October is Breast Cancer and Liver Cancer Awareness Month.

Other than skin cancer, breast cancer is the most common cancer among American women. Mammograms are the best way to find breast cancer early, when it is easier to treat and before it is big enough to feel or cause symptoms.

This Weekly's Hot Topics

MOASC greatly appreciates the more than 55 UCI Hematologists, Medical / Surgical / Radiation / GYN / Neuro-Oncologists who have renewed their support for 2021-2021.

MOASC has partnered with PayGround to deliver an end-to-end patient collections platform for MOASC members. With their modern patient-first approach, MOASC expects members to increase their patient collections by 12%, decrease their overall days to collect by 4 days, all while saving 26% in processing fees. With this partnership, MOASC members not only gain access to PayGround’s aggregated payment platform, but MOASC negotiated with PayGround to waive all processing fees for the first 90 days for MOASC members. For more information visit go.payground.com/MOASC or attend the November 4 webinar.   

MOASC Programs - Save the Dates - All Times are Pacific

Targeted Oncology cordially invites MOASC Members to two upcoming virtual roundtables intended for oncologists treating Myeloproliferative neoplasms: Myelofibrosis and Polycythemia Vera and Relapsed/Refractory Multiple Myeloma. These Virtual Case-Based Roundtable Meetings are collaborative, small-group meetings designed around case-based clinical profiles and peer-dialogue led by an expert physician. These sessions offer practicing oncologists the perfect opportunity to sharpen their skills and expertise in treatment strategies. Attendees are paid $500 of compensation, per session, by Healthcare Research Analytics®, for their attendance, participation & completion of the post-event HRA survey.

Program 1: Myeloproliferative neoplasms: Myelofibrosis and Polycythemia vera is on Wednesday, October 6^th, 7-8:30pm PDT. 

Program 2: BCMA-Targeted Therapies for Relapsed/Refractory Multiple Myeloma is on Tuesday, October 19^th, 7-8:30pm PDT.

October 7, 6:30pm, OncLive will be hosting a webinar, focusing on an FDA approved first-line monotherapy option in advanced NSCLC. The main target audience for this program is HCP’s, nurse practitioners, PA’s, Pharmacists, but OncLive welcomes any medical professionals with an interest in treating NSCLC.

October 13, 5:30pm Breast Cancer Overview, Presented by: Adeline Wang, MD, PhD, and Chad Barnett, PharmD, BCOP. Topics include: Overview of Epidemiology; Mechanisms of Disease; Early Breast Cancer; Metastatic Breast Cancer; Clinical Trials and Endpoints; Quality of Care. Sponsored by Pfizer.

October 21, 12:30pm Adcetris Clinical Data Update and Patient Management, presented by: Elizabeth Brem, MD, Assistant Professor, Division of Hematology/Oncology, Department of Medicine, UCI. Sponsored by Seagen. 

October 29-30, the University of California San Diego invites you to their inaugural Delivering Discoveries: Updates in Oncology CME conference. The diagnosis and management of cancer patients is increasingly complex and requires multidisciplinary management. This 1.5 day event will address all aspects of cancer from basic science research, advances in clinical care, to community-based approaches that optimize prevention and interception. 

November 4 and November 10, SAVE THE DATE for MOASC’S Annual Practice Management Series! The virtual Educational Series will be presented in two tracks.

Track One – Oncology Administration November 4, 11:45am – 3:15pm

Topics include: Prevent Burnout & Employee Fatigue, Time Management and Creating a More Productive Practice with Process Automation and Improving Patient Collections Experience. 

Track two – Oncology Billing November 10, 11:45am – 3:15pm

Topics include: 2022 Billing updates, Overview of Medicare Regulations, Billing tips for Practicing with Advanced Practice Providers and How to Increase Revenue.

Thank you, AstraZeneca, BeiGene, Bristol Myers Squibb, Grail, Inc., Oncopeptides, Pfizer Oncology, Takeda Oncology, AbbVie, Astellas, Daiichi Sakyo, Inc., Incyte, Johnson and Johnson, Merck, Novartis, ADC Therapeutics, Agios Pharmaceuticals, Exact Sciences, Foundation Medicine, Gilead, G1 Therapeutics, Guardant Health, Kite Pharma, Lilly Oncology, MorphoSys, Inc., Myovant Sciences, Pharmacyclics, Sanofi-Genzyme, Seagen, Stemline Therapeutics, Coherus Biosciences, Rigel Pharmaceuticals, VerdePharm Health.

Practice Administrator in the Arizona market is looking to relocate back to the Southern California area to be closer to family. She previously worked at a large Oncology Group in Glendale, CA prior to taking leadership roles at a few Oncology clinics in the Arizona market, including Ironwood Cancer. She has 22+ years of oncology experience. If interested, please contact the MOASC Office for more information at moasc@moasc.org.

AB 342 was signed by Governor Newsom – a great win for colorectal cancer patients.

New research by UC San Diego and UCSF scientists involving techniques also deployed to fight COVID-19 has the potential to revolutionize cancer treatment by creating opportunities for more precision treatments, they say — which can be far less harmful than chemotherapy. The collaborative effort — called the Cancer Cell Map Initiative — found that mapping the protein disruptions caused by DNA mutations, rather than just the mutations themselves, is very useful for grouping different kinds of cancer-causing mutations together. That opens up the opportunity to create precision treatments that can target groups of mutations, rather than just one.

On Oct. 7, 2021, Optum will start managing online requests for outpatient radiation oncology therapies. This applies to UnitedHealthcare Community Plan Medicaid members in:

Prior authorization request process and the online tool for submitting notification/prior authorization requests. The online tool will be open on Oct. 1, 2021, for prior authorization requests with a start date of Oct. 7, 2021, or later. After you register, you’ll receive a confirmation email with an option to add the training session to your calendar. Questions unitedoncology@uhc.com.

On October 14-15, 2021 the WC4 goals remain focused on how Covid-19 has disrupted access to the CRC care continuum in the western region, highlighting ways for screening programs to recover mid-pandemic, with many presenters focusing on health disparities and inequities, both pre- and mid-pandemic. The California Colorectal Cancer Coalition (C4) is very excited to share the expertise of their speakers and the abundance of interesting topics. The virtual format (Whova) allows for a robust engagement, allowing participants to navigate the conference venue at their choosing, similar to an in-person event, without the risk of Covid-19/Delta variant exposure for you and your loved ones. There will also be free AAFP CME (currently 13.25h, subject to change) available through your conference attendance.

 Noridian News

Implement Operating Rules - Phase III Electronic Remittance Advice (ERA) Electronic Funds Transfer (EFT): CORE 360 Uniform Use of Claim Adjustment Reason Codes (CARC), Remittance Advice Remark Codes (RARC) and Claim Adjustment Group Code (CAGC) Rule - Update from CAQH CORE CR12428. CR 12428 tells you Council for Affordable Quality Health Care (CAQH) Committee on Operating Rules for Information Exchange (CORE) will publish the next version of the Code Combination List on or about October 1, 2021. Make sure your billing staff knows of these updates.

Reminder that Remittance Advices (RA) are issued in either Standard Paper Remittance (SPR) or Electronic Remittance Advice (ERA). An RA provides finalized claim details and contains explanatory claim processing message codes. Effective 9/29/2021, RAs are required when contacting claims review.

Quarterly Medicare Updates - A/B Webinar - October 5, 2021. This event includes: CMS and Noridian Updates, October 2021 Quarterly Provider Updates, Change Requests (CR), Recurring Updates, Special Editions (SE), and Resources.

October 12 - Molecular Testing for Risk Stratification of Upper Gastrointestinal Cancer Contractor Advisory Committee (CAC) Meeting Announcement.

Quarterly Medicare Updates - A/B - After Hours Webinar - October 14, 2021. This event includes: CMS and Noridian Updates, October 2021 Quarterly Provider Updates, Change Requests (CR), Recurring Updates, Special Editions (SE), and Resources.

October 20 - Live Chat with Provider Enrollment Webinar - This event includes: Provider Enrollment, Live Chat with Provider Enrollment, and Telehealth/Telemedicine. 

October 26 - External Breast Prosthesis (EBP), Mammography and Physician Orders Webinar. This webinar is intended for Medicare Part B providers and DME suppliers and will include: • Mammography Screening/Diagnostic • Coverage Criteria and Coding • Orders and Documentation • Reminders and Resources. 

October 27 - The Noridian Provider Outreach and Education (POE) staff is hosting the Screening Services: Mammography, Pap Test and Pelvic Exam webinar. This webinar is intended for Medicare Part B Providers and will include: • Screening Mammography • Screening Pap Test • Screening Pelvic Examination • Screening for Cervical Cancer with Human Papilloma Virus (HPV) Test • Resources.

October 27 - Comprehensive Error Rate Testing (CERT) Clinic Webinar. The CERT Overview will address, Part A Missing Documentation - SNF, Labs/Diagnostic Tests, TAVR, ICD, OP Therapy, Part B Missing Documentation - Policy-Based Denials, DME - NPI Billing Errors, Refill Request Errors, Error Prevention, and Website Tour.

CMS is making updates to a popular Quality Payment Program amid “prevailing concerns” from the physician community. CMS just recently released final scores and feedback on provider performance in the Merit-based Incentive Payment System. During the regular review period, clinicians alerted the agency about two errors as part of the process.

Influenza Vaccine Payment Allowances - Annual Update for 2021-2022 Season - Medicare’s payment allowances for the seasonal flu shots available on the CMS Seasonal Influenza Vaccines Pricing webpage.

CR 12422 informs you of the October 2021 updates to the Medicare Physician Fee Schedule Database (MPFSDB). Make sure your billing staff knows these updates.

2022 Annual Update for the HPSA Bonus Payments - CMS will provide your MAC with files for the automated payments of Health Professional Shortage Area (HPSA) bonuses for dates of service from January 1, 2022, through December 31, 2022. Make sure your billing staff knows about this update.

The Biden Administration’s, Health Resources and Services Administration, has formally rescinded a proposed rule created under President Donald Trump's administration, which would have required community health centers pass on the 340B discounts they get for insulin and Epi-Pens directly to patients. HRSA is pulling the regulation because of the "excessive administrative costs and burdens that implementation would have imposed on health centers," the agency wrote in a notice published in the Federal Register Thursday.

The American Medical Association says the regulations for “balance billing” will further erode independent physician practices' ability to negotiate network contracts. The Department of Health and Human Service (HHS) joined other federal agencies, last Thursday, in releasing the third in a series of rules about surprise medical bills. They had already proposed a rule, among others, on consumer protections against surprise billing. These rules, which would ensure that consumers are protected from most surprise bills, would take effect on January 1, 2022. The battles will be concentrated in fights between insurers and medical practitioners.

HHS guidance for employers and employees regarding how HIPAA applies to disclosure of COVID-19 vaccination information emphasizes that HIPAA applies only to disclosure of data by entities in the health care sector and doesn't prohibit anyone from asking another person about their vaccination status, nor does the law prohibit anyone from disclosing their own vaccination status. Entities subject to HIPAA may require employees to disclose their vaccination status to their employer, but health care professionals are not allowed to disclose patient information, including vaccination status, to an employer without the patient's permission.

Oncologists will be best served in communicating with & updating their referral sources. Many patients with cancer, as well as doctors in fields other than oncology, are unware of just how much progress has been made in recent years in the treatment of cancer, particularly with immunotherapy. Non-cancer doctors often grossly underestimate patients' chances of survival.

The home is the next frontier. MOASC member, City of Hope, V-P and Chief Communications & Marketing Officer, with 6 other health executives, share their ideas on how innovation will shape health care in the coming years. They expect more care to be provided at home, along with increasing connection and frequency of care. As IT infrastructure currently supports care in physician offices, hospitals and peripheral locations, the advancing health care networks as designed in an IT infrastructure, home care is the next frontier for site-of-service treatment and care. 

United Healthcare’s October policy newsletter has been released. 

In honor of breast cancer awareness month, ANCO will be having Dr. Pamela Munster participate in the October 21st ANCO Connections. Dr. Munster recently authored Twisting Fate, about her experience as an oncologist and a cancer patient. The first 20 registered health care providers will receive a copy of her book. 

ANCO's Hematologic Malignancies Updates (part III of III), will be November 6, 2021- Hyatt Regency San Francisco Embarcadero. The faculty will present the latest research on treatment modalities for hematologic malignancies—leukemias, lymphomas, and myeloma—along with case studies for these diagnoses. Registration deadline is Thursday, November 4th.

ASH is looking forward to your participation in this year’s Scientific Workshops at the 63rd ASH Annual Meeting and Exposition! Several workshop organizers are actively soliciting speakers, so if you are interested in attending and/or presenting in any of the workshops this year, please visit the ASH website for additional details The workshops, which are scheduled to take place as in-person events on Friday, December 10, will feature interactive discussions focused on the latest scientific developments in different fields of hematology. They will also be broadcast on the ASH annual meeting virtual platform to accommodate virtual participants.

The ASCO Nominating Committee has selected 15 distinguished members as candidates for open leadership positions within the Society. This year’s diverse slate reflects significant innovations that were adopted by the membership to increase diversity and inclusivity in ASCO governance. Voting Members are urged to vote in the election beginning November 3, 2021. Voting will close on December 7, 2021.

ASCO has created a temporary online job board to help connect oncology trainees with positions of employment, in lieu of the in-person networking received at the ASCO Annual Meeting. Between September 16 and October 15, 2021, trainees can view the list of available jobs, seek out more info, and apply. If you are recruiting trainees for open positions at your organization, please fill out the form or forward it to your hiring department.

Kite Pharma, Inc. announced that the FDA approved TECARTUS^® (brexucabtagene autoleucel) for an additional indication. TECARTUS is a CD19-directed genetically modified autologous T-cell immunotherapy indicated for the treatment of adult patients with relapsed or refractory (R/R) mantle cell lymphoma (MCL). This indication is approved under accelerated approval based on overall response rate and durability of response. Continued approval for this indication may be contingent upon verification and description of clinical benefit in a confirmatory trial. Following the new FDA approval, TECARTUS is now indicated for the treatment of adult patients with R/R B-cell precursor acute lymphoblastic leukemia (ALL).

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.