California Oncology Weekly
"An Oncologists’ Source for Timely Information"
A publication of the
Medical Oncology Association of Southern California, Inc.
November 10, 2020
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New Evidence in First-Line AML, TODAY, November 10 at 5:00pm PT Industry News
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This Thursday! MOASC’s 30th Annual Educational Series Billing Track MOASC News
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This Thursday! MOASC’s Virtual Clinical Conference Gastric Cancer Care Precision Medicine MOASC News
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Summary of most significant new health laws of interest to physicians California News
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MOASC is in receipt of more Members’ letters from healthplans regarding brown & white bagging of drugs. MOASC Executive Director, Nichole East, has been meeting with various specialty societies and associations, lobbyists, pharma and other stakeholders discussing these policies and possible next steps. Below is a link to a template letter, developed by Community Oncology Alliance (COA) in collaboration with the law firm, Frier Levitt, edited by MOASC, which you may use as part of oncology’s efforts to combat this trend. Please communicate with MOASC should you receive letters from healthplans. Thank you.
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MOASC PROGRAMS - SAVE THE DATES All Times are Pacific
Register now for MOASC’s 30th Annual Educational Series tailored for YOU! This Thursday, November 12, make room in your practice for the billing and revenue experts MOASC has invited to speak with you. What are traditional denial management methods really costing your practice? Studies suggest that most providers see overall denial and rejection rates as high as 15-20 percent. And a high percentage of those denied and rejected claims never get resubmitted, resulting in lost revenue. Because of these issues and many more, billers must Zoom in on Thursday, November 12 at 12:30pm.
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Please welcome and thank these MOASC Series partners when they visit your practice!
AstraZeneca, BeiGene, Pfizer Oncology, Puma Biotechnology, AbbVie, Merck, Verastem, Astellas, Bristol Myers Squibb, Foundation Medicine, Johnson and Johnson, Agios Pharmaceuticals, Exact Science, Genentech, Immunomedics , Kite Pharma, Eli Lilly, Novartis, Oncology Supply, Pharmacyclics, Regeneron Healthcare, Sanofi-Genzyme, Stemline Therapeutics, Takeda and Walgreens. THANK YOU!
This Thursday, November 12, back by clinical demand, is another MOASC Virtual Clinical Conference. This program is titled Up Close and Personalizing Gastric Cancer Care Precision Medicine With HER2-Targeted Therapies and Other Novel Agents. As the management of gastric/GEJ cancer is rapidly evolving, oncologists and other healthcare professionals will benefit from receiving practical guidance on the role and use of current and emerging personalized therapies. PeerView has developed this collection of educational activities to highlight the importance of molecular testing, help synthesize the latest advances and data of novel HER2-directed and other targeted therapeutics, and offer optimal strategies to effectively integrate personalized medicine in gastric cancer care.
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Continue to learn and support the advocacy performed on your behalf by renewing your MOASC membership TODAY! Thank you.
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The California Medical Association has published a summary of the most significant new health laws of interest to physicians. For more details, see "Significant New California Laws of Interest to Physicians for 2021."
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California voters approved the California Privacy Rights and Enforcement Act of 2020, expanding and making permanent the 2018 California Consumer Privacy Act. The law gives consumers more control over how businesses collect, use and share their personal information, including geolocation, financial, genetic, biometric, health, racial and other data, writes attorney Ian Stewart.
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Physicians who write prescriptions for Medi-Cal patients must sign up for the state’s new Medi-Cal Rx portal before Jan. 1, 2021. Physicians are encouraged to start the registration process as soon as possible, to ensure their ability to prescribe for Medi-Cal patients is not interrupted.
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The California Dialogue on Cancer (CDOC) requests that continued efforts be extended to promote cancer screening in neighborhoods, associations, networks and clinics, as we know that cancer screening rates are down nationally and in California. The American Cancer Society (ACS) has just produced a new toolkit that has some excellent resources. Please consider organizing Calls To Action to urge your community not to put off cancer screening, especially in underserved communities who continue to experience cancer screening related disparities in the area of breast, colorectal, lung and prostate. Please reach out to CDOC (916) 731-2528 if you wish to partner on cancer plan implementation activities to initiate programs that call for prevention and screening uptake in our diverse communities.
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Noridian News
Noridian Medicare Portal Eligibility Webinar in on November 12, 2020
This event includes: Hours of availability, Eligibility, Medicare beneficiary identifier look up, and Resources.
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Providers are encouraged to attend the many educational events offered by Noridian. The schedules of region-specific events, webinars and training are JEA, JEB, JAF and JFB.
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Medicare changes that will keep you updated in this next quarter
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The complete listing of locally hosted coverage articles can be viewed.
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CMS News
The Centers for Medicare & Medicaid Services (CMS) released the 2020 Medicaid and Children’s Health Insurance Program (CHIP) Managed Care final rule. The final rule fulfills one of the Trump Administration’s earliest commitment to states by reducing unnecessary administrative burden and federal regulatory barriers. The purpose of the rule is to ensure state Medicaid and CHIP agencies are able to work effectively to develop and implement managed care programs that better serve each state’s growing number of Medicaid and CHIP beneficiaries.
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The Center for Medicare and Medicaid Innovation (Innovation Center) is excited to announce that 51 Direct Contracting Entities (DCEs) are participating in the Implementation Period of the Direct Contracting Model for Global and Professional Options, which runs from October 1, 2020 through March 31, 2021. The Implementation Period provides an opportunity for DCEs to prepare for the first Performance Year (PY1), which starts on April 1, 2021. All 51 DCEs participating in the Implementation Period will have the opportunity to participate in PY1, along with DCEs that applied to start participation beginning in PY1. The DCEs will serve beneficiaries in 39 states as well as in the District of Columbia and Puerto Rico. The 7 California entities are: American Choice Healthcare, LLC; CareMore Aspire Medical Innovation Partners; Central Valley Medical Group, Inc.; Landmark Primary Care, LLC; Premier Care of Northern California Medical Group; Rancho Family Medical Group; Vively Health.
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Seniors with traditional Medicare plans will see a slight increase in their 2021 monthly premiums, CMS said last week. Monthly premiums for Medicare Part B will rise 2.7% to $148.50 in 2021 from $144.60 in 2020. Those fees cover doctors' appointments, and outpatient hospital care as well as other services. Deductibles will see a similar 2.5% rise, from $198 to $203.
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Physicians who have yet to receive any General Distribution payments and submitted their TIN for validation by November 6 will have until November 27 to submit their Phase 3 General Distribution application once their TIN has been validated.
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A survey involving 397 US organizations and 7.1 million workers showed 73% of organizations plan to shift to more value-based care delivery models and expand them in the next three years. Willis Towers Watson, who conducted the survey, found that 90% of employers intend or plan to offer high-performance narrow networks, which links members to a narrow network of lower-cost but higher-value providers, while 59% of workers currently have or will have access to such plans in the near future.
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Physician practice viability is under threat as physicians continue to see fewer patients in-person, according to a new report from the American Medical Association (AMA).
Based on findings from a survey of 3,500 physicians, 81% of physicians said revenue was still lower than pre-pandemic levels by August 2020. 1 in 5 physicians reported revenue declines of 50% or more, although the average drop in revenue was 32%. Physicians are seeing significantly fewer patients, with 70% of physicians reporting that they were still providing fewer total visits at the time of the survey compared to pre-pandemic levels. In fact, average total visits decreased from 101 to 72 per week even though telehealth use exploded during the pandemic.
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The Supreme Court will make a decision on the future of the Affordable Care Act on Today. The justices will begin hearing arguments and later decide the case, likely in the spring of 2021. At the center of the case before the court — California v. Texas (known as Texas v. U.S. in the lower courts) — is whether if one section of the Affordable Care Act is deemed unconstitutional, can the rest of it stand?
As of Jan. 1, 2021, United Healthcare (UHC) is expanding Medicare Advantage plan offerings into more than 1,337 counties. Many, but not all, UnitedHealthcare and AARP®-branded HMO plans will deploy a new feature – access to a national network of contracted Medicare Advantage providers. That means these HMO members, who select a plan with national network access, will have nationwide access to care at in-network costs.
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UHC will retire their fax number, 800-628-0654 in early 2021. If you use this fax number for: Pre-Service Prior Authorization requests; Medical records requested during prior authorization review; Admission Notifications, and Medical records to support inpatient concurrent review, please use the HIPAA Electronic Data Interchange (EDI) 278N transaction link Please send hospital face sheets and materials ONLY when requested. When UHC requests information, submission instructions will be provided. Need help? Please call the Help Desk at 866-842-3278, option 1. Representatives are available Monday - Friday 5 a.m. - 7 p.m. Pacific Time. If you are unable to use the online tools, please call Provider Services at 877‐842‐3210 to submit a Prior Authorization or Admission Notifications request by phone. Questions? Please call the number on the member’s ID card.
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UHC reviews and updates their Credentialing Plan at least every two years to maintain compliance with all state and federal regulatory requirements, as well as accreditation requirements of the National Committee for Quality Assurance (NCQA). The 2021–2023 UnitedHealthcare Credentialing Plan will be effective March 1, 2021.
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Affiliate Association News |
ANCO News
Four seats on the ANCO Board of Directors are up for election in 2020. ANCO seeks nominations for candidates to stand for election to these seats. This year's election will be conducted via mail ballot in December. Candidates with the top four vote totals will serve for three years (i.e., from 2021-2023, inclusive). The ANCO Board of Directors governs the Association, developing advocacy strategies and policies, approving educational meeting proposals and activities, and considering membership benefits. The Board meets in person approximately once per year in the San Francisco Bay Area and via bimonthly teleconference. Expenses associated with attending Board meetings are reimbursed. Communication with the Board is also conducted via e-mail. You may nominate an ANCO member (including yourself) to stand for election to the Board via e-mail to courtney@anco.org no later than November 16.
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ASH News
Abstracts submitted for oral and poster presentations at the 62nd ASH Annual Meeting& Exposition represent important, novel research in the field and are considered the best of the thousands of abstracts submitted. Begin browsing the top science selected for oral and poster presentations, and start planning your annual meeting schedule now.
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ASH has developed clinical practice guidelines for treating newly diagnosed acute myeloid leukemia (AML) in older adults that reflect risk benefit analyses for intensive and non-intensive therapeutic approaches captured in real-time conversations that occur between patients and their providers. This webinar will highlight the guideline recommendations along with the underlying evidence and rationale for the recommendations. Register to attend this educational webinar on Wednesday, November 17, at 2:00 p.m. Pacific time.
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Leukemia & Lymphoma Society News
The Leukemia & Lymphoma Society's Light The Night Walk funds treatments that are saving the lives of patients today. LLS is making cures happen by providing patient support services, advocating for lifesaving treatments and pioneering the most promising cancer research anywhere.
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NCCN News
NCCN has published updates for Acute Myeloid Leukemia (AML), Version 1.2021
NCCN has published updates to the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®), NCCN Imaging Appropriate Use Criteria (NCCN Imaging AUC™), and the NCCN Drugs and Biologics Compendium (NCCN Compendium®).
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Register for AbbVie’s National Broadcasts: New Evidence in First-Line AML, TODAY, November 10 at 5:00pmPT. See article in Industry News below for more information.
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AbbVie is excited to announce their upcoming National Broadcast: New Evidence in First-Line AML, TODAY, Tuesday, November 10 at 5:00pmPT. These educational events support oncologists and care teams. Attendees will have the opportunity to learn directly from experts in AML. During this interactive presentation the speakers will: Recognize VENCLEXTA as a BCL-2 inhibitor for 1L AML; Review the phase 3 efficacy and safety outcomes of VENCLEXTA + azacitidine from the pivotal VIALE-A study for patients with 1L AML, ineligible for intensive induction chemotherapy due to age or comorbidities.
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Kite Pharma cordially invites MOASC Members, tomorrow, Wednesday, November 11 at 5:30pm, to their upcoming webinar about A CAR T-cell Therapy for the Treatment of Relapsed or Refractory Mantle Cell Lymphoma – TECARTUS™ Prescribing Information. TECARTUS™ is the first and only CAR T-cell therapy approved for adult patients with relapsed/refractory mantle cell lymphoma (MCL). Learn about incorporating TECARTUS™ CAR T therapy into your practice, gain an understanding of MCL disease and unmet needs and review and discuss the use of TECARTUS™ for R/R MCL. Presented by: Joshua Sasine, M.D.
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AbbVie is excited to announce their upcoming National Broadcast: Exploring Outcomes with Fixed-Duration Treatment in CLL, this Thursday, November 12 and again on November 17 across multiple time zones. These educational events support oncologists and care teams. Attendees will have the opportunity to learn directly from experts in CLL. During this interactive presentation the speakers will: Recognize VENCLEXTA as a BCL-2 inhibitor for 1L and R/R CLL; Explore the efficacy and safety outcomes of VENCLEXTA’s chemo-free, fixed duration CLL regimens.
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Seattle Genetics cordially invites MOSC Members to their upcoming Educational Program to review data from ECHELON-1, on Thursday, November 12. A superiority trial comparing ADCETRIS+AVD to ABVD. This trial introduces a bleomycin-free regimen for adult patients with previously untreated Stage III/IV classical Hodgkin’s Lymphoma (cHL). Also discussed will be the latest data from the North American subset analyses. Presented by: Andrew Evens, D.O., MSc, Rutgers Cancer Institute of New Jersey. To register please contact Stacey Dominguez at sdominguez@seagen.com or 310-560-1104.
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AstraZeneca cordially invites MOASAC Members on November 19 to their webcast in support of the PAOLA-1 launch. They will hold expert discussions on LYNPARZA® (olaparib) and LYNPARZA + bevacizumab as Maintenance Monotherapy or Combination Therapy in advanced Ovarian Cancer: Results from Key clinical Trials.
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Incyte cordially invites MOASC Members to attend their MONJUVI Speaker Program, November 19 at 6:30pm PT. Presented by Marin Xavier, M.D., Scripps MD Anderson Cancer Center, San Diego, CA. Location: Water Grill South Coast Plaza, 3300 Bristol Street, Costa Mesa, CA 92626.
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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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