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.
March 6, 2018
|
|
|
- 18th Multidisciplinary Management of Cancers March 16-18. (ANCO News)
- CMS approved State Plan Amendment to pay for physician services(Medi-Cal News)
- Physician dispensing pharmacies can now contract with CVS Caremark (National News)
|
California News
- The
CMA Practice Resources (March 2018) is now available online at
www.cmanet.org/cpr and features articles entitled Anthem agrees to fully rescind modifier 25 policy; State to investigate Aetna coverage denials; Physicians report delays, challenges in the wake of Anthem Blue Cross eliminating contracting phone support; CMA publishes guide for physicians affected by EHS contract terminations; DMHC issues proposed regulations for "average contracted rate" under out-of-pocket network billing and payment law; CMS launches new MIPS reporting tool; CMS to offer 2017 MIPS submission question and answer sessions; CMS to begin issuing new Medicare cards in April; Ask the expert: Am I required to respond to medical record requests for commercial risk adjustment?; The Coding Corner: Coding and billing for "multiple procedures"
|
|
|
- Did you know the annual MAC Satisfaction Indicator (MSI) survey will be conducted in March 2018? The MSI measures your satisfaction with our processes and service delivery so we can gain valuable insights and determine process improvements. Thanks for your feedback in 2017. You may read about the changes made based on last year's survey.
- Noridian/JEMAC has posted more updates to its website:
* MLN Connects
News & Announcements--
New Medicare Card: Video for your Waiting Room; MIPS: Apply to Participate in Quality Measures Study by March 23; MIPS Reporting Deadlines; MIPS 2018 QCDR Measure Specifications; MIPS Claims Based Quality Measures Projections and Results Video; What's New with Physician Compare Webinar Materials
Events--
Low Volume Appeals Settlement Option Update Call-March 13; Open Payments: The Program and Your Role Call-March 14; E/M Services: Documentation Guidelines and Burden Reduction Listening Session-March 21
Publications
--Provider Compliance Tips for Oral Anticancer Drugs and Antiemetic Drugs Used in Conjunction Fact Sheet-New; Provider Compliance Tips for Enteral Nutrition Fact Sheet-New; Provider Compliance Tips for Immunosuppressive Drugs Fact Sheet-New; Provider Compliance Tips for CT Scans Fact Sheet-Revised; Medicare Enrollment for Physicians, NPPs, and Other Part B Suppliers Booklet-Revised
* Nerve Blockade for Treatment of Chronic Pain and Neuropathy LCD-R12
* March Educational Events-Register Now
* QMB Indicator Reinstated in Medicare FFS Claims Processing System from CR9911-Revised CR10433
- Upcoming Noridian/JEMAC webinars include:
* Preventive Services and Screenings Webinar (March 7)
* Low Volume Appeals (LVA) Settlement Option Update Call (March 13)
* Modifier 59, NCCI and MUE Webinar (March 22)
* Electronic Claim Submission Webinar (March 28)
|
DHCS/Medi-Cal News
- Allowing for the distribution of supplemental payments to physicians funded by the California Healthcare, Research and Prevention Tobacco Tax Act of 2016 (Proposition 56), CMS recently approved State Plan Amendment (SPA) 17-030 submitted by the California Department of Health Care Services (DHCS). SPA 17-030
authorizes supplemental payments for certain fee-for-service physician services provided between July 1, 2017, and June 30, 2018. The supplemental payments are for new and established patient office/outpatient visits. Click here for more information.
|
|
|
- City of Hope presents a dual track of "How the Experts Treat Hematologic Malignancies,"
March 14-17, 2018 in Las Vegas. Please contact Continuing Medical Education at (626)218-5622 or
CityofHope.org/cme
-
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.
- MOASC held its 3rd Annual Oncology Summit discussing Harnessing the Power of Immunotherapy. Speakers included: Keynote Speaker - Dr. Pal, City of Hope, Dr. Reckamp, City of Hope, Dr. Hamid, The Angeles Clinic & Research Institute, Dr. Hurvitz, UCLA, Dr. Fakih, City of Hope, Dr. Kesari, John Wayne Cancer Institute. With more than 100 attendees, there was a robust discussion on the role of immunotherapy within disease categories Lung, Melanoma, Breast, Colon and Neuro-Oncology. Photos, interviews and videos, are available on
www.oncologytube.com/MOASC
.
|
|
 |
| Ashkan Lashkari, M.D. |
|
|
|
|
- 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.
- If you attended Best of SABCS San Francisco in Berkeley on January 27, then please visit www.bestofsabcs.com for instructions on how to claim your CME credit.
|
|
|
- Signaling the first significant move in the upper chamber to follow the U.S. House of Representatives' push for 340B reforms, the Senate health committee is planning an oversight hearing for the 340B drug discount program. The House Energy & Commerce Committee is expected to hold hearings later this month on a packet of bills that would significantly change 340B operations. Meanwhile, key senators have introduced legislation that scrutinize the drug discount program. Last Thursday, Sen. Chuck Grassley (R-Iowa) released a bill that would require hospitals to report to HHS both the prices they pay to drug manufacturers for the 340B-discounted drugs as well as all revenues received for the drugs from private insurers, Medicare, Medicaid, the Children's Health Insurance Program and patients. View Grassley Bill.
Sen. Bill Cassidy (R-La.), who sits on the Senate health committee, is another vocal critic of the 340B program operations and he also has legislation on the agenda. He introduced a bill in January that would put a moratorium on new 340B hospitals or registration of associated sites, with an exception for rural providers.
Bills upcoming in the House Energy & Commerce Committee include new reporting and transparency measures for hospitals who receive the 340B drug discount from pharmaceutical manufacturers, as well as legislation by Rep. Chris Collins (R-N.Y.) to amend the statute to define which patients qualify for the drug discount that is passed along to hospitals.
- The UnitedHealthcare Network Bulletin (March 2018) is now available online at
www.unitedhealthcareonline.com >Tools & Resources > News & Network Bulletin and features articles about Updates to Notification/Prior Authorization Requirements for Specialty Medications for UnitedHealthcare Commercial and Community Plan Members, Denosumab (HCPCS code J0897) Will Require Prior Authorization, Revision to Laboratory Services Policy, Pharmacy Update: Notice of Changes to Prior Authorization Requirements and Coverage Criteria for UnitedHealthcare Commercial and Oxford, Concurrent Drug Utilization Review.
- UnitedHealth Group Inc. said it would start passing along some rebates it gets from drug makers to consumers who take the medicines amid pressure to reduce costs and increase transparency around pharmaceuticals.
- Through the diligence of COA, contracting with CVS Caremark for physician dispensing pharmacies, that were unable to get into network since last year, has been opened to new physician dispensing pharmacies as of July 1, 2017. Many practices applied then, but it has not been until this year that physician dispensing pharmacies have been approved. Everyone else should still be in network.
|
CMS News
- CMS has stated that effective for claims with dates of service on or after April 1, HCPCS code Q5102 (which describes both currently available versions of infliximab biosimilars) will be replaced with two codes--Q5103 (Reflectra) and Q5104 (Reflexes). The new biosimilar payment policy also makes the use of modifiers unnecessary for claims with dates of service on or after April 1. Also, the definition of Q5101 has been revised to filgrastim-sndz, biosimilar, zarxio, 1mcg. Beginning April 1, HCPCS code Q5102 and modifiers ZA, ZB, and ZC will be discontinued.
- Those interested in participating in a new voluntary bundled-payment model that will be considered an advanced alternative payment model under MACRA have until March 12 to apply. The Bundled Payments for Care Improvement-Advanced Model includes 32 clinical-care episodes that providers can choose from, 29 of which are in the inpatient setting and three in the outpatient setting. The first cohort will begin Oct. 1. The model performance period will run through Dec. 31, 2023. Under the model, clinician payment will be based on quality performance during a 90-day episode of care. See the full text of this
CMS Press Release
.
-
Physicians face March deadlines for 2017 MIPS data submission
. The data submission deadline for the 2017 Merit-Based Incentive Payment System are March 16 for the "group" reporting deadline, and March 31 for most "individual physicians," through the CMS web interface, to avoid a penalty in 2019.
CMS has created a Top Ten List of things to know and do before the March deadlines, along with important dates to remember.
Key Dates:
March 31, 2018:
Last day for all other
MIPS
reporting, including via qpp.cms.gov
April 1, 2018:
CMS will begin providing performance feedback
January 2019:
Payment Adjustments applied
-
CMS e-mailed a reminder to providers this year, 2018, regarding compliance to the Electronic Health Record (EHR) Meaningful Use program.
Verify that you have appropriately trained staff entering orders under the CPOE (computerized physician order entry) objective to maintain compliance with meaningful use. EHR Meaninful Use Program
-
You can now find the EHR Incentive Programs FAQs on the EHR Incentive Programs website.
To find a specific FAQ, health care providers can search the FAQ pageon the EHR Incentive Programs website by topic or within the comprehensive FAQ documentby FAQ number. For more information on the EHR Incentive Programs, please contact the EHR Information Center at 888-734-6433 (press option 1) or 888-734-6563 (TTY number). The EHR Information Center is open Monday - Friday from 7:00 a.m. to 3:00 p.m. PT, except federal holidays.
- CMS wants to partner with providers and others to create new quality measures that will track whether certain care is leading to better patient outcomes. CMS has unveiled $30 million in grant funding to develop new quality measures for the Merit-based Incentive Payment System. The agency wants to partner with clinicians, health systems, patient advocates and other stakeholders to develop measures that will lead to better health outcomes for patients. The agency is especially interested in developing measures that track oncology, palliative care, pathology and radiology, orthopedic surgery, mental health and substance use conditions, and emergency medicine.
|
Affiliate Association News
- The
2018 Community Oncology Conference
-Keeping Patients at the Center, is scheduled for April 12 -13, 2018 at the Gaylord National Harbor Hotel.
The four tracks of the 2018 Community Oncology Conference really make this four meetings in one. They cover the breadth and depth of what we do every day in community oncology: Clinical; Business, Advocacy and Pharmacy. Check out the full Conference schedule to see all the great speakers and sessions:
conference.communityoncology.org/2018-conference-agenda/
.
The discounted Community Oncology Conference room block is selling out fast. Be sure to register and reserve your room today. Join more than 1,300 oncologists/hematologists, pharmacists, practice administrators, nurses, advocates, payers, and industry partners for two days of learning and networking. Visit www.COAConference.org for details.
- Come early, May 31 & June 1, and expand your educational opportunities at the
2018 ASCO Annual Meeting.
(June 2 - 5).
ASCO has two types of educational programs that offer innovative learning opportunities prior to the official start of the Annual Meeting. Space for these sessions is limited - register today.
-
Registration for ASCO's QOPI Round 1
opened on February 20 and will close on June 1.
-
After a lot of coding and hard work, the Community Oncology Pharmacy Association (COPA) is pleased to offer you a preview of COAnalyzer
, a new benchmarking tool for managing your oncology pharmacy. Free to COA and COPA members, COAnalyzer gives pharmacies access to real-time data on how they are performing and how their performance compares to peers, including mean, median, and percentile benchmarks. A free webinar to learn more about COAnalyzer and see it in action will be held on Thursday, March 29, from 9:00am-10:00 am PST. Registration is required for this free webinar. To register follow this link: https://coacancer.zoom.us/webinar/register/WN_q4JX1MnvSN-WOR2ICkDybw
- Download MGMA's free white paper entitled Business Tax Changes That Will Impact Medical Practices Under the Tax Cuts and Jobs Act at
- NEXT WEEK! March 11-17 marks Patient Safety Awareness Week. Established by the Institute for Healthcare Improvement, the week is designed to raise awareness around the need to remain continuously vigilant and critical of the processes employed to deliver healthcare. This year's theme is "Patient Engagement and Safety Culture", but how do we translate that into meaningful actions that will help drive patient safety? Read More
- NCCN has published updates to the below. For the complete updated versions, please visit
NCCN.org
. Recent updates include: anal carcinoma (V1.2018), B-cell lymphomas (V2.2018), malignant pleural mesothelioma (V2.2018),
myeloid growth factors (V1.2018),
ovarian cancer (V1.2018), prostate cancer (V1.2018).
|
|
|
- Lilly Oncology informs ANCO and MOASC that the United States Food and Drug Administration has approved Verzenio in combination with an aromatase inhibitor as initial endocrine-based therapy for postmenopausal women with hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative advanced or metastatic breast cancer.
- Pharmacyclics and Janssen Oncology inform ANCO and MOASC the the United States Food and Drug Administration has approved a new formulation of Imbruvica as one pill, once a day. In addition, the FDA recently approved a new dosage strength of 70mg for patients with moderate hepatic impairment or in patients with B-cell malignancies who are concomitantly taking specific posaconazole dosing regimens. As of May 15, the original 140mg capsules will no longer be available. Every patient will need a new prescription for their exact dosage of the new Imbruvica pill (i.e., 70mg capsules, 140mg tablets, 280mg tablets, 420mg tablets, or 560mg tablets). For additional safety information, please see the full
Prescribing Information
.
- Teva Oncology informs ANCO and MOASC that the United States Food and Drug Administration has approved Trisenox in combination with all-trans retinoid acid (ATRA) tretinoin for first-line treatment of adults with newly diagnosed, low-risk acute promyelocytic leukemia (APL) and t(15;17) or PML-RARA gene expression.
|
|
|
|
MOASC CALENDAR
LunchTime Series
March 28, 2018
|
(Napa, March 16-18)
(San Francisco,
April 27-28)
|
|
|
|
|
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
|
|
| |
|
