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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.
October 18, 2016
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California News
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The law "gives the insurance companies the power of government," saying it empowers private insurance companies to set prices for physicians and other caregivers who are not in their network.
A political advocacy group for physicians has filed a lawsuit against the new California law designed to protect consumers from unexpected out-of-network medical bills. The Association of American Physicians and Surgeons, in the lawsuit filed late last week in the U.S. District Court for the Eastern District of California in Sacramento, asked the court to block the law.
- The delivery of health care, and its costs, remains at the forefront of California politics. Dramatic changes, such as the Affordable Care Act, escalating health care premiums, consolidation of health plans, rising drug costs and the implementation of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), continue to create uncertainty in the marketplace, causing a relatively new state legislature to question nearly every aspect of health care delivery in California. The result during the 2016-2017 legislative session was a record number of significant legislative challenges to the core policy beliefs of the California Medical Association (CMA).
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Noridian News
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MolDX: ResponseDX Tissue of Origin Billing and Coding Guidelines - R1
The MolDX: ResponseDX Tissue of Origin Coding and Billing Guidelines coverage article has been revised and published for notice. Read the complete update
> MolDX-CDD: ConfirmMDx Epigenetic Molecular Assay LCD - R2
The following JE Local Coverage Determination (LCD) has been revised. Read the complete update
> MolDX: Progensa PCA3 Assay Billing and Coding Guidelines - R2
The MolDX: Progensa PCA3 Assay Billing and Coding Guidelines coverage article has been revised and published for notice. Read the complete update
> MolDX: Corus CAD Test Billing and Coding Guidelines - R3
The MolDX: Corus CAD Test Billing and Coding Guidelines coverage article has been revised and published for notice. Read the complete update
> MLN Connects Provider eNews Special Edition - October 14, 2016
CMS has made available the latest edition of the MLN Connect Provider e-News. Read the complete update
- Forthcoming Noridian/JEMAC educational events:
* Getting Paid and Keeping it-In-Person Seminar in Union City (October 25)
* Evaluation and Management Modifiers (October 26)
* Ordered, Referred, and Prescribed Services (November 15)
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DHCS/Medi-Cal News
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- The Department of Health Care Services (DHCS) will accept a second round of applications for Whole Person Care (WPC) pilot projects. The second round of applications is due on March 1, 2017. WPC pilots are part of the Medi-Cal 2020 Section 1115 demonstration waiver, approved in December 2015 by the federal Centers for Medicare & Medicaid Services. The pilots are intended to provide locally-based comprehensive care to specified patient groups, using coordinated physical health, behavioral health, and social services in a patient-centered manner, and improving the health and well-being of beneficiaries through a more efficient and effective use of resources. The general requirements for the second round of applications will remain the same, but DHCS plans to update the second round of applications based upon lessons learned from the first round, which is expected to conclude late this month. During the second application period, applicants may amend applications already approved in the first round to add new target populations and/or services and interventions. New applicants also may apply. Additional guidance will be provided prior to the release of the second round of applications. Additional information about WPC pilots is available on the DHCS
website
. For questions or comments, please contact
1115WholePersonCare@dhcs.ca.gov
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- Mark your calendars, and save the date, for MOASC's Fall Clinical Staff, Billing and Administrator Programs, November 9 and 10, 2016 at Embassy Suites Anaheim-Orange 400 N. State College Blvd., Orange. The Clinical Staff Track & Billing Staff Track will be held on Wednesday, November 9th from 8am - 2pm. The Administrator's Program will be on Thursday, November 10th from 8am - 2pm.
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- ANCO's 4Q2016 Hematological Malignancies Update will take place on November 12
at the Stanford Park Hotel, Menlo Park, with Bruno Medeiros, M.D., Stanford University, Jeffrey L. Wolf, M.D., University of California, San Francisco, and Gregory P. Kaufman, M.D., Stanford University. The latest research on novel treatment modalities for acute and chronic leukemia's, and myeloma, along with case studies for these diagnoses will be presented. The program begins at 8:30AM with breakfast. This meeting is supported by Janssen Biotech, Seattle Genetics, and Takeda Oncology. Space is limited to the first 50 physician or nurse registrants only. Meeting announcements were mailed in early October. Download the meeting announcement/registration form at www.anco-online.org/4Q2016HemeMalig.pdf.
- ANCO is pleased to announce the 17th Multidisciplinary Management of Cancers: A Case-based Approach on March 17-19, 2017 at The Silverado Resort and Spa in Napa. Sign up for more information at www.multicancers.org.
- ANCO seeks nominations to its Board of Directors. Four seats on the Board are up for election in 2016. This year's election will be conducted via mail ballot in December. Candidates with the top four vote totals will serve for three years (i.e., from 2017-2019, inclusive). The ANCO Board of Directors governs the Association, developing advocacy strategies and policies, approving education meeting proposals and activities, and considering membership benefits. The Board meets in person approximately once each year in the San Francisco Bay Area and via bimonthly teleconference. Expenses associated with attending Board meetings are reimbursed. Communication with the Board is also conducted via FAX broadcast and e-mail. You may nominate an ANCO member (including yourself) to stand for election to the Board via FAX to the ANCO office at (415) 472-3961 or e-mail to execdir@anco-online.org no later than November 18, 2016.
- ASCO has announced its roster of candidates for open leadership positions. Amongst the candidates are two ANCO members--Eric Small, MD, UCSF, and A. Dimitrios Colevas, MD, Stanford University. ASCO members will be able to vote for their chosen leaders from November 1 through December 2, 2016. Go to www.asco.org/election for more information.
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- The White House, yesterday, said its "cancer moonshot" initiative is paying off in such areas as the digital storage of large groups of genetic data and research into environmental causes, but it urged Congress to approve funding for the venture.
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- There is great concern among the patient advocacy community about CMS' proposed Part B Drug Payment Model changes that, if implemented, would severely disrupt care for vulnerable beneficiaries with cancer, macular degeneration, rheumatoid arthritis, neurological disorders, primary immunodeficiency diseases, rare diseases, and other serious medical conditions. This proposed rule changes speaks to a larger issue: CMMI's (the Centers for Medicare & Medicaid Innovation) unchecked power to make changes to Medicare, which millions of Californians rely on every day. Earlier this year you made calls into a few key congressional offices, can we count on you to make calls to our new targets?
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Member
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Phone Number
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David Valadao
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(202) 225-4695
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Jeff Denham
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(202) 225-4540
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Anna Eshoo
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(202) 225-8104
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Kevin McCarthy
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(202) 225-2915
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TALKING POINTS
My Name is __________ and I'm calling on behalf of (ORG).
Earlier this year CMMI - the Centers for Medicare & Medicaid Innovation - proposed the "Medicare Part B Payment Model" which would reduce payment for many providers and make centralized, one-size-fits-all decisions about treatment, ignoring patient differences and perspectives.
This was very concerning to us.
With programs as large and as impactful in the lives of everyday Americans as Medicare and Medicaid, we need to make sure that any changes that might impact the end user - the patient - are given the proper analysis and oversight.
That's why we think Congress needs to put guardrails around CMMI, to put necessary checks and balances in place that protect patient safety above all else
.
Millions of Medicare patients rely on Part B to get the medicines they need to treat complex conditions.
For people living with chronic illnesses, disruption in treatment plans can have tremendously negative effects, physically and emotionally.
These patients need immediate access to the treatments that are most appropriate for their individualized condition.
We hope we can count on the Congressman/woman to protect patient safety and place necessary guardrails on CMMI
.
Thank you!
- The Centers for Medicare & Medicaid Services (CMS) invites you to join a webinar on October 26 at 11:00am-12:00pm Pacific Time,
Register:
https://engage.vevent.com/rt/cms/index.jsp?seid=530
on the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) final rule with comment period. The webinar will provide an overview of the Merit-based Incentive Payment System (MIPS) and Advanced Alternative Payment Model (APM) incentive payment provisions under MACRA, collectively referred to as the Quality Payment Program.
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The Centers for Medicare & Medicaid Services (CMS) with the MLN Connects® call invites you to join a webinar November 15 on
Quality Payment Program Final Rule
Target Audience:
Medicare Part B Fee-For-Service clinicians, office managers and administrators; state and national associations that represent healthcare providers; and other stakeholders. During this call, learn about the provisions in the recently released final rule; participants should review the rule prior to the call. A question and answer session will follow the presentation. To learn more about the final rule and the Quality Payment Program, view the following resources:
- CMS encourages the public to submit comments on the MACRA final rule. Comments are due 60 days after the date of filing for public inspection, and can be submitted in several ways, including:
Electronically via
https://www.regulations.gov ;
By regular mail; By express or overnight mail; By hand or courier.
- 2015 Supplemental QRUR Physician Feedback Program, "How to Interpret Your 2015 Supplemental Quality and Resource Use Report (SQRUR),"is scheduled for Thursday, October 20, 2016, 10:30 AM - 12:00 PM Pacific Time. This MLN Connects® National Provider Call provides an overview of the 2015 Supplemental Quality and Resource Use Reports (QRURs), confidential feedback reports for medical group practices and solo practices on resource utilization for Fee-For-Service episodes of care. The 2015 Supplemental QRURs report on 23 major episode types and an additional 44 episode subtypes, resulting in 67 total reported episode types. The 2015 Supplemental QRURs are for informational purposes only and are not used to adjust payments. Learn more about the reports on the Supplemental QRURs and Episode-Based Payment Measurement webpage. The call will be more meaningful if you have your 2015 Supplemental QRUR in front of you to follow along. Visit How to Obtain a QRUR and access your report prior to the call. To register for this event, please visit the MLN Connects Event Registration website.
- The average premium for Medicare Part D prescription drug insurance plans will increase by 9 percent for 2017, according to a new analysis, published in the Washington Examiner. All Medicare beneficiaries may get some sense of what their 2017 premiums will be today, Tuesday, when the Social Security Administration releases its annual cost-of-living adjustment for retirement benefits.
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Affiliate Association News
- Making AML therapy decisions at CR1: Free CME webinar. How does disease status and the timing of treatment for patients with AML impact outcomes at first complete remission (CR1) On Thursday, Oct. 20 at 2 p.m. Pacific Time. Making AML therapy decisions at first remission: Is timing everything? will provide the latest research to help answer that question. During the webinar, speakers Robert J. Soiffer, M.D. (moderator), Ellen Ritchie, M.D., and Roland Walter, M.D., will use an interactive format to present case studies that identify disease-specific factors for assessing risks and benefits of post-induction therapy, including minimal residual disease. An additional webinar, AML in older adults: Are outcomes age dependent? will be held Thursday, Nov. 17, from 2-3 p.m. Pacific Time. Speakers include Fred Appelbaum, M.D. (moderator), James Foran, M.D., and Laura C. Michaelis, M.D. Register for both webinars, or select the one that fits your schedule. Find full details on CME and the activities online at BeTheMatchClinical.org/AMLCME. This series is being sponsored by the National Marrow Donor Program®/Be The Match®.
- MOASC
is pleased to be a co-sponsor of the California Partnership for Access to Treatment, (CPAT) upcoming seminar titled From Molecule to Miracle - The Process of Drug Discovery and Development. This seminar is an educational forum and complimentary luncheon which will take place on Wednesday, October 26, 2016 at the Comprehensive Blood & Cancer Center in Bakersfield, California. Emily Burke, Ph.D., Director of Instruction at BioTech Primer is the keynote speaker. Click Here to Register. For more information e-mail Erica Root.
- At the MGMA 2016 Annual Conference, Oct. 30 - Nov. 2 in San Francisco, you'll find the best practices, proven strategies and lasting support you need to grow professionally; see and capitalize on opportunities; and, ultimately, lead your practice to even greater success. Click here for the full schedule and session details.
- AML webinar series explores the changing landscape of clinical decision making. From emerging molecular and cytogenetic alterations to treatment timing to improving outcomes for older patients, the landscape of treatment decision-making in AML is changing. The last two upcoming live webinars will use case studies to provide physicians and advanced practice professionals with the latest research on key areas affecting clinical decision-making for patients with AML.
*On Thursday, Oct. 20, Robert J. Soiffer, M.D., Ellen Ritchie, M.D., and Roland Walter, M.D., will share research on making AML therapy decisions at first remission, and how timing impacts outcomes.
*On Thursday, Nov. 17, Fred Appelbaum, M.D., James Foran, M.D., Laura C. Michaelis, M.D., will discuss patient comorbidities, disease factors and assessment tools that influence treatment decision-making for patients with AML over age 60.
All webinars are scheduled from 2-3 p.m. Pacific Time. Find full details on CME and the activities at BeTheMatchClinical.org. Whether you see a few patients a year with AML or dozens, the free webinars will present information you can apply to your clinical practice. Register for the webinars, or select the ones that fit your schedule. This series is being sponsored by The National Marrow Donor Program®/Be The Match®.
- Join Dr Neil Love and his education group, Research To Practice, at the Loews Santa Monica Beach Hotel (1700 Ocean Avenue) on Saturday, November 12, 2016, for another installment of the Year in Review multi-tumor oncology CME program. The daylong event (from 8:00am - 4:00pm) we will be joined by an exceptional faculty panel that will review many of the year's most important new data sets and conference presentations in several distinct areas of oncology: breast cancer, lung cancer, genitourinary cancers, select gastrointestinal cancers, melanoma, multiple myeloma and Hodgkin and non-Hodgkin lymphoma. For more information or to register and secure hotel accommodation, visit: http://www.researchtopractice.com/Meetings/YIR2016/CA.
- Learn about the most significant scientific discoveries
in hematology and how these discoveries impact clinical practice, at the 58th ASH Annual Meeting & Exposition. December 3-6, 2016 in San Diego. Advance registration is open for a limited time. Register today to secure the best rates available for this year's event and to book your housing. ASH Registration and Housing Center, 888-273-5704 (U.S. toll free)
Email: ashregistration@spargoinc.com ashhousing@spargoinc.com
- A recent COA-commissioned Milliman study upended a commonly held belief about cancer costs compared to other health care spending. Find out how the cost to treat cancer compares with other health care spending. Read Article
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Comments on the proposed Medicare Physician Fee Schedule for CY2017 have been submitted by:
- ACCC has launched a free, multimedia, online learning portal at www.accc-cancer.org/elearning that provides two-way, engaging education on operational, administrative, and clinical topics.
- The 6th edition of the ASH Self-Assessment Program (ASH-SAP) contains 23 pertinent peer-reviewed chapters, covering the full spectrum of adult and pediatric hematology. Order your copy or learn more at www.hematology.org/BuyASHSAP6.
- The Community Oncology Alliance (COA) has launched the Advance Practice Provider Network (CAPP Network) to support advanced practice providers (NPs, PAs, etc.). To join the CAPP Network, visit www.communityoncology.org/capp.
- COA has launched a peer-to-peer support network for practices participating in the CMS Oncology Care Model (OCM). The COA OCM support network was created at the request of OCM practices, and nearly 200 individuals from more than 112 cancer care teams have already joined. It is free of charge for all OCM practices to join, completely noncommercial, and practices to no have to be members of COA to participate. If you are interested in joining the support network, e-mail OCMSupport@coacancer.org
- NCCN has published updated NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) with NCCN Evidence Blocks™ for the following disease sites:
- Basal Cell Skin Cancer, Version 1.2017
- Dermatofibrosarcoma Protuberans, Version 1.2017
- Merkel Cell Carcinoma, Version 1.2017
- Squamous Cell Skin Cancer, Version 1.2017
- Occult Primary (Cancer of Unknown Primary). These NCCN Guidelines are currently available as Version 2.2017. The previous update (Version 1.2017) to the NCCN Guidelines for Occult Primary, published on September 21, 2016, is available at:https://www.nccn.org/professionals/physician_gls/pdf/occult.pdf
- Updates to the NCCN Guidelines and the NCCN Drugs & Biologics Compendium (NCCN Compendium®) for Non-Small Cell Lung Cancer are currently available as Version 1.2017.
For the complete updated versions of the NCCN Guidelines, NCCN Guidelines with NCCN Evidence Blocks™, the NCCN Compendium®, the NCCN Chemotherapy Order Templates (NCCN Templates®), and the NCCN Imaging Appropriate Use Criteria (NCCN Imaging AUC™), please visit NCCN.org.
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- AbbVie will host a clinical discussion entitled Venclexta for Treatment of Previously Treated CLL with 17p Deletion with Daruka Mahadevan, M.D., Ph.D., University of Arizona Cancer Center, on October 20 in Sacramento. Please RSVP by October 14 to Sean Taylor, (916) 521-7805, or go to http://abbvie.meintl.com/OHD08-OB02-16.
- Pharmacyclics will host an exhibitor theater to discuss Imbruvica in CLL/SLL with Kevin R. Kelly, M.D., University of Southern California, on October 29 in Anaheim. Please RSVP at http://bit.ly/registerCSHP.
- TMCI Global provides science-based, online medical education for healthcare professionals who want to learn about medical cannabis and its potential clinical application to deliver quality care and address patient questions. With medical cannabis gaining traction nationwide, there's an increasing need for a trusted learning resource. Make sure that each of your members is prepared as their patients seek information and guidance in this expanding field. TMCI Global offers comprehensive, evidence-based, CME-certified courses designed to educate practicing clinicians on both research and clinical application of medical cannabis. Learn clinical applications of cannabis in cancer patients or potential benefits of cannabidiol for cancer patients.
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MOASC CALENDAR
LunchTime Series
October 26th
Oncology Roundtable Teleconference
November 30th
ASCO State Affiliate
Meeting in Virginia, VA
October 26th - 28th
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Hematological Malignancies Updates (November 12; Palo Alto)
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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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