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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.
November 8, 2016
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California News
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- Calling it a classic "bait and switch," a California consumer group, last week, lashed out at Anthem Blue Cross of California, claiming it failed to adequately warn customers they were being shifted in 2017 to brand-new, stripped-down plans. Santa Monica-based Consumer Watchdog announced it has filed a class action lawsuit against the health insurance giant after Anthem moved hundreds of thousands of its Preferred Provider Organization customers to Exclusive Provider Organization plans for 2017 - all the while calling the new plans "similar coverage." PPO plans cover a portion of out-of-network costs, while EPO plans cover none of them. The Mercury News: Consumer Group Sues Anthem Over "Bait And Switch'' Tactics For 2017 Health Plans
- San Francisco Bay Area companies say Sutter Health is strong-arming them into a contract that would help the hospital system secure its power over prices and potentially raise the cost of medical care for their employees in the future. Dozens of companies have received a letter, via their insurance administrators, asking them to waive their rights to sue Sutter. If they don't, a fact sheet included in the letter says, the companies' employees who get care through Sutter's network of hospitals, doctors and medical services will no longer have access to discounted in-network prices.
- Forthcoming CMA webinars include:
* Nondiscrimination Statements: A Detailed Guide to Compliance (November 9)
- The CMA's Practice Resources (CPR) for November is now available online at www.cmanet.org/cpr and includes articles entitled: CMA publishes FAQ and hosts webinar on new law to end "surprise billing"; Blue Shield fee schedule changes effective December 1; Know Your Rights: Timely filing denials; and, The Coding Corner: Undercoding isn't a solution, it's a potential compliance liability.
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Noridian News
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* MLN Connects Provider News
Announcements--Quality Payment Program: CMS Finalizes Hospital OPPS Changes to Better Support Hospitals and Physicians Improve Patient Care; Home Health Agencies: Final Payment Changes; Hospital Value-Based Purchasing Program Results for FY2017; 2017 PQRS Results: Submit an Informal Review by November 30; Recovery Audit Contractor Awards
Claims, Pricers, and Codes
--Billing for Influenza: New CPT Code 90674
Events
--Quality Payment Program Final Rule Call-November 15; CMS 2016 Quality Conference-December 13-15
Publications
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* ALJ and Federal District Court Amount in Controversy Increase for 2017
* Self-Service Reopenings Available Through Noridian Medicare Portal
* ASP Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing Files-January 2017 CR9843.
- Forthcoming Noridian/JEMAC meetings/workshops include:
* Ordered, Referred and Prescribed Services (November 15)
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DHCS/Medi-Cal News
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- Doctors, hospitals and health care advocacy groups are hoping two November ballot measures will do what they've been unable to do at the state Capitol: Bring more money to California's health care program for the poor. The industry groups have tried for years to get more state funding for Medi-Cal - California's version of Medicaid. They argue that as Medi-Cal's population grows under the Affordable Care Act, there simply aren't enough doctors willing to treat patients because the state's payment rates are too low. But they've run into a roadblock. Capital Public Radio/KXJZ: Brown's Resistance To Medi-Cal Rate Increases Spurs Ballot Push
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- IT'S TOMORROW & THURSDAY! DON'T MISS MOASC's Fall Clinical Staff, Billing and Administrator Programs, scheduled for November 9 and 10, 2016 from 8:00am - 2:00pm, at Embassy Suites Anaheim-Orange 400 N. State College Blvd., Orange. On Wednesday, November 9th, the Clinical Staff Track discussion highlight is Chemotherapy and Biotherapy Clinical Hot Topics in 2016. The Billing Staff Track discussion highlight is Oncology Billing Overview and Updates. On Thursday, November 10th the Administrator's Program discussion highlights are: Self Advocating for Protections Against Hazardous Drugs with an overview of USP 800; MACRA, and Mitigating financial risk in the practice and Payer Contracting/Negotiations. Contact the MOASC Office for more information and registration. moasc@moasc.org .
- MOASC is proud to present their 2017 Oncology Summit: How Personalized Medicine fits into your treatment pattern for Lung cancer, Prostate cancer and Multiple Myeloma. Saturday, March 11, 2017, 7:30am to 3:30pm at the Hyatt Regency Huntington Beach. The confirmed speakers for Non-Small Cell Lung Cancer are: Edward Garon, MD, Associate Professor Medical Oncology, UCLA and Karen Reckamp, MD, MS, Associate Professor Medical Oncology, City of Hope; for Prostate Cancer, Przemyslaw Twardowski, MD, Associate Professor Medical Oncology, City of Hope and David I Quinn, MD, Associate Professor Medical Oncology, USC, and for Multiple Myeloma, James R. Berenson, MD, and Amrita Krishnan, MD, FACP,
Director, Judy and Bernard Briskin Center for Myeloma, City of Hope.
For complete information on this superb program, please contact the MOASC Office at 909-985-9061 ext.1 or
moasc@moasc.org
or
www.moasc.org
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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.
- UC San Francisco's Thomas Martin, M.D., will present Back to Basics: Tenets of Testing in Myeloma Diagnostics--A Webinar with Live Q&A on November 14, 16, and December 12. The webinars are organized by MediCom Worldwide. Go to http://forms.medicaled.com/zstdeXWy for more information and to register.
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ANCO's Medicare Reimbursement for Oncology 2017
with Bobbi Buell takes place January 4 in San Jose and January 5 in Sacramento. Learn the latest information impacting Medicare's oncology reimbursement for 2017. These meetings are supported by ARIAD Pharmaceuticals, Exelixis, Helsinn Oncology, and Merck. Download the meeting announcement and registration form at www.anco-online.org/MedicareUpdate2017.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 through December 2, 2016. Go to www.asco.org/election for more information.
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- Participants of last Tuesday's IPAB tele-town hall heard the latest on the Independent Payment Advisory Board (IPAB) repeal efforts and the potential impact on Medicare beneficiaries, as well as proposed Senate activity. If you missed the call, an audio recording of the tele-town hall can be found on medicaretoday.org. The Healthcare Leadership Council (HLC) is again spearheading a large group sign on letter calling for repeal of IPAB, similar to efforts conducted in previous years. In order to make the most impact, the goal is to exceed the number of signers on the previous group sign-on letter, which most recently had over 530 signers. We have kept the language in the letter the same as the last letter and only made one change by removing a sentence due to outdated statistics. If you want to be included, please follow this link and fill out the form by Friday, November 11. Additional background information is also available there. If you have questions please direct them to Amanda Uherek auherek@hlc.org.
- UnitedHealthcare's Network Bulletin (November 2016) is now available online at http://unitedhealthcareonline.com > Tools & Resources > News & Network Bulletin and features articles entitled Revisions to the Multiple Procedure Payment Reduction (MPPR) for Diagnostic Imaging Policy--Professional Component Reduction Change and Changes in Advance Notification and Prior Authorization Requirements.UnitedHealthcare will also be issuing new 2016-2017 Premium Designation physician results www.cmanet.org/cpr.
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- Finalized on November 2nd, the 2017 Physician's Fee Schedule Published by CMS will be implemented January 1, 2017. In addition to physicians, a variety of practitioners and entities are paid under the physician fee schedule. The annual Physician Fee Schedule updates payment policies, payment rates, and quality provisions for services provided in CY 2017. Additional policies finalized in the 2017 payment rule include, finalized data collection strategy for global services with significantly reduced burden for practitioners compared to the proposal, and enhanced program integrity and data transparency in the Medicare Advantage program. Please click on the links here to download and/or review the details of this important rule: Click Here to review the Final Rule in the Federal Register; Click Here for the CMS narrative explanation (blog)
- 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 10:30am to 12:00pm Pacific Time MLN Connects Event Registration. 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:
- Information on physicians having until November 30 to dispute 2015 PQRS and QRUR findings; MACRA not create new reporting burdens, and the last day to change your Medicare participation status for 2017 (December 31) can be found at www.cmanet.org/cpr.
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Affiliate Association News
- THIS SATURDAY, November 12, 2016, join Dr Neil Love and his education group, Research To Practice, at the Loews Santa Monica Beach Hotel (1700 Ocean Avenue) 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.
- 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.
*On Thursday, Nov. 17, Fred Appelbaum, M.D., James Foran, M.D., Laura C. Michaelis, M.D., will discuss patient co-morbidities, 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®.
- The 58th ASH Annual Meeting and Exposition is only a month away. Be sure to
register. 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
- Read the various
summaries of the CMS Final MACRA rule:
- ASCO and Innovative Oncology Business Solutions (IOBS) have announced a new collaboration, ASCO COME HOME--an oncology medical home program designed to transition community oncology practices from volume-based to value-based care by structuring reimbursement around the full range of services needed by patients with cancer. ASCO COME HOME will also prepare oncology practices for full implementation of the Quality Payment Program under MACRA and will be available across the country starting on January 1. ASCO is now recruiting practices for the fee-based 2017 ASCO COME HOME program. For more information, please contact Elaine Towle (
elaine.towle@asco.org). Learn more about ASCO's physician payment reform efforts at www.asco.org/advocacy-policy/policies-positions-guidance/coverage-reimbursement/physician-payment-reform.
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Comments on the proposed Medicare Physician Fee Schedule for CY2017 have been submitted by:
- ASCO is accepting applications for its 2017 Quality Training Program. In 2017, the Program is shifting its model of in-person sessions at ASCO headquarters in Alexandria to regional settings, including Portland. The comprehensive six-month program brings oncology teams together to create and facilitate an improvement project. Each team selects a project that will solve a problem in its own clinical setting, so the learning experience is simultaneously fostering a solution or best practice. For more information about the Quality Training Program, visit
www.asco.org/training-education/professional-development/quality-training-program.
- ASCO is accepting applications for its prestigious Health Policy Fellowship, a one-year Fellowship opportunity designed to give early-career oncologists the unique skills necessary to monitor and shape the regulatory and legislative policies that directly affect the practice environment and impact patients with cancer and their care teams. The deadline for submitting applications is December 30 at
www.asco.org/node/7556.
- ASCO's Annual Election of leaders is now open through December 2. Go to
www.asco.org/election to learn about the candidates and vote.
- 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.
- View the 2016 ASH Meeting on Hematologic Malignancies Webcast with more than 13 hours of exclusive educational content. The webcast provides access to 21 sessions and 8 panel discussions featuring top experts in hematologic malignancies. The content is available online as video recordings of the speakers synced with slides from their presentations. Free previews from the 2015 meeting are available for viewing.
Order Now
- Starting in November, join select 2017 ASH Meeting on Hematologic Malignancies (MHM) Program Planning Committee members and speakers for a free, five-part series previewing content from the core malignant hematology themes covered during the meeting--leukemia, lymphoma, myelodysplastic syndromes, myeloma, and myeloproliferative neoplasms. Learn more and register at
https://cc.readytalk.com/registration/#/?meeting=6vai7w2z06v&campaign=5u5sdn5oml8r
.
- NCCN has published updated NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) with NCCN Evidence Blocks™ for the following disease sites:
* Kidney Cancer (V2.2017)
* Multiple Myeloma (V2.2017)
* Testicular Cancer (V1.2017)
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.
- NCCN is pleased to offer pocket-sized versions of the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Melanoma free of charge. These hard cover, ring-bound pocket guides are conveniently sized to fit in a lab coat and serve as a valuable reference tool.
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- Clovis Oncology is hosting several webcasts entitled The Evolving Science of Ovarian Cancer on November 11. Learn more and register at
www.clovisspeakers.com.
- ARIAD Pharmaceuticals is hosting a webcast entitled Advancing the Conversation in ALK+ NSCLC on November 15 at several time during the day. Learn more and register at
www.alknsclcprograms.com (HCP access code: Schedule; select Webinars).
- AstraZeneca is a sponsor of the upcoming 2016 American Cancer Society Cancer Action Network, Personalized Medicine Roundtable on November 16th, in Los Angeles, and invites the members of Medical Oncology Association of Southern California to attend the event as AstraZeneca's guest. There a total of 4 seats left. Please don't register, but let Silvina Martínez, smartinez@cullarigroup.com , 916.813.1252,know if you and/or others would like to attend, and she will submit your names to ACS as AstraZeneca's guests. For details of the event go to 2016 ACS CAN Los Angeles.
- Johnson & Johnson Health Care Systems shares their 2017 MACRA Final Rule Highlights and Q&A documents that the legal team at Johnson & Johnson pulled together. This gives a concise summary of the 2017 MACRA Final Rule ~ Please note~ CMS is accepting comments until December 13, 2016.
- Heron Therapeutics is committed to becoming the premier, long term partner to Community Oncology through differentiated clinical innovation, best in class patient support programs and demonstrating our understanding of the business of oncology. Their first commercial product, SUSTOL® (granisetron) extended-release injection, was approved by the FDA, is a serotonin-3 (5-HT3) receptor antagonist indicated in combination with other antiemetics in adults for the prevention of acute and delayed nausea and vomiting associated with initial and repeat courses of moderately emetogenic chemotherapy (MEC) or anthracycline and cyclophosphamide (AC) combination chemotherapy regimens.The clinical benefits of SUSTOL are clear but Heron also understands the economic pressures faced by practices and patients. Heron is fully committed to removing access barriers to SUSTOL. To that end, Heron has developed a suite of best in class patient and practice support tools. Please feel free to contact your local Heron Sales Representative or your GPO partners to discuss this opportunity in more detail. SUSTOL Connect™: 1-855-SUSTOL-6 (1-855-787-8656), 8 AM to 8 PM ET, Monday through Friday, or visit sustol.com. To learn more about SUSTOL and other products that Heron Therapeutics is developing, please visit www.herontx.com.
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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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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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