California Oncology Weekly
"An Oncologists’ Source for Timely Information"
A publication of the
Medical Oncology Association of Southern California, Inc.
October 20, 2020
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Click anywhere on picture to view the past 30 years |
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Check your voter registration and see if your county changed your election process California News
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Submit YOUR comments to support fixes to the 340B program National News
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Register today for the COPA advisory board Affiliate Association News - COA News
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MOASC PROGRAMS - SAVE THE DATES All Times are Pacific
Don’t miss the next MOASC Virtual Clinical Conference in November, “Up Close and Personalizing Gastric Cancer Care.” The date and further information will be shared in this publication soon.
A payer's request for an itemized claim statement may signal the claim is being closely scrutinized. Including a coding specialist on every claims denial team prevents line-item denials. Appeals must be submitted within a deadline, often 30 to 45 days, and health information management and coding professionals need time to identify the physicians involved in the case, review records and help develop justification for the services in question. Billers need to
Register now for MOASC’s 30th Annual Educational Series virtual Billing Track, which will be held on November 12 View the agenda. The virtual Administrator Track will be on November 4 View the agenda. MOASC has secured the professionals to provide attendees with the tools and resources to tackle the challenges of addressing patient care, protecting staff, safety and surviving financially during this most unique time. Register Here.
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.
MOASC’s membership drive started October 1 with renewing member dues prorated through June 2021. If you have any questions please contact the MOASC Office at moasc@moasc.org. Thank you.
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Many counties recently changed their elections process under the “Voter’s Choice Act” and in response to the COVID-19 pandemic. You are encouraged to check your voter registration and see if these changes affect you Click Here.
To view the California Medical Association (CMA) Click Here which includes CMA’s positions on November 2020 statewide ballot measures.
The 2020 Medi-Cal Promoting Interoperability Program (aka Meaningful Use) continues. While the CTAP has ended, the CMS MU program still allows Program Year 2020 Medi-Cal Stage 3 Meaningful Use attestations to be submitted up through March 31, 2021. Your EHR reporting period may end as late as December 31, 2020. Do not forget to complete or review a Security Risk Analysis (SRA) during the 2020 Calendar Year! See our SRA news below. If your organization’s Eligible Professionals have not completed six years in the incentive program, the final program year (2021) will be open for attestations from April 1, 2021 through September 15, 2021, with 90 day MU and CQM reporting periods that can start as early as January 1, 2021. For California State Level Registry program information Click Here. For CMS information on the Stage 3 Objectives and Measures, Click Here.
On September 29, 2020, Governor Gavin Newsom signed AB 890 into law changing the rules of physician supervision of nurse practitioners (NPs) for two newly created classifications of NPs. To ensure that physicians understand the potential effects of this bill, CMA has published a new fact sheet titled AB 890: An Overview for Physicians. Read More.
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Noridian News
The coverage article for Billing and Coding: Chemotherapy Administration - R26 and R27 has been revised and published for notice under contract numbers: 01112 (NCA), 01182 (SCA), 01212 (HI and Territories), and 01312 (NV). Read More.
Medical Review Top Trending Error: Chronic Care Management (CCM) webinar on October 22 at 12:00pm Pacific. Hosted by the Provider Outreach and Education (POE) staff, the event includes: Chronic Care Management Overview; Coverage & Indications; Documentation; Examples; Resources. Register Here.
Providers are encouraged to attend the many educational events offered by Noridian. Read the complete update The schedules of region-specific events, webinars and training are JEA, JEB, JAF and JFB. For a schedule of Noridian events of interest, go HERE
Medicare changes that will keep you updated in this next quarter can be found Here
The complete listing of locally hosted coverage articles can be viewed Here. All LCDs and LCAs can be viewed Here.
CMS News
CMS hosts varied recurring stakeholder engagement sessions to share information related to the agency’s response to COVID-19. Calls recordings and transcripts are posted on the CMS podcast page Here.
The Centers for Medicare and Medicaid Services (CMS) announced the latest expansion of 11 new codes in the list of telehealth services that are eligible for reimbursement during the Public Health Emergency (PHE). CMS is also providing additional support to state Medicaid and Children’s Health Insurance Program (CHIP) agencies in their efforts to expand access to telehealth.
CMS Administrator Seema Verma said transitioning the US health care system towards a value-based care model is one of the agency's priorities, but only five of at least 54 payment models developed by the Center for Medicare & Medicaid Innovation have showed statistically significant savings and the center needs "a course correction in model design and portfolio selection, if value-based care is to advance." Speaking at a virtual event hosted by CMS, Verma said to create more successful value-based care models, CMMI should focus on models with "design elements that require participants to have skin in the game," and it must create effective, meaningful benchmarks that can be used to evaluate the success of the models.
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Senator Lamar Alexander (R-TN), Chairman of the Senate HELP Committee, and Representative Greg Walden (R-OR-02), Ranking Member of the House Energy and Commerce Committee, released a request for information (RFI) related to the 340B Drug Discount Program. You are encourage to submit individual comments, as well, to showcase the robust support for fixes to the 340B program that improve accountability and oversight of disproportionate share hospitals and contract pharmacy participation in the program. Comments and recommendations should be submitted by October 30 to the following email addresses: 340B@help.senate.gov and 340B@mail.house.gov. Read Draft Here
Algorithms that help health care professionals throughout the US develop individual care plans are based on data that reflect racial disparities in health care spending, utilization and access. Consequently, the algorithms inadvertently perpetuate disparities by scoring the needs and health risks of white patients higher than those of Black patients with similar or higher risks, researchers say. Read More.
A national specialty practice survey of 155 Specialty Practices, where 46% of the respondents were Oncology practices, evaluated major aspects of how specialty practices have been impacted by the COVID-19 pandemic and how they have responded and leveraged available resources. Survey Results
It CAN happen to your practice! A Piedmont Cancer Institute employee email account was compromised from April 5 to May 8, potentially exposing 5,226 patients' personal and protected health data. The cancer center in Atlanta now requires multifactor authentication on all email accounts and has trained employees on email security. An update to the HHS Security Risk Assessment (SRA) Tool was updated last month. This tool provides support for small- and medium-sized health care organizations in their efforts to assess security risks. The newly enhanced version of the SRA Tool includes a variety of new features like improved navigation throughout the assessment sections, export options for reports, and enhanced user interface scaling. Access the free tool here.
At least 69% of health care providers are now using the top five key performance indicators that help improve patients' satisfaction with telehealth visits, according to a survey from JD Power. These five KPIs include spending enough time to provide quality care with patients, completely resolving patients' medical concerns during visits, and following up after telehealth visits.
Healthcare providers will have the opportunity to provide feedback on their EHR's interoperability in the future through a 28-question survey. HHS contracted with The Urban Institute to develop the survey as part of the 21st Century Cures Act of 2016. On Oct. 13, the first version of the survey became available. The Urban Institute posted a draft of the criteria online this past summer for a 60-day comment period and made revisions based on public feedback.
Sign up & join the Q&A with the rock legend and co-founder of Teen Cancer America, Roger Daltrey! This event takes place November 14th at 12p PT. Be there and make sure you have your questions ready! **There are only a few VIP tickets left! These tickets grant you access to talk directly with Roger himself, so have your questions ready!**
Chat and INTERACT LIVE with Roger (only 25 spots available), or you can also purchase your place as participant and you can watch the entire interview.
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United Healthcare News
You may receive a PTCFD Smart Edit when a professional claim is inappropriately billed in a facility place of service by a health care professional. The PTCFD Smart Edit is applicable to commercial and Medicaid claims and is aligned to UnitedHealthcare’s Professional/Technical reimbursement policy. Smart Edits is a claims optimization tool that identifies potential billing errors and notifies you on your 277CA clearinghouse rejection report. For more information on Smart Edits, please visit UHCprovider.com/smartedits. To learn more, please Click Here.
United Healthcare has published the following enhancements to the Prior Authorization and Notification tool. You can check if a prior authorization is required by procedure code:
Check up to 5 CPT/HCPCS codes at a time. Include an optional diagnosis code. Select from recommended servicing facilities suggested based on the member’s eligibility, diagnosis, and location or utilize the standard search functionality. Visit uhcprovider.com/paan for the latest service category launch dates, system functionality and an Interactive Guide Opens in a new window for Prior Authorization and Notification Tool. You can also attend a live training: Register Here.
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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.
Congratulations to Sue S. Yom, MD, PhD, MAS, for being has selected as a distinguished ASTRO member to receive the ASTRO Fellow (FASTRO) designation. Dr. Yom is a Professor at the University of California, San Francisco. See the publication here
ANCO's 2020 Virtual Professional Education Meeting will take place on Thursday, October 29th. The meeting will focus on the fiscal impact of 2021 E&M coding changes, Medicare update and Documentation, as well as preparing for the 2021 E&M coding changes. Register online no later than Friday, October 23.
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ANCO's three part series of Hematologic Malignancies Updates: Leukemias, Lymphomas, & Myelomas 2020 is going Virtual! The faculty will present the latest research on treatment modalities for hematologic malignancies—leukemias, lymphomas, and myeloma—along with case studies for these diagnoses. The series is scheduled to take place on the following Saturdays: November 14, and December 19.
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Use ANCO's job board to post or search for employment opportunities at ANCO member practices.
Follow ANCO on Twitter at @ANCO News.
ASH News
ASH submitted comments on 21st Century Cures 2.0. The original 21st Century Cures Act was signed into law in December 2016 and focused on the discovery of new cures. This second iteration of the legislation will explore ways to safely and efficiently modernize the delivery of treatments to patients.
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ASH will accept late-breaking, high-impact studies The late-breaking abstracts site will close on time, Wednesday, October 28, at 11:59 p.m. Pacific. ASH recognizes that the results of some top-quality research were not available by the general abstract submission deadline for the 62nd ASH Annual Meeting and Exposition. In an effort to showcase this top-quality research completed after the general abstract submission deadline, the Society has extended the deadline. All abstract submissions must be made electronically through ASH’s online abstract submission system.
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COA News
The Community Oncology Pharmacists Association (COPA) has been asked to conduct an advisory board on December 7, 2020, honorariums will be provided for knowledge surrounding the topic of an oral oncology product currently approved for Relapsed/Refractory Follicular Lymphoma (FL) and will be covering an array of topics associated with the prescribing, treating, ordering, management and reimbursement for said oral agent. Invited participants include Pharmacists, Oncology Nursing staff inclusive of Nurse Practitioners as well as Practice Administrators. Key discussion topics would include your perception of the:
Current R/R FL management; your roles in helping R/R FL patients to access their treatments;
How the new oral treatment and related diagnostic tests are managed within your practice;
Potential ways to improve patient access to this product.
The advisory board attendee would be required to do 30 minutes of pre-work and a 90 minute virtual advisory meeting scheduled late day/early evening on December 7, 2020. If interested in being considered for one of the 8-10 slots, please do reply back to this email with your interest. If selected, you will receive a confirmatory email in the weeks to come. If you are interested, please respond as soon as practical to COPA.
The WSJ has published an article, penned by COA, regarding the drop in cancer screenings. Read Article. COA Board members are speaking with companies about funding a public service announcement campaign about screenings and treatment. It would tie in the message of getting screened with community oncology open for treatment. If you have any patients adversely impacted due to delayed screenings please contact Nick Ferreyros, Director of Communications nferreyros@coacancer.org
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Community Oncology Alliance (COA) Payment Reform Brief Details 35 Oncology Payment Models Underway or Planned Across Country. The Community Oncology Alliance (COA) announced today the release of its inaugural 2020 Payment Reform Brief, providing a unique look at community oncology payment reform trends at both the national and state levels.
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COA is looking for practices that have recently been taken out of the CVS Caremark managed Medicaid plans, Affinity, Health First, Fidelity, without warning. Commercial CVS Caremark plans are still okay. If you have experienced this, please contact Ricky Newton rnewton@COAcancer.org.
In previous editions of this publication, it was reported that COA has continues to work to stop CVS from slow rolling dispensing applications to be in network. Regardless of whether you are impacted or not by this, please read this because there is an important lesson learned that practitioners need to remember when dealing with the PBM/insurer complex. COA CVS Caremark
The National Cancer Treatment Alliance (NCTA) is a national network of leading, independent community oncology practices that are making cancer care better. A benefit corporation (B Corp), NCTA is solely owned by the Community Oncology Alliance (COA). Working with a national network of independent, community oncology practices, NCTA provides information, resources, and education to employers and other stakeholders to improve our nation’s cancer care system. Learn More .
Attend an NCTA “Lunch and Learn” Program.
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MGMA News
The MGMA Government Affairs regularly advocates on behalf of physicians, practices MGMA members, customers and supporters. They have recently taken a strong interest in the 2020 Monthly Surveys and believe it could serve as data to direct analyses they bring forward to members on the Hill. Can they count on your help to provide a voice from the front lines? Access to the survey: data.mgma.com.
Participants of the survey will receive a copy of the report results, which will include monthly trends of the 2020 calendar year. Custom reports comparing each participating practice's data alongside the MGMA data will also be available.
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NCCN News
NCCN has published updates to the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) and the NCCN Drugs & Biologics Compendium (NCCN Compendium®) for Gestational Trophoblastic Neoplasia. These NCCN Guidelines® are currently available as Version 3.2020. Read More
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AbbVie has announced that the FDA has provided full approval to VENCLEXTA® (venetoclax) in combination with azacitidine, or decitabine, or low-dose cytarabine (LDAC) for the treatment of newly-diagnosed acute myeloid leukemia (AML) in adults who are age 75 years or older, or who have comorbidities that preclude the use of intensive induction chemotherapy. The approval is supported by data from the Phase 3 VIALE-A (M15-656) and VIALE-C (M16-043) studies and updated data from the Phase 1b M14-358 and the Phase 1/2 M14-387 studies. The FDA previously granted accelerated approval to VENCLEXTA for this indication in 2018.5 Please find additional details regarding the approval within our press release Here.
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Agios Pharmaceuticals, cordially invites MOASC Members, on Thursday, October 22, 2020 at 6:00 PM-PDT, to their upcoming webinar about TIBSOVO® (ivosidenib): A Targeted Therapy for IC-Ineligible Patients with Newly Diagnosed AML and Patients with R/R AML with an IDH1 Mutation,. Presented by: Gary Schiller, MD, Professor of Medicine, David Geffen School of Medicine, UCLA Ronald Reagan, UCLA Medical Center, Los Angeles, CA.
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AstraZeneca cordially invites MOASC Members, on October 22, to their upcoming webcast series 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. View the multiple dates and invitation here.
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Bristol Myers Squibb and Exelixis, Inc. announced that the U.S. Food and Drug Administration (FDA) has accepted the supplemental Biologics License Application (sBLA) and supplemental New Drug Application (sNDA), respectively, for OPDIVO® (nivolumab) in combination with CABOMETYX® (cabozantinib) for patients with advanced renal cell carcinoma (RCC). The FDA granted Priority Review to both applications and assigned a Prescription Drug User Fee Act (PDUFA) goal date, or target action date, of February 20, 2021.
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Kite Pharma cordially invites MOASC Members 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, MD on Wednesday, November 11, 2020 05:30 PM - 06:30 PM.
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Merck announced positive results from two studies from the company’s leading lung cancer clinical development program evaluating KEYTRUDA, Merck’s anti-PD-1 therapy: KEYTRUDA in combination with chemotherapy (KEYNOTE-021 [Cohort G]) and KEYTRUDA in combination with quavonlimab (MK-1308), Merck’s novel investigational anti-CTLA-4 antibody.
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Premier Alternate Site Programs is conducting a survey to understand how healthcare providers are incorporating wearable technology/remote health technology within their facilities. This survey will better help determine if there is sufficient need and interest to pursue additional sourcing opportunities for members. The survey should take approximately 10 minutes to complete. Please respond by Monday, November 16, so that we can collect this important data. Your individual answers will be kept confidential and not shared outside of Premier. Thank you in advance for your critical input.
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Seattle Genetics cordially invites MOASC Members to their upcoming series of Educational Programs to review data from ECHELON-1, 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 lymphoma (cHL).1 Also discussed will be the latest data from the North American subset analyses. Presented by: Andrew Evens, DO, MSc, Rutgers Cancer Institute of NJ, New Brunswick, New Jersey. To register contact Stacey Dominguez at sdominguez@seagen.com or 310-560-1104.
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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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