication of the
Medical Oncology Association of Southern California, Inc.
May 4, 2021
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May is the month designated for awareness and advocacy for survivors and treatments of Melanoma & Skin Cancer – Brain Cancer – Bladder Cancer.
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May 6 webinar on Metastatic Triple-Negative Breast Cancer. MOASC News
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May 11 webinar on Treatment of Prostate Cancer. MOASC News
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Certain cancer screening considered "low-value." Medicare News/ CMS News
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Congress considers adding drug pricing measures, as allowing the government to negotiate drug prices. National News
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May 7 is YOUR LAST CHANCE to highlight how strong community oncology is right now. Affiliate Association News/COA News
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May 7 is YOUR last opportunity to submit your data to the 2021 MGMA Practice Operations Survey. MGMA News
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MOASC Programs - Save the Dates - All Times are Pacific Daylight
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May 06, 5:30pm, MOASC members are encouraged to attend a webinar to learn more about an FDA-approved Treatment for Metastatic Triple-Negative Breast Cancer, presented by: Rena D. Callahan, M.D., Assistant Clinical Professor of Medicine, UCLA. Dr. Callahan will discuss: the clinical landscape of metastatic TNBC; appropriate populations for a metastatic TNBC therapy; and safety and efficacy of a therapy in patients with metastatic TNBC. Sponsored by Gilead Sciences, Inc.
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On May 11, MJH Life Sciences brings you the Treatment of Prostate Cancer, presented by Dr. David Quinn (USC Norris Comprehensive Cancer Center, Hospital and Clinics). On May 13th the Treatment of Multiple Myeloma will be presented by Dr. Joseph Mikhael (Translational Genomics Research Institute, City of Hope Cancer Center).
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Just around the corner, MOASC’s partnership with Dr Neil Love presents the Year in Review, virtual webinar. This program is accredited for almost 7 hours of CME/MOC-and NCPD programming. You are encouraged to sign-up for this complimentary daylong, fully virtual event, taking place on Saturday, May 15, 2021 from 7:30am– 3:30pm.
A multi-tumor approach with 14 expert clinical investigators will review current management strategies and recent advances in breast cancer, AML/MD, chronic lymphocytic leukemia and lymphomas, gastrointestinal cancers, genitourinary cancers, lung cancer and multiple myeloma. In lieu of traditional didactic lectures, the participating faculty will review recent data
as well as review cases provided by MOASC clinicians. To learn more or to register for this complimentary virtual program, please visit RTP’s website:
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Last week, Governor Gavin Newsom released a statement endorsing the anticipated FDA reported move to ban menthol-flavored cigarettes. |
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Medicare B News JE April 2021 Bulletin - Now Available
The Medicare B News Bulletin dated April 2021 is now available on the Noridian Bulletins webpage.
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Billing and Coding: Prostate Cancer Genomic Classifier
Assay for Men with Localized Disease - R2 - Effective January 01, 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).
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Addition of the QW Modifier to HCPCS Code 87636 CR12269
CR 12269 informs you of the addition of the QW modifier to Healthcare Common Procedure Coding System (HCPCS) code 87636
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July 1 is the effective date of the Quarterly Update to the National Correct Coding Initiative Procedure-To-Procedure edits, Version 27.2. CR12226. Please be sure your billing staffs know of the updates.
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Local and National Coverage Determination (LCD/NCD) Webinar - May 11, 2021
This event includes: Overview, National Coverage Determination (NCD), Local Coverage Determination (LCD), Medicare Coverage Database (MCD), and Resources.
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May 12, Differences Between Sole Proprietor and Sole Owner webinar will be presented. This event includes: Provider Enrollment, Sole Owner Enrolling in Medicare - Part B, Sole Proprietor Enrolling in Medicare - Part B.
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May 18, Signature Requirements webinar, includes: Overview and Purpose, Valid Signatures, Signature Guidelines, Signature Log and Attestation Statement, Common Signature Errors, and Resources.
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May 20, the Radiation Oncology webinar includes: Radiation Oncology Overview and Billing, Local Coverage Determinations (LCDs), Radiation Treatment Management, Noteworthy Information, Resources.
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May 26, the Ordered, Referred, and Prescribed Services webinar includes: Ordering/Referring Requirements, Claim Editing for Ordering/Referring Provider, Ordering/Referring Services, Signature Requirements, Medical Records Documentation, Resources and Reminders
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May 27, the Noridian Medicare Portal (NMP) Eligibility webinar includes: Hours of Availability, Eligibility, MBI Lookup, Resources
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Certain cancer screening services considered to be "low-value" in Medicare’s preventive medical services that don't have clear health benefits or may even cause harm, according to a study in the Journal of General Internal Medicine. The services, which received a "D" rating from the US Preventive Services Task Force, include cancer screening services for adults who may be too old to benefit and screening for cardiovascular disease among low-risk adults. Medicare spends about $478 million per year on seven of these services.
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CMS Proposes to Enhance the Medical Workforce in Rural and Underserved Communities to Support COVID-19 Recovery and Beyond.
CMS issued a proposed rule (CMS-1752-P) for inpatient and long-term care hospitals that builds on the Biden Administration’s key priorities to close health care equity gaps and provide greater accessibility to care. Major provisions in the proposed rule would fund medical residency positions in hospitals in rural and underserved communities to address workforce shortages and require hospitals to report COVID-19 vaccination rates among their workers to contain the spread of the virus.
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A study in Health Affairs found Medicare spending on common imaging and laboratory tests increased by more than $73 million from 2013 to 2016, and vertical integration in the industry was a key driver of that spending increase. "Medicare and many other payers pay more for the exact same service if it is done in the hospital versus the non-hospital setting," RAND policy researcher Christopher Whaley said, but a CMS effort to institute site-neutral payments was struck down in court.
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Last Friday, the Biden administration finalized the second part of the Notice of Benefit Payment Parameters. The rule makes it easier for consumers to qualify for a special enrollment period for Affordable Care Act exchange coverage, in addition to several other major changes. One of the major changes focuses on pharmacy benefit management (PBM) transparency. The rule includes a new requirement for the collection of prescription drug data directly from PBMs. Per CMS, the data will be used to enhance CMS’ understanding of the true cost of prescription drugs provided in exchange plans and shed light on the role that PBMs play in their cost.
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With information coming from many different sources, CMS has up-to-date resources and materials to help you share important and relevant information on the COVID-19 vaccine with the people that you serve. You can find these and more resources on the COVID-19 Partner Resources Page and the HHS COVID Education Campaign page. We look forward to partnering with you to encourage our beneficiaries to get vaccinated when they have the opportunity. For more information, visit the CMS COVID-19 Policies and Guidance page.
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Leading Senate and House Democrats said they're considering adding drug pricing measures, such as a provision allowing the government to negotiate drug prices, to the American Families Plan as the package moves through the Congress. Some lawmakers are also pushing for inclusion of a measure that would lower the Medicare eligibility age to 55 or 60.
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Members of the Senate and House from both parties have proposed eight antitrust bills designed to stop tactics they say are aimed at thwarting competition from generic drug makers. The proposals would make it easier to bring biosimilars to market, make it more difficult to secure a new patent after a minor medication change, stop pay-for-delay patent settlements and ban sham citizen petitions.
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Congress recently passed the “Advancing Education on Biosimilars Act of 2021 (S.164). This bill promotes biosimilars, which are FDA-approved and often lower-cost alternatives to biologic therapies. The legislation would inform patients, providers, and caregivers about the safety and effectiveness of biosimilars. Spreading the word about the benefits of biosimilars could lead to increased use and ultimately reduce overall U.S. healthcare costs. While education about biosimilars is important, it is important to let your Congress person know not to stop a just promoting biosimilars but that there is need to insure patients’ access to these innovative treatments. Send a message urging key members of Congress to support biosimilars and patients’ access to life-saving treatments!
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United Healthcare has published their May Provider News. |
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Affiliate Association News |
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ANCO's three part series of Hematologic Malignancies Updates: Leukemias, Lymphomas, & Myelomas 2021 will kick off online May 15. Faculty will present the latest research on treatment modalities for hematologic malignancies—leukemias, lymphomas, and myeloma—along with case studies for these diagnoses.
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ANCO announces a new series of events titled: ANCO Connections. This is a series of monthly roundtable presentations on the day-to-day issues of importance to the cancer community by local and national thought leaders.
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ASCO News
2021 ASCO Annual Meeting will be a virtual meeting held June 4-8, and will feature a dynamic program of educational and scientific sessions, showcasing what is possible when the cancer care community comes together to advance cancer research, treatment, and equity for every patient, every day, everywhere. Featuring 48 high-impact broadcast sessions with real-time engagement, live Q&A, and unparalleled learning, browse the list of sessions that align with your interests and expertise, including 175 on-demand presentations from poster and poster discussion sessions, clinical science symposia, and dynamic education sessions.
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The ASCO Foundation cordially invites you to an evening to Conquer Cancer. On Saturday June 5 at 4:00pm PDT, this virtual event will raise support for cancer research. Please RSVP by May 28, registration is required. Learn how you can make an impact on breakthrough research for every cancer, every patient, everywhere! Together we can conquer cancer.
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Can’t attend? Make a donation now to help conquer cancer
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COA News
Medscape is working with COA on a feature story, and possibly series, about “the challenges cancer centers have faced and how they kept their doors open” (aka succeeded) during the pandemic. COA has told them a positive story to share about community oncology resilience, resourcefulness, and innovation. COA is looking to you to back that up with your positive stories. This is a fantastic opportunity to highlight how strong community oncology is right now and counter the narrative (which the reporter presumed, and academics have predicted) that practices are suffering. Are you interested in telling your practice’s story over the last year? If so, please get in touch! The reporter is hoping to do interviews this week, by Friday, May 7. If you are interested please let Nick Ferreyros know ASAP nferreyros@coacancer.org. Thank you.
COA is partnering with CancerCare on a project to create a toolkit to help employers make better Rx coverage decisions and they need our help. As part of the project, CancerCare is creating video and written case studies about people who have had their treatments interrupted, delayed, or otherwise compromised due to utilization management practices. They are looking for patients willing to share their stories on camera and in print. They currently have a few good examples for issues such as non-medical switching and formulary exclusions, but are specifically looking for a patient who has had to deal with step therapy, and someone who has not filled a prescription or followed their dosing instructions due to high out of pocket costs. If you have a patient suggestion please contact Nick Ferreyros, Director of Communications at
This is a fast timeline, as CancerCare is hoping to film the stories in May. Thank you.
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MGMA News
THIS FRIDAY, May 7, the MGMA encourages you to fill out their extension form in order to participate in the 2021 MGMA Practice Operations Survey. The 30+ year history of this annual survey has provided practices with valuable practice numbers to better determine the practices position among like practices and valuable contracting comparative information. MOASC encourages you to spend the time for the most beneficial return and respond to their survey TODAY!
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On May 11, the MGMA presents their Medical Practice Excellence Pathways Conference. This is where business leaders and professionals from across the healthcare industry go for the inspiration and insights to achieve medical practice excellence. This reformatted event brings the best of MGMA’s popular Spring conferences — The Financial Conference, The Operations Conference and The Data Conference — under one roof, offering customizable experiences that help you set a path to success for your organization. This conference will provide an opportunity, unlike any MGMA has offered before, where you will advance your expertise in just three days from these three important areas of business.
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MOASC acknowledges and thanks ADC Therapeutics. as an annual sponsor. Please welcome and THANK them for supporting your organization, when they call or e-mail you.
ADC Therapeutics is a clinical-stage oncology biotechnology company leading the development and commercialization of next-generation antibody drug conjugates (ADCs) with highly potent and targeted pyrrolobenzodiazepine (PBD) dimer technology.
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Incyte presents three live disease education webinars for patients diagnosed with a myeloproliferative neoplasm (MPN), on May 5, 11 & 25. Please share with your patients and peers.
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Lilly Oncology informed MOASC that ERBITUX® (cetuximab) has FDA approved weekly and bi-weekly dosing schedules for mCRC.
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May 11, at 10 am, Bobbi Buell cordially invites you to attend her Webinar: The ABCs of Infusion and Injection? Billing these codes can be confusing and billing visits with them is also tricky! This webinar will review the billing requirements for all kinds of drug administration. Everyone is welcome!! The webinar is free and sponsored by RxVantage.
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May 13, 202, 3-4 pm PDT Oncopeptides cordially invites you to a virtual webcast titled, African American Experience in Multiple Myeloma. This presentation will feature a panel of experts discussing key data around the African American Experience in Multiple Myeloma and strategies to remove disparities and barriers to care, followed by a Q&A session. This is not a promotional event.
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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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