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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 15, 2016
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California News
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- The California Supreme Court today ruled that health plans cannot absolve themselves of the responsibility to pay claims for emergency care by non-contracted providers by negligently delegating that responsibility to a risk bearing organization that it knows-or should have known-to be financially insolvent. Read More
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Noridian News
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* MLN Connects Provider News
Announcements--2017 PQRS Results: Submit an Informal Review by November 30; Value Modifier: Informal Review Request Period Open through November 30; Quality Payment Program Presentations Available
Claims, Pricers, and Codes
--
--Quality Payment Program Final Rule Call-November 15; CMS 2016 Quality Conference-December 13-15
Publications
--PECOS for Physicians and Non-Physician Practitioners Fact Sheet-Revised
* New Physician Specialty Code for Hospitalist CR9716.
* 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
* Open Enrollment Participation Program
* CCI Edits, Version 23.0, Effective January 1 2017-Quarterly Update CR9847
* 2017 MPFS Available Soon.
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DHCS/Medi-Cal News
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- The Department of Health Care Services (DHCS) will hold its first Access Assessment Advisory Committee meeting on Friday, November 18, 2016, from 9 am - 3 pm in Sacramento. California's Medi-Cal 2020 1115 Waiver Special Terms and Conditions require DHCS to conduct an Access to Care Assessment (Assessment). DHCS is working with its External Quality Review Organization to conduct the Assessment, which will evaluate primary, core specialty, and facility access to care for Medi-Cal managed care beneficiaries. As a part of the Assessment process, the State established an Advisory Committee that includes representatives from consumer advocacy organizations, providers/provider associations, health plans/health plan associations, and legislative staff. The Committee will provide input into the assessment structure, including network adequacy requirements and metrics that should be considered, as well as provide feedback on the Assessment's initial draft report. Please visit the Access Assessment Webpage for more information. For questions or comments, please contact Access.assessment@dhcs.ca.gov
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- 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
.
- "...attended both days and took away a lot of useful information, Thank you MOASC for putting together great speakers..." IF YOU MISSED IT.... THERE'S ALWAYS NEXT YEAR! MOASC's Fall Clinical Staff, Billing and Administrator Programs, held last week were a resounding success. Discussions highlighted were: Ron Culberson, MSW, CSP, CPAE, Speaker, Author, Humorist, presented Do It Well, Make It Fun! The Key to success in Oncology.Cheryl Bradley, Associate Director, CMA discussed MACRA and what you need to know!Seth Eisenberg, RN, ASN, OCN, BMTCN, Professional Practice Coordinator, Infusion Services, Seattle Cancer Care Alliance Ambulatory Clinic, presented Self Advocating for Protection Against Hazardous Drugs. Stephanie L. Jackson, MSN, RN, AOCNS, BMTC, Oncology Clinical Nurse Specialist, Hematology/Stem Cell Transplantation, Ronald Reagan UCLA Medical Center and Pattie Jakel, MSN, AOCN, Oncology Clinical Nurse Specialist, Solid Tumor Program Santa Monica UCLA Medical Center discussed Chemotherapy and Biotherapy Clinical Hot Topics in 2016.Edwina Rains, CPC, Associate Consultant, Oncology Management Consulting Group, President, ER's HealthCare Consulting presented Oncology Billing Overview. Kristy McGowan, Business Practice Consultant, Innovation Cancer, AmerisourceBergen discussed Mitigating financial risk in the practice and Payer Contracting/Negotiations.
"...A lot of applicable information, always a good reminder, excellent speaker, great suggestions..."
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- 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 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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National News
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- CMA informs ANCO and MOASC that the effective November 1, Anthem in partnership with AIM Specialty Health expanded its Pre-service Review to the medical necessity of coverage requests for all not otherwise classified (NOC) oncology and biologic drugs. Pre-service clinical review will be based on specific medical policy or clinical guideline when available. In instances where a specific policy or guideline is unavailable, then Clinical Guideline CG-DRUG-01, Off-Label Drug and Approved Orphan Drug Use, will be used for HCPC codes J9999 and J3590. If the drug is not reviewed pre-service then Anthem will conduct a post-service review based on the same clinical criteria and may request records as part of that review. This pre-service clinical review program apples to commercial, local ASO, national accounts and Medicare Advantage members. Please contact (800) 676-2583 to verify any pre-service review recommendations or requirements for BlueCard business. Ordering physicians may submit a request for services to AIM through the AIM ProviderPortal, through the Availity Web Portal, or by calling the AIM call center at (877) 291-0360.
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- The HHS Office of Inspector General "will review Medicare incentive payment data to identify payments to providers that should not have received incentive payment" and "assess CMS's plans to oversee incentive payments for the duration of the program and corrective actions taken regarding erroneous incentive payments," according to the agency's work plan for 2017. The agency will also evaluate the security of certified EHR technology and audit covered entities that have received these payments from the CMS, the work plan stated.
CMS has released information that physicians can consult to determine whether they will be subject to 2017 payment penalties associated with the Physician Quality Reporting System (PQRS) and the Value Modifier. Practices that have concerns about the findings in their report have until November 30 to file for an informal review of their data. Go to www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/PhysicianFeedbackProgram/Obtain-2013-QRUR.html for instructions on how to access your Quality and Resource Use Report (QRUR).
Information on physicians having until November 30 to dispute 2015 PQRS and QRUR findings; MACRA will 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
-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®.
- 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 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
- 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
.
- ASH's 2017 Highlights of ASH in North America will take place in Seattle on January 27-28. Go to
www.hematology.org/highlights
for more information and to register.
- Read the various
summaries of the CMS Final MACRA rule
:
- Comments on the proposed Medicare Physician Fee Schedule for CY2017 have been submitted by:
- 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
.
- 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
.
- 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 Bone Cancer (V2.2017). 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
.
- As part of its mission to improve the quality, effectiveness, and efficiency of cancer care so that patients can live better lives, the National Comprehensive Cancer Network® (NCCN®) has announced the launch of Just Bag It: The NCCN Campaign for Safe Vincristine Handling. This campaign encourages health care providers to adopt a policy to always dilute and administer vincristine in a mini IV-drip bag to prevent a deadly medical error. Attached is the Flash Update detailing the Chemotherapy Order Templates that are affected by this policy.
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- AMGEN informs ANCO and MOASC up 2017 coding updates for Neulasta. Effective January 1, a new drug administration CPT code (93677) will be available for use with the Neulasta Onpro Kit (J2505). For the Neulasta Prefilled Syringe for Manual Injection use CPT code 96372.
- 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.
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Bristol-Myers Squibb Oncology
informs ANCO and MOASC that the United States Food and Drug Administration has approved Opdivo
for the treatment of patients with recurrent and metastatic squamous cell carcinoma of the head and neck (SCCHN) with disease progression on or after a platinum-based therapy.
- Genentech launched the cancer immunotherapy Centers of Research Excellence (imCORE) Network, which will bring together many of the world's leading scientific and clinical experts in cancer immunotherapy to collaborate in the investigation of promising new treatment approaches. The imCORE research network is made up of scientists from 21 leading academic centers. The goal is to access and share technology, data and expertise to rapidly initiate pre-clinical and clinical research based on the latest discoveries and identify approaches to expand the number of people who may benefit from cancer immunotherapy. Genentech is working in collaboration with the network on existing and new investigational medicines, diagnostic technologies and emerging data. To learn more visit the Genentech cancer immunotherapy topic page.
- 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.
- Merrimack Pharmaceuticals informs ANCO and MOASC that Onivyde has been assigned J-code 9205 (1mg).
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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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