California Oncology Weekly
"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.
February 6, 2018
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- Providers now required to use Noridian Medicare Self Service Portal. (Noridian News)
- UnitedHealthcare Network Bulletin for February 2018 is now available. (National News)
- Resources available to help students with cancer succeed in school. (Affiliate Association News)
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California News
- Practices experiencing problems with EHS, Inland Valleys IPA or Multicultural are encouraged to contact CMA's Reimbursement Helpline at (888) 401-5911
economicservices@cmanet.org. CMA previously reported that the California Department of Managed Health Care (DMHC) issued a cease & desist order on December 26, 2017, requiring nine health plans to terminate their contracts with Employee Health Systems (EHS) Medical Group Inc. This order comes after SynerMed-a company closely affiliated with EHS-was accused of blocking patient access to specialists to hold down costs. CMA is working with the health plans to ensure claims for services that were authorized by EHS, Inland Valleys IPA and Multicultural Medical Group, but performed after the termination dates, are still honored by the plans. CMA has also requested enrollee transfer documents through a public records request.
Physicians should be diligent in obtaining updated insurance information from patients and verifying eligibility at the time of scheduling, if possible, to avoid unnecessary patient confusion and denials of payment for services rendered.
Patients may also be able to continue to see their physicians, even if they are not contracted with the patient's new delegated entity, under California's continuity of care law.
#2: Enforce electronic health record (EHR) vendor compliance and interoperability
#9: Exempt physician in-office drug compounding from new U.S. Food and Drug Administration (FDA) rules.
- The CMA is seeking nominations for physicians to serve as at-large delegates and alternates to the American Medical Association (AMA) House of Delegates. Current delegates who are eligible for reappointment must submit an application for the 2018 term. They will not be reappointed if a form is not submitted. The CMA is seeking physicians who are active CMA members and able to serve as delegates or alternates twice a year during the annual (June) and interim (November) meetings of the AMA House of Delegates for a two-year term beginning January 1, 2018. Service on the delegation entails both a commitment of time and a commitment to advocate for CMA's interests, as well as a willingness to meet the basic responsibilities of the role set forth by AMA in its "Delegate Role and Responsibilities."
Please submit nominations to nominations@cmanet.org. Please indicate that the nomination is for the California Delegation to the AMA in the subject line. Every nomination must include a
Nominations must be submitted no later than 11:59 p.m. on Friday, February 23, 2018.
The CMA Committee on Nominations will present its recommendations to the CMA Board of Trustees at its meeting on April 27, 2018, and appointments will be announced shortly thereafter.
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- Noridian/JEMAC has posted more updates to its website:
* MLN Connects
Announcements--Therapy Cap Claims Rolling Hold; New Medicare Card: Web Updates; New Medicare Card: When Will My Medicare Patients Receive Their Cards?; MIPS Clinicians: 2017 Extreme and Uncontrollable Circumstances Policy; Quality Payment Program: Patient-facing Encounters Resources; Find Medicare FFS Payment Regulations
Publications
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* NMP and/or IVR Required Use for Claim Status-Effective February 5, 2018
* Therapy Claims Being Held for January 2018
* Eligibility Inquiries on the Noridian Medicare Portal
* MolDX: Oncotype DX Genomic Prostate Score for Men with Favorable Intermediate Risk Prostate Cancer Final LCD-Effective March 18, 2018
* February Webinars-Register
* Medicare Participating Physician Directory Information
* Medicare B News JE January 2018 Bulletin-Now Available
- Upcoming Noridian/JEMAC webinars include:
* Advance Beneficiary Notice of Noncoverage (ABN) Webinar (February 6)
* Modifier 59, NCCI, and MUE Webinar (February 7)
* Chronic Care Management (CCM) Webinar (February 14)
* Reopenings Webinar (February 21)
* Basic Non-Covered Services Webinar (February 28)
- Effective yesterday, February 5, 2018, providers are required to use the Noridian Medicare Self Service Portal or the IVR for all Eligibility inquiries and to check the status of their enrollment application without having to call customer service. Click here to begin using it today!
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- You are cordially invited to MOASC's 3rd Annual Oncology Summit®, Harnessing the Power of Immunotherapy. March 3, 2018 at the Waterfront Hilton, Huntington Beach. Topics & speakers: *Head and Neck Ezra Cohen, MD, UCSD *Colon Cancer Marvan Fakih, MD, COH *Lung Cancer Karen Reckamp, MD, COH *Breast Cancer Sara Hurvitz, MD, UCLA *Melanoma Omid Hamid, MD, The Angeles Clinic & Research Institute. Register at
moasc@moasc.org.
- Once you are registered for the MOASC Oncology Summit®, you are invited to participate in the Biocept Advisory Board Meeting, Saturday, March 3, 2018, 2pm - 5pm, immediately following the MOASC Oncology Summit®. Topic: Liquid Biopsies: The Future is Now. Register early as there is limited seating for the advisory board. Honorarium is provided. The purpose of the ad board is to:
1. Compare the relative strengths and limitations of liquid biopsy against those of conventional tissue biopsies;
2. Discuss current and emerging testing technologies with respect to sensitivity, specificity, and clinical applications for patients with cancer;
3. Evaluate clinical evidence pertaining to specific testing modalities that may help to individualize treatment protocols for patients with cancer;
4. Discuss which cancer types are best suited for liquid biopsy testing;
5. Discuss the clinical value of plasma testing be used be used in conjunction with tissue testing;
6. Discuss the value of doing targeted marker liquid biopsy testing vs. large panels for liquid biopsies.
- Attend, MOASC Member, City of Hope's dual track presentation of "How the Experts Treat Hematologic Malignancies," March 14 - 17, 2018 in Las Vegas.
OBJECTIVES:
- Provide an update of new molecular & immunological treatments being developed for these diseases.
- Discuss the rationale for new targeted diagnostic therapeutic strategies for lymphoma, myeloma and leukemia
- Summarize the evolving therapeutic strategies in the treatment of hematologic malignancies
- Review the role and timing of hematologic cell transplant in the management of younger and older patients
- Integrate best practices for prevention, detection and management of side effects related to current therapies.
- MOASC Member, UC Irvine, presents their 3rd Annual UCI Hematology Symposium on Saturday, April 21, 2018. The program will feature regional and national experts bringing you state-of-the-art updates on sickle cell disease, modern anticoagulants, CAR-T Cell therapy, and others. New this year, we will feature a Case Conference segment with individual case presentations and interactive discussions. We hope to see you at the 3rd Annual UCI Health Hematology Symposium.
- If you were unable to join us at the MOASC Spotlight On Hematology, held
Saturday, January 27, 2018,
at the Waterfront Hilton in Huntington Beach, you can view the entire program hereSpotlight On Hematology MOASC would like to thank:
AbbVie, Alexion, Amgen, Celgene, Daiichi Sakyo, Inc., Foundation Medicine, Ipsen Biopharmaceuticals, Merck, Pharmacyclics, Takeda, Teva,
and UCI for their sponsorship of this event.
- In
case you missed
the MOASC
LunchTime Series
presentation of
"Medicare Reimbursement in Oncology and Revenue Cycle State of the State with Southern California Data on Denial Rates, Days To Pay and Days To File," by Roberta "Bobbi" Buell, Principal onPoint Oncology, Inc.
, you can listen to the recording by dialing 1-888-203-1112 and enter the pass code 190823916. This recording will be available for the next 30 days. Contact the MOASC Office,
moasc@moasc.org, for the handouts to follow along with the recording.
- In a continuing effort to improve the information, presentations, and content of future MOASC events, it is extremely important for us
to obtain your feedback on the meeting you attended or listened to. Please take a few moments to answer these questions.
1. What was your overall opinion of this LunchTime Series Presentation?
2. Was the information presented helpful?
3. Any suggestions for future topics?
If you have any questions, please email the MOASC Office at
moasc@moasc.org.
Thank you in advance for your comments!
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- 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.
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- The deadline is now March 2, 2018 for reporting offers of health coverage made during the 2017 calendar year. The Internal Revenue Service (IRS) issued an extension of the due date. Previously, insurers and employers had until January 31, 2018, to provide individuals with either Form 1095-B, Health Coverage, or Form 1095-C, Employer-Provided Health Insurance Offer and Coverage. Click to continue »
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CMS News
- CMS has disseminated a coding update on ESAs. Read Bobbi Buell's analysis of the coding update by clicking HERE. ANCO and MOASC are seeking clarification of the questions raised by the update from Noridian/JEMAC and CMS (via ASCO).
- CMS has proposed increasing baseline Medicare Advantage payment rates for 2019 by an average of 1.84 percent. According to CMS, the proposed payment increase is based on better use of encounter data and changes to the risk adjustment model used to pay for aged and disabled beneficiaries. Medicare Advantage is at an all-time high, with approximately one-third of all Medicare beneficiaries enrolled in a Medicare managed care plan. Enrollment has more than doubled over the past decade. CMS is accepting comments on the proposal until March 5, with the final rates posted on April 2. For more information, see the CMS fact sheet.
- To help you prepare for the transition to the Medicare Beneficiary Identifier (MBI) on Medicare cards beginning April 1, 2018, review the new information about remittance advices. Beginning in October 2018, through the transition period, when providers submit a claim using a patient's valid and active Health Insurance Claim Number (HICN), CMS will return both the HICN and the MBI on every remittance advice. Here are examples of different remittance advices:
Find more new information on the New Medicare Card provider webpage.
- Applications for the Model Performance for BPCI Advanced must be submitted via the
Application Portal, which will close on March 12, 2018, at 8:59 pm PT. The Model Performance Period for BPCI Advanced starts on October 1, 2018, and runs through December 31, 2023. For more information about the model and its requirements or to download a Request for Applications document, the application template, and attachments, visit the BPCI Advanced webpage. See the full text of this excerpted CMS Press Release.
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Affiliate Association News
- There is no doubt a cancer diagnosis and treatment changes a person, and that is true for college students as well. Their views on life, how they handle college, the accommodations they might need, and many other factors come into play when they choose to go to school. Fortunately, there are many resources available that are designed to help students with cancer succeed in school. Learn more about support resources, academic accommodations, scholarships and advice from a cancer survivor who attended college here.
https://www.affordablecollegesonline.org/college-resource-center/students-with-cancer/
- Highlights from the 2017 National Oncology Benchmark Study (NOBS) for Infusion Services and Radiation Oncology will be presented complementary by Oncology Management Consulting Group, Thursday, February 8th at 11:00am Pacific.
- The deadline to submit your research abstract is February 13, 2018, at 8:59 PM (PST)
to be considered for presentation or publication at the 2018 ASCO Annual Meeting. The ASCO Scientific Program Committee seeks abstracts across 24 disease-based and cross-cutting tracks in oncology research to present in Chicago from June 1-5, 2018. When submitting, select the track and subcategory that best fits the focus of your research. Abstract submission guidelines. Please reserve your hotel now to ensure the best accommodations and experience.
- Register for the 2018 Community Oncology Conference, April 12 & 13 !
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. 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!
- NCCN has published updates to the below. For the complete updated versions, please visit
NCCN.org. Recent updates include: colon cancer (V1.2018), testicular cancer (V1.2018), thymus and thyme carcinomas (V1.2018), and uterine neoplasms (V1.2018).
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- Novartis Oncology informs ANCO and MOASC that the United States Food and Drug Administration has approved Lutathera for the treatment of a type of cancer that affects the pancreas or gastrointestinal tract call gastroenteropancreatic neuroendocrine tumors (GEP-NETs).
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MOASC CALENDAR
Oncology Summit
March 3, 2018
Huntington Beach, CA
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(San Francisco, February 8-10)
(Napa, March 16-18)
(San Francisco,
April 27-28)
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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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