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"Where California Oncologists Go For Answers!"
A collaborative publication of the
Medical Oncology Association of Southern California, Inc.
and the
Association of Northern California Oncologists, Inc.
November 21
, 2017
We are thankful
for your continued support of California Oncology.
We wish you and your family a wonderful Thanksgiving holiday!
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- Hear MOASC President's radio interview on the 340B program. (MOASC News)
- Read FDA letter regarding IV & drug shortages. (National News)
- Preview period for Physician Compare is extended to December 1. (CMS News)
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California News
- The California Medical Association (CMA)Practice Resources (CPR) for November is now available online at www.cmanet.org/cpr and features articles entitled: Anthem Blue Cross announces plans to significantly cut reimbursement on E/M services with modifier 25; Be prepared for Covered California changes in 2018; Do you know if non-contracted mayors are complying with AB72 interim payment rules?; Remember: Don't hesitate to revalidate or Medicare will deactivate; Blue Shield to require electronic claim submission; Anthem Blu Cross to alter member ID cards; Remember: TRICARE transitions to HNFS on January 1; Act now to avoid 4 percent Medicare penalty in 2019 (Spoiler alert: It's easy!); Anthem Blue Cross to discontinue ProviderAccess effective December 8; CMS extends Physician Compare preview period; Reminder: Blue Shield fee schedule changes effective December 1; Last day to change your Medicare participation status for 2018 is December 31; The Coding Corner: E/M services with same-day immunization administration.
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- Noridian/JEMAC has posted more updates to its website:
* MLN Connects
Announcements--CMS Offers Medicare Enrollment Relief for Americans Affected by Recent Disasters; Physician Fee Schedule Final Policy, Payment, and Quality Provisions for CY2018; Hospital OPPS and ASC Payment System and Quality Reporting Programs Changes for 2018; HHAs: Payment Changes for 2018; Quality Payment Program Rule for Year 2; New Medicare Card: Help Notify Your Patients; Hospital Value-Based Purchasing Program Results for FY2018; Quality Payment Program Resources in New Location; New Medicare Card: New Webpage Information; Physician Compare: How to Update Your Listing
Claims, Prices & Codes--Evaluation and Management: Correct Coding-Reminder
Events--Quality Payment Program Year 2 Final Rule Call-November 30
Publications--Medicare and Medicaid Basics Booklet-Revised
* MSP Payment Calculator Now Offers Enhanced Details
* MolDX: Bladder Tumor Marker FISH Billing and Coding Guidelines-R2
* DecisionDx-UM Billing Guidelines Article Retirement-Effective September 22, 2017
* MolDX: AlloSure Donor-Derived Cell-Free DNA Test Final LCD-Effective December 1, 2017
- Upcoming Noridian/JEMAC webinars include:
* Modifier 59, NCCI, and MUE Webinar (November 29)
* Preventive and Screening Services Webinar (December 6)
* Modifier 59, NCCI, and MUE Webinar (December 13)
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- Hear MOASC President, Warren Fong, M.D.'s interview with Larry Marino, host of KRLA's Sunday Morning Newsmakers to discuss the 340B program. The interview will first run this Saturday November 25th, at 10:00 AM on AM 590, a program called "Politics and Issues," which reaches the Inland Empire and other parts of the Southern California area. Then, on Sunday, December 3, it will run again on KRLA's "Sunday Morning Newsmakers," AM 870 "The Answer."
- YOUR INPUT IS NEEDED! During the roundtable discussion at the MOASC Educational Series program of November 8 & 9, the following topics were discussed:
- UHC problem with NDC numbers and the N4 code.
- Monarch/SCOA takes 160 days for payment.
- Blue Shield wants records and takes 45+ days to review, even when office sends the records at the beginning of treatment.
ACTION:
Please provide the MOASC Office moasc@moasc.org with examples of the above specific issues. MOASC will compile and forward the the California Insurance Commissioner for resolution. Thank you.
- IN MEMORIA: Long time MOASC member, Steven Alexander Armentrout, M.D., passed away in his home on November 10, 2017. Dr. Armentrout had been in practice in Orange County for more than 20 years, with a specialty in hematology. He moved to California in 1971 to join the faculty of the University of California Irvine, College of Medicine, where he held various positions. He also published numerous articles in medical journals and dedicated his time as an Assistant Editor for the Journal of Infusional Chemotherapy, and a Reviewer for both the Journal of Medical and Pediatric Oncology and the Journal of Laboratory and Clinical Medicine. The family has scheduled a memorial service to celebrate Dr. Armentrout's life on December 1, 2017 at 2:00 p.m. at Pacific View Memorial Park located at 3500 Pacific View Drive in Corona Del Mar. All are invited to attend. In lieu of flowers, donations may be made to UC Irvine Health www.ucirvinehealth.org/giving. He will be greatly missed.
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So that we may enjoy Thanksgiving with family and friends, the MOASC Office will be closed Wednesday, November 22, and will open again at 8:00 am on Monday, November 27. Blessings to you for a joyous holiday!
- MEMBER ONCOLOGIST CLOSING PRACTICE, DRUG STOCK AVAILABLE. A MOASC member is closing their practice and has leftover stock available. If you are interested in purchasing some of leftover stock of chemo meds, please contact moasc@moasc.org for the list of drugs and information.
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- ANCO's Medicare Reimbursement for Oncology 2017 & Revenue Cycle State of the State with Bobbi Buell takes place in San Jose on January 3 and Sacramento on January 4. Learn the latest information impacting Medicare's reimbursement for oncology in 2018 and what to do about your denial rate, days to pay, and days to file using data specific to northern California. This will be a unique opportunity to get benchmarks that you can use for billing and appeals at your facility. Download the meeting announcement and registration form at www.anco-online.org/MedicareUpdate2018.pdf.
- The 18th Multidisciplinary Management of Cancers: A Case-based Approach returns to the Silverado Resort and Spa in Napa on March 16-18, 2018. The meeting is sponsored by the Association of Northern California Oncologists, Stanford Cancer Institute, UC Davis Comprehensive Cancer Center, and UCSF Helen Diller Family Comprehensive Cancer Center. Go to www.multicancers.org for more information, to register, and arrange for housing.
- ANCO is pleased to share that James M. Ford, M.D., Stanford Cancer Institute, is the Editor of ASCO's new online journal JCO: Precision Oncology (JCO PO). Learn more at http://po.jco.org.
- ANCO is pleased to share that Albert Koong, M.D., Ph.D., Stanford Cancer Institute, has been named a Fellow of the American Society for Radiation Oncology (ASTRO).
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VERY IMPORTANT: You need to send an email to
drugshortages@fda.hhs.gov to describe your particular problems in getting IVFs and the problems you are encountering with patient care. Don't treat this as just another thing you don't have time to do - IT IS VERY IMPORTANT that you go on record. Obviously, if you don't have a problem there is no need to respond.
The following comes from the FDA regarding IV & drug shortages.
Good Morning,
Thank you for your email. We are aware of the critical shortage of IV fluids. As you're likely aware this shortage of IV fluids has recently worsened due to Hurricane Maria's impact on the Baxter PR facility. However, it actually began before the hurricane and the manufacturers have been in a very tight supply situation since 2014. In 2014 the approved manufacturers, which were Hospira (now ICU Medical), Baxter and B. Braun at that time, were dealing with increased demand that had built up over time and the firms were not able to keep up with demand. We worked with manufacturers to begin importing IV Saline from 3 different firms (Baxter, B. Braun and Fresenius Kabi) to help with the shortage, and things improved with the imports, however since we needed additional capacity to be able to meet US demand with approved manufacturers we encouraged the approved firms to add capacity and also searched for additional manufacturers to help prevent future shortages. The overall IV fluid situation worsened this fall when B. Braun, one of the approved manufacturers, announced they were slowing down production:
We've continued the imports from B. Braun to help with the shortage and also due to the Baxter PR facility impact, we've recently added imports from Baxter facilities in Ireland, Australia, Mexico and Canada and continuing to evaluate additional supply options. It's important to note that when importation from another country is initiated, FDA evaluates the overseas firm and product and ensures there are no significant risks to patients and a letter explaining that the drug is being imported to address a shortage is posted on the FDA Drug Shortage website and also accompanies the drug when it is shipped.
In addition to the temporary imports, FDA is expediting review of any applications that will assist with this shortage and we recently approved Fresenius Kabi (the firm that was previously importing) as well as Laboratorios Grifols and both firms are coming on line in the coming weeks. The supplies from the imported products will be small to start but are expected to increase in the coming weeks. With the new approvals and the imports we do anticipate this situation to improve over time and we will continue to do all we can to address this shortage.
Thank you
CDER/DSS
- Get the latest information on the current IV fluid shortages, and other drug shortages, at
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CMS News
- According to ASCO, the 2018 Physician Fee Schedule established a conversion factor of approximately $36 resulting in an anticipated impact on hematology/oncology of 0% and radiation oncology of 1%; separates billing codes and payments for newly approved biosimilars paid under Medicare Part B (effective January 1 biosimilars with a common reference product will no longer be grouped into the same billing code); and, defers the new Appropriate Use Criteria (AUC) rule for diagnostic imaging until 2020. The 2018 Hospital Outpatient Prospective Payment System reduces 340B reimbursement for separately paid drugs to ASP minus 22.5% and finalizes revision to the 14-day rule for molecular pathology and advanced diagnostic laboratory tests by unbundling lab tests ordered at discharge and permitting labs to bill CMS directly for the tests, and, the 2018 Quality Payment Program moves forward with applying the MIPS adjustment to Medicare Part B items and services, including Part B drugs; weights the Cost category at 10% with no risk adjustment in the methodology; and weights the Quality category at 50% of total MIPS scores.
- On Jan. 1, 2018, TRICARE Select will replace TRICARE Standard and TRICARE Extra
. As a result, beneficiaries will notice improved coverage for preventive services with TRICARE Select. Preventive care helps take command of health concerns and manage potential issues before symptoms are experienced. This type of health care allows the beneficiary to address health problems before they become life threatening. Read the full article here.
- The preview period for the Physician Compare is extended and is now ending Friday, December 1 at 5 pm PT. The Centers for Medicare & Medicaid Services (CMS) opened the Physician Compare preview period on October 18. The 30-day preview period provides an opportunity for clinicians and groups to preview their 2016 performance information before it is publicly reported on Physician Compare profile pages later this year and in the Physician Compare Downloadable Database.
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Affiliate Association News
- MOASC Member, City of Hope invites you to the State of the Science Summit on Lung Cancer Advanced Non-Small Cell Lung Cancer, Monday, December 04, 2017, 6:00 pm - 9:15 pm at the Pasadena Hilton 168 S Los Robles Ave, Pasadena, CA 91101
Topics of Discussion:
* Biomarkers in NSCLC * Surgical resection in an era of biomarker driven therapy * Assessing challenges of disparity in lung cancer therapy * Combination strategies with immunotherapy in frontline NSCLC * Immuno-radiotherapy in non-small cell lung cancer * Targeted Therapies: EGFR, sequencing * Targeted Therapies: ALK, sequencing
* Checkpoint Inhibition for surgically resectable patients * Question & answer sessions
- At the 59th ASH Annual Meeting, experience these one-of-a-kind educational opportunities, and engage in new education sessions. Don't miss either of the two newly announced U.S. Food and Drug Administration (FDA)-sponsored sessions on new drugs. A joint session, co-sponsored by the FDA, will take place Sunday, December 10, and feature new drug approvals in acute lymphoid leukemia and non-hodgkin lymphoma. Then, on Monday, December 11, the FDA will host another joint session which will feature new drug approvals in acute myeloid leukemia. At both sessions, speakers will give an in-depth analysis of newly approved drugs and their current and future roles in the treatment of these diseases.
- ASCO seeks applications for volunteers at its ASCO Volunteer Portal
https://volunteer.asco.org. Your application will be used for all upcoming Volunteer Corps opportunities and 2018 committee consideration. Apply by January 31, 2018 for 2018 committee consideration.
- ASCO University is having a 2017 Year-End Sale offering discounts on ASCO Annual Meeting or Symposium captured presentations; and, ASCO-SEP, 5th Edition Book/eBook. Discounts are valid through December 4 at https://university.asco.org.
- The second annual ASCO-SITC Clinical Immuno-Oncology Symposium, January 25-27 in San Francisco, will feature more than 40 expert faculty discussing the latest clinical and translational advances in immuno-oncology. These specialists will facilitate in-depth discussions on cutting-edge research currently shaping the clinical application of immunotherapy, as well as provide insight into what this research means for future patient care.
- Registration is now open for the 2018 Community Oncology Conference! The Conference will center on keeping patients and their needs paramount in transforming our nation's cancer care system. Over two packed days of learning and networking, community oncology practices and allied professionals will gain insights into how to overcome the challenges to patient care that they face on a daily basis. Balancing the many external and internal forces in community oncology requires constant adaption and teamwork. Attending the 2018 Community Oncology Conference will help keep you current with all that it takes to deliver community cancer care, while remaining focused on expert, tailored care for every patient. Register Today to Save Your Seat!
- The abstract submitter is now open for the 2018 ASCO Annual Meeting. Submit an abstract by February 13, 2018, at 8:59 PM (PST) to be considered for presentation or publication at this year's Annual Meeting, held June 1-5, in Chicago, Illinois.
- ASH has started accepting applications for the ASH Congressional Fellowship Program for 2018 - 2019. This year-long opportunity will place a hematologist on Capitol Hill to work in a Congressional office and help shape health care and hematology policy. This opportunity will be available for one ASH member starting in September 2018. For requirements, more information or to apply today, please visit the Congressional Fellowship Program website.
- NCCN has published updates to the below. For the complete updated versions, please visit NCCN.org. Recent updates include: B-cell lymphomas (V1.2018), breast cancer (V3.2017), colorectal cancer screening (V2.2017), melanoma (V1.2018), ovarian cancer (V4.2017), primary cutaneous B-cell lymphomas (V1.2018), soft-tissue sarcoma (V1.2018).
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- AstraZeneca informs ANCO and MOASC that the United States Food and Drug Administration has approved Faslodex, to include use with abemaciclib, a CDK4/6 inhibitor, for the treatment of hormone receptor-positive (HR+), human epidermal growth factor receptor 2 negative (HER2-) advanced or metastatic breast cancer (MBC) in women with disease progression after endocrine therapy.
- Bristol-Myers Squibb Oncology informs ANCO and MOASC that the United States Food and Drug Administration has approved Sprycel for pediatric patients with chronic phase (CP) Philadelphia chromosome-positive (Ph+) chronic myeloid leukemia (CML).
- Genentech BioOncology informs ANCO and MOASC that the United States Food and Drug Administration (FDA) has approved Gazyva in combination with chemotherapy, followed by Gazyva monotherapy, in patients achieving at least a partial remission for the treatment of adult patients with previously treated stage II bulky, III, IV follicular lymphoma. In addition, the FDA has approved Hemlibra for routine prophylaxis to prevent or reduce the frequency of bleeding episodes in adult and pediatric patients with hemophilia A (congenital factor VIII deficiency) with factor VIII inhibitors. Also, CMS has assigned J-code 9022 (10mg) to Tecentriq effective for dates of service on or after January 1, 2018. Finally, the FDA has approved Zelboraf for patients with Erdheim-Chester disease (ECD) with BRAF V600 mutation. Zelboraf is not indicated for treatment of patients with wild-type BRAF ECD.
- Pfizer informs MOASC and ANCO that the United States Food and Drug Administration (FDA) has approved Sunitinib Malate for the adjuvant treatment of adult patients at high risk of recurrent renal cell carcinoma following nephrectomy. For more information click here.
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MOASC CALENDAR
Professional Educational Series
November 8-9
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(San Francisco, January 18-20)
(San Francisco, January 25-27)
(San Francisco, February 8-10)
(Napa, March 16-18)
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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
Association of Northern California Oncologists
(ANCO) is an association of hematologists/oncologists dedicated to promoting high professional standards of cancer care by providing a forum for the exchange of ideas, data, and knowledge.
The material contained in the
California Oncology Weekly
is intended as general information for ANCO and 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 or ANCO accepts no liability for any statements or articles herein.
CPT codes are owned and trademarked by the American Medical Association. All Rights Reserved.
MOASC: P.O. Box 161, Upland, CA 91785 | P (909) 985-9061 | F (909) 804-5006| www.moasc.org
ANCO: P.O. Box 151109, San Rafael, CA 94915 | P (415) 472-3960 | F (415) 472-3961 | www.anco-online.org
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