California Oncology Weekly
"Where California Oncologists Go For Answers!"
A publication of the
Medical Oncology Association of Southern California, Inc.
September 1, 2020
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Take Action NOW to protect patient safety. California News
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Review updated Cal/OSHA guidance on use of NIOSH certified respirators. California News
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New ABN form is now mandatory. Noridian News
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Provider Relief Fund applications due September 13. National News
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- Legislators are set to vote on a bill that would grant full practice authority to nurse practitioners (NPs). This bill (AB 890, Wood) would remove critical patient protections by allowing NPs to practice without physician supervision. Physicians are urged to contact their legislators now and ask them to protect patient safety and vote NO on AB 890.
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- The California Division of Occupational Safety and Health (Cal/OSHA), released interim guidance for health care employers that may be facing shortages of respirators during the ongoing COVID-19 pandemic. While the supply chain for respirators (such as N95 masks) has improved, it is not yet fully restored, according to Cal/OSHA. The latest guidelines replace the previous guidance published in mid-June. The updated guidance requires covered employers to provide and ensure the use of NIOSH certified particulate respirators by all employees occupationally exposed to novel pathogens such as SARS-CoV-2, the virus that causes COVID-19. The update guidance also includes new optimization strategies to reduce the use and destruction of respirators, including:
Relaxing fit testing requirements to allow less frequent fit testing if appropriate;
Allowing employees to wear their own respirator if it complies with Cal/OSHA requirements;
Allowing the use of certain expired respirators; and
Procedures for extending the use of the respirators
- You are encouraged to read the “step therapy” opinion editorial written by Rimal Bera, M.D., psychiatrist and professor at UC Irvine School of Medicine,and Alliance for Patient Access (AfPA) member physician, which appeared in Capitol Weekly last week. Dr. Bera penned this op.ed. to share why policymakers should restrict the practice of step therapy. If waiving step therapy for COVID-19 treatments makes sense, shouldn't it make sense after the pandemic and for other conditions too? Please share this op.ed. with your colleagues and on social channels tagging .@patientaccess. Step therapy: Harmful delays and the patient may suffer |Capitol Weekly: The Newspaper of California State Government and Politics.
- The COVID-19 pandemic has created an unprecedented threat to the viability of physician practices. The CMA has called on state lawmakers to ensure that health plans and insurance companies do their part to maintain our health care infrastructure, and to ensure we emerge from the COVID-19 crisis with a health care system that can meet patients’ needs. For more information, contact CMA Reimbursement Helpline, 888-401-5911 or economicservices@cmadocs.org .
- CMA launched a new 12-part webinar series on Telehealth for Small and Medium Practices. Catch the next 10 presentations that will take place over the next five months, and will cover all aspects of implementing telehealth in a medical practice. The webinar series will have an emphasis on the use of telehealth in Medi-Cal. Please follow this link for more information. https://www.cmadocs.org/event-info/sessionaltcd/CMA20_0813_COVID-19/t
- UCSF is providing voluntary genome sequencing for all patients. This free service is the most comprehensive precision medicine program of its kind in the nation. Full Story
- The Office of Environmental Health Hazard Assessment California Environmental Protection Agency now has Spanish-language versions of our two new fact sheets on New Proposition 65 for cannabis smoke and THC. They offer valuable information for anyone using, or thinking about using, cannabis or THC products. Visit the Proposition 65 warnings website at www.p65warnings.ca.gov. You encouraged to see what's new.
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- Upcoming Educational Events - The schedules of region-specific events, webinars and training are JEA, JEB, JAF, and JFB.
- The Medicare Part B payment allowance limits for seasonal influenza and pneumococcal vaccines are 95% of the Average Wholesale Price (AWP) as reflected in the published compendia except where the vaccine is furnished in a hospital outpatient department. When the vaccine is furnished in the hospital outpatient department, payment for the vaccine is based on reasonable cost. See the complete table.
- Part A Ask the Contractor Teleconference (ACT) - Prior Authorization - September 16, 2020. This event includes: Presubmitted Questions, Prior Authorization Updates, and Open Question and Answer Read the complete update.
- Rebuttal, Reconsiderations and CAPs Webinar - September 16, 2020. This event includes: What is the Rebuttal Process, What is a Reconsideration Request, What is a Corrective Action Plan (CAP) Read the complete update.
- Evaluation and Management (E/M) Modifiers - After Hours Webinar - September 29, 2020. This event includes: Basics of E/M modifiers, Supporting documentation, Knowledge assessment, Resources Read the complete update.
- Required Use for Telephone Reopenings - Effective October 1, 2020
Starting on October 1, 2020. Noridian will require providers to use the Noridian Medicare Portal (NMP) for all Reopenings that are available through Self-Service Reopenings. Read the complete update.
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- If you missed the very well attended MOASC LunchTime Series Teleconference held last week on “The 2021 Evaluation and Management Changes,” presented by Allison Hirschorn, ASCO’s Senior Coding and Reimbursement Specialist, you can listen to the recording by dialing 1-888-203-1112 and enter the pass code 791083099. This recording will be available for the next 30 days. To view the handouts for the presentation, please email the MOASC office at
- The MOASC Office has received information from a Member regarding the required "fail first" policy of United Healthcare applied to IV iron infusions. UnitedHealthcare, has an authorization policy stating that Injectafer may only be used after a failed trial of another product. If you have received denials from commercial health plans for failed trial of another product before use of preferred drug, please contact the MOASC Office at moasc@moasc.org. MOASC is looking at taking this up with the insurers. Thank you for your help.
- As California’s wildfire season is well underway, rolling blackouts leave thousands without power, and hurricanes Laura & Marco batter the Gulf coast, we want to remind you of MOASC’s Oncology Patient Emergency Network (OPEN). Created for patients, their care providers and physicians, in the event of an emergency, to provide continuity of care for displaced cancer patients actively receiving treatment, provide access to alternative physicians, have medications available at alternative physician’s office, less stress dealing with insurance companies, provide “wallet card” with critical diagnostic and treatment information. We encourage you to participate. Please go to www.open-central.com for more information or moasc@moasc.org.
MOASC MEMBER BENEFIT
- MOASC, in partnership with Innovatix, is pleased to announce a price decrease and opportunity to save with Sandoz Inc. Effective immediately, contract pricing for Ziextenzo™ (pegfilgrastim-bmez) injection decreased under contract number 28835. Ziextenzo™ is a biosimilar to Neulasta® (pegfilgrastim). CLICK HERE for detailed product and pricing information. For more information about our agreement with Sandoz Inc., please contact your Innovatix representative at (888) 258-3273.
MOASC JOB BOARD
- MOASC Member City of Hope Seeks a Medical Oncologist to Join the Melanoma & Skin Cancer Care Team. The Department of Medical Oncology & Therapeutics Research at City of Hope National Medical Center is seeking an Associate Clinical Professor level Medical Oncologist, board-certified/eligible in Internal Medicine and Medical Oncology with additional experience in all aspects of Melanoma and Skin Cancer, including treatment, prevention, research, and clinical trials. Click here for more details. Interested candidates, please send your CV to: Jacqui Paris, Physician Recruiter, at MDRecruitment@coh.org
MOASC PROGRAMS - SAVE THE DATES
All times are Pacific
- Wednesday, 09/02/20, 5:30pm to 6:30pm - Specifically for Physicians, a webinar with Arthur Lurvey, M.D., Noridian, Jurisdiction E Part B Medicare Medical Director, presenting “Updates on Dealing with Issues related to the COVID-19 Pandemic.”
- Wednesday, 11/04/20, 12:00pm to 3:00pm - MOASC Virtual Oncology Administrator program will cover: Patient Access Strategy for your practice; Optimize Cash Flow; and Telemedicine.
- Thursday, 11/12/20, 12:00pm to 3:00pm – MOASC Virtual Oncology Biller program will cover: Medicare Updates on COVID Coding Changes/telehealth updates, Medicare Physician Fee Schedule and Outpatient Prospective Payment System, How to prepare for a MAC/RAC Audit, 2021 changes to E&M coding, data from PracticeNET and CancerLinQ, as well as Guide for Cancer Care Delivery.
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- Congratulations to Drs. Bridget Keenan, Nancy Nguyen, and Mohana Roy, recipients of ANCO's Travel Awards for 2020. Dr. Keenan is a fellow at the University of California, San Francisco. Dr. Nguyen is a fellow at University of California, Davis, and Dr. Roy is a fellow at Stanford University.
- The Association of Northern California Oncologists (ANCO) continues to monitor the novel coronavirus (COVID-19) pandemic and is committed to providing the membership the best possible information with which to make clinical and personal well-being decisions. https://anco.org/anco-covid-19-updates-resources/
We encourage member practices to let ANCO know of COVID-19 resources they are depending upon and found useful and how they are responding to COVID-19 and serving their patients and staff at director@anco.org (Use Subject: COVID-19: RESPONSE). Thanks!
- ANCO physician members, their practice staff, and representatives from ANCO's corporate members must register to access password-protected content (e.g., The ANCO Directory, ANCO meeting materials) on the ANCO website www.anco.org.
- ANCO's ASCO20 Virtual Highlights will take place on Saturday, August 22nd. The meeting will summarize the major research and treatment advancements presented at this year's ASCO20 Virtual Meeting. The program will focus on breast, gastrointestinal, genitourinary, head and neck, and lung cancers as well as a panel on cancer care during the time of COVID-19. The faculty will place these developments in context as to their immediate clinical utility. Read More
- Use ANCO's job board to post or search for employment opportunities at ANCO member practices.
- Follow ANCO on Twitter at @ANCO News.
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- HHS announced, last week, it is again extending the deadline for physicians to apply for the Provider Relief Fund for both Medicare and Medicaid providers. Physicians now have until September 13 to apply. This deadline applies to the targeted distribution for Medicaid providers as well as Medicare providers who missed the previous deadline to apply for additional funding
- In an August 5, 2020, notice to providers, Blue Shield announced it would be temporarily increasing reimbursement rates for certain Evaluation and Management services to help reduce the negative impacts to practices as a result of the COVID-19 pandemic. The increased reimbursement rates, which reflect a flat 5% fee schedule increase, will apply to providers on the Blue Shield standard fee schedule and will be effective for dates of service from August 24 to December 31, 2020. Some of the temporarily increased reimbursement services are: 99201-99205; 99211-99215; 99241-99245; 99441-99443; 99421-99423; 99446-99449. The new rates are available on the Blue Shield website (log in then select “Professional Fee Schedule” under the Claims section of the menu). You can search for the above listed temporary rates by CPT code with a date of service on or after August 24, 2020. Physicians can also request a copy of the new fees by completing the allowance review form enclosed with the notice, or by calling the Blue Shield Provider Information and Enrollment Department at (800) 258-3091.
- Earlier this year, UnitedHealthcare (UHC) communicated their plan to discontinue physician payments via paper checks and will require contracted and non-contracted physician to receive payments via automated clearinghouse (ACH)/direct deposit or through virtual credit card payments. UHC has since announced in its August 2020 Network Bulletin that the program will move forward with a phased rollout beginning with its commercial line of business starting in August 2020. UHC Medicare Advantage and Community and State (Medicaid) Plans will follow with rollouts slated for fall 2020 and early 2021. UHC will be publicizing the change to both contracted and non-contracted physicians, who will be directed to sign up for ACH/direct deposit through Optum Pay or via the UHCprovider.com/payment website. Physicians who do not elect to sign up for ACH/direct deposit will automatically be signed up to receive virtual credit card payments in place of paper checks. Physicians with questions or concerns, or that need to request a hardship exemption from this policy, should contact their UHC Provider Service Advocate or UHC at (877) 842-3210 for more information. With the virtual credit card (VCC) payment method, payers send credit card payment information and instructions to physicians, who process the payments using standard credit card technology. This method is beneficial to payers, but costly for physicians. Health plans often receive cash-back incentives from credit card companies for VCC transactions. Meanwhile, VCC payments are subject to transaction and interchange fees, which are borne by the physician practice and can run as high as 5% per transaction for physician practices. Physicians can avoid these interchange fees by enrolling in ACH/direct deposit.
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- Fee Schedule Adjustments Reminder for 99441-99443. CMS announced that they were changing the fee schedule allowance for these procedures to mirror codes 99212-99214, they also announced that MACs would be adjusting previously submitted claims to allow the codes billed at a higher allowance.
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Affiliate Association News |
- Don't miss an update on state-of-the-art advances in clinical hematology. The ASH Consultative Hematology Course is an interactive, half-day virtual program led by faculty familiar with consultative practice issues and commonly encountered clinical problems that require the expertise of a hematologist. All sessions will take place virtually on Thursday, September 10. View the program.
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- Please read Dr. Debra Patt’s, request for your participation in the Leukemia and Lymphoma Society’s Light the Night campaign. Thank you.
Dear Oncology Colleagues:
I am proud to represent Texas Oncology in chairing Light the Night for the Leukemia and Lymphoma society this year.
It has been a challenging year for philanthropy overall, as we are all virtual and revenue streams have not been robust.
I wanted to take a moment and remind you all the ways that the Leukemia and Lymphoma Society help the patients we serve.
They offer peer to peer support, information specialists, nurse navigators for clinical trials, dietician support, online chats, podcasts, educational booklets and webcasts, caregiver support,
Online communities, health manager apps, financial assistance, and COVID-19 related assistance. They offer resources for healthcare professionals. They fund research to advance cancer care.
Can we set up a meeting to discuss how your organization may consider forming a team to assist with LTN, or can you consider a personal donation here on my donation page.
I appreciate all of your efforts in our fight against cancer. Please consider forming a team or donating. Let me know if we can set up a meeting to discuss or please let me know if you are interested in making a contribution.
As they say at LLS, beating cancer is in our blood.
Thank you for all you are doing to help in these efforts and I appreciate your consideration.
Debra Patt, MD PhD MBA FASCO, is Executive Vice President, Policy and Strategic Initiatives, Texas Oncology, Editor in Chief Journal of Clinical Oncology Clinical Cancer Informatics, Chair- Council on Legislation, Texas Medical Association.
- The 2020 ASH Meeting on Hematologic Malignancies: A Virtual Experience, August 27 - September 12 features top experts in the field presenting the latest clinical research. The meeting will include live and on-demand sessions with exciting updates in each of the core hematologic malignancies. Get the knowledge you need to make an immediate impact on your practice. Visit the ASH website for additional details and to register.
- Cedars-Sinai 3rd Annual Gastrointestinal Tumor Conference is on Saturday, September 12, 2020. Concise and comprehensive updates on the most recent research and advances in immunotherapy for gastrointestinal cancers, will be presented. A stellar faculty has been assembled to share developments in precision medicine, research, and immunotherapeutic approaches to the treatment of cancers of the pancreas, liver, and gastric/esophagus. For more information and to register go to cedars.cloud-cme.com/gicancercme.
- The NCCN publishes complete updated versions of the NCCN Guidelines, please visit NCCN.org.
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- Foundation Medicine announced that the U.S. Food and Drug Administration (FDA) approved FoundationOne®Liquid CDx, a Comprehensive Pan-Tumor Liquid Biopsy Test with Multiple Companion Diagnostic Indications for Patients with Advanced Cancer. FoundationOne Liquid CDx Analyzes More Than 300 Genes and Genomic Signatures to Help Inform Treatment Decisions for all Solid Tumor Cancers. To read the press release click here
- Astellas Pharma US, cordially invites MOASC Members to their upcoming webinar to discuss XOSPATA® (gilteritinib): A Targeted Therapeutic Approach for Relapsed or Refractory FLT3m+ AML Patients (077-0621-PM) on Thursday, September 24, 2020 at 6:00 PM-PDT. Presented by: Gary Schiller, MD, Los Angeles, CA. Register at https://astellas.virtualspeakercast.net/Registration/index/48 before September 21, 2020.
- BeiGene cordially invites MOASC Members to their upcoming webinar to discuss BRUKINSA for adult patients with Mantle Cell Lymphoma (MCL) who have received at least one prior therapy. Presented by John Pagel, MD, PhD, Chief, Hematologic Malignancies Director, Stem Cell Transplantation Swedish Cancer Institute. The webinar will be on September 23, 2020 at 5:30PM-PDT. To register please email si.doan@beigene.com
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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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