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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 22, 2016
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Noridian News
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- Noridian would like to solicit their providers' assistance in shaping their customer service offerings - now and into the future - and are hoping you will help them. They want to hear from providers if their current offerings are meeting the needs of the provider community and, importantly, would like to hear your ideas on how they can continue to meet those needs into the future. Noridian strives to deliver that information in "easy to use" approaches and by means that meet the needs of the provider community. Noridian's provider community ranges from clinician offices that submit less than 10 claims a year to very large hospitals. Noridian understands that one offering or technology solution will not meet the needs of all the providers. They would like to begin a meaningful dialog with the provider community to see if they are "hitting the mark" and to identify new, effective ways to get information to providers. Some of the new ideas will be enabled by technology but they do not have to be. Noridian's ultimate goal is to use your recommendations based on your experience as a provider, and feedback from your peers, to ensure they are meeting the target expectations of outreach needs and self-help tools of their provider community. Please complete the charts below by sharing details regarding Noridian's current offerings and let them know if they are useful. Also, looking into future years, what would you support using to best communicate with Noridian? If you can reply by December 8, to Wade Carlin
Wade.Carlin@noridian.com
, Provider Outreach and Education Representative, Noridian Healthcare Solutions LLC, Fargo, N.D. Thank you.
Current Offerings
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Offering Method
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What works great, what needs to be added or improved?
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Noridian Medicare Portal
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Interactive Voice Response (IVR)
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Contact Center staff
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Email Lists
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Educational Events (webinars, in-person events/visits, Ask the Contractor Teleconferences)
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External Partnerships and Associations
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Postal Mailings (postcards, booklets)
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Tutorials / Online training videos
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Other
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Future - Identify new methods to provide useful information
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Social Media (Twitter, YouTube, Facebook, LinkedIn, etc.
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Smart Phone applications and downloaded tools
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Skyping or Virtual Conversations (without PII or PHI)
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Live Chat instant messaging
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Secure messaging through the portal
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Other
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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; Open Payments: Physicians and Teaching Hospitals Review Public Data by December 31
Claims, Pricers, and Codes
--
Events
--CMS 2016 Quality Conference-December 13-15
Publications
--
* Payment Reduction for X-Rays Taken Using Film CR9727
* Therapy Cap Values-2017 CR9865
* Guidance to Physician/Practitioner and Supplier Billing Offices that Submit Hard Copy Claims to Medicare to Help Reduce Incidence of Claims Not Crossing Over Due to Duplicate Diagnosis Codes and Diagnosis Code Pointers SE1629
* 2017 Medicare Physician Fee Schedule Now Available
* Annual Update to the Therapy Code List-2017 CR9782.
-
CMS finalized CMS-4159-F, "Medicare Program; Contract Year 2015 Policy and Technical Changes to the Medicare Advantage and the Medicare Prescription Drug Benefit Programs
" on May 23, 2014.
Read the complete update
- Updates to the Remittance Advice Remark Code (RARC) and Claim Adjustment Reason Code (CARC) lists and instructs Medicare system maintainers to update Medicare Remit Easy Print (MREP) and PC Print.
Read the complete update
- There are updates to the MAC system changes, as needed, the Claim Status and Claim Status Category Codes used for the Accredited Standards Committee (ASC) X12 276/277 Health Care Claim Status Request and Response and ASC X12 277 Health Care Claim Acknowledgment transactions.
Read the complete update
- Place of Service (POS) code set by creating a new code (POS 02) for Telehealth services, effective January 1, 2017.
Read the complete update
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DHCS/Medi-Cal News
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- The CMS wants to end billions in supplemental funding that helped safety net and Medicaid providers care for the poorest people. Pass-through payments are paid to Medicaid managed care plans as "add-ons" to the base capitation rate. The plans are required to pass through these payments to contracted providers who often treat a disproportionate share of Medicaid or uninsured patients with complex or costly cases. The CMS says the additional payments are not actuarially sound since they are not directly related to contracted services.
In the final mega managed Medicaid rule
released this past summer
, the CMS told states to stop making such payments, but said they could be phased out over 10 years for hospitals and five years for physicians and nursing facilities.
That raised questions about whether new contracts could include pass-through agreements. In response, the
CMS Friday issued a proposed rule
that said only states with contracts submitted to the agency by July 5, 2016, would be able to continue pass-through payments during the transition period. Comments are due on Dec. 22.
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- There's MORE information from MOASC's Fall Clinical Staff, Billing and Administrator Programs
. Seth Eisenberg, RN, ASN, OCN® BMTCN, discussed Protection Against Hazardous Drugs. A member of the audience requested a list of drugs that were inactivated by Surface Safe. Click here to access the list.
- MOASC has been made aware of Highmark BCBS mandatory program (Highmark Medical Injectable Drug Program) eff. April 2016 under Highmark plans (MCR plans) to obtain certain oncology drugs through their specialty pharmacy. MOASC would like to get feedback from California oncologists regarding any health plans you are contracted with that is requiring white and/or brown bagging through the health plan's specialty pharmacy. Please respond with your specific circumstances regarding health plan required white/brown bagging in California to
moasc@moasc.org
. Thank you!
- The 2nd Annual UC Irvine Health Hematology Symposium, presented by the Department of Pathology and the Department of Medicine, Division of Hematology/Oncology, will take place on Saturday, March 25, 2017, at Disney's Paradise Pier Hotel, Anaheim, CA.
Topics will include:
* Molecular diagnostics in selected disorders
* Myelodysplastic syndrome
* Primer on flow cytometry for the general practitioner
* Venous thromboembolism
* Approach to the evaluation of anemia
* Selected vector-borne diseases
* Lupus anticoagulant and antiphospholipid antibody syndrome.
For registration or more information please contact Dannielle Lampkin at
dlampkin@uci.edu
or 714-456-8621 or visit the Hematology Symposium registration website,
- 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.
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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 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.
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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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- MOASC is one of over 650 groups who reconfirmed their support of the Independent Payment Advisory Board (IPAB) Repeal Sign-On Letter thus far. The deadline to join us is fast approaching; please sign-on by Monday, November 28 if your organization wishes to be part of the large group sign-on letter. The group letter will be officially released on Tuesday, 11/29 as part of a media call about IPAB repeal. Please feel free to join this call on Tuesday, November 29th at 10:00am Pacific Time. To register for the conference call, please follow this link. Use the dial-in information provided in the confirmation email to join the conference call. If you have questions, contact Frank at fwalsh@MessagePartnersPR.com; 202-868-4820.. For organizations who would like to add their organization's name to the letter, please follow this link and fill out the form. Additional background information is also available there. If you have questions please direct them to Amanda Uherek auherek@hlc.org.
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Anthem, DOJ Attorneys Present Opening Statements In Merger Trial. Attorneys for the U.S. Department of Justice and Anthem laid out their arguments Monday in opening statements of a court battle over what would be the largest ever health insurer mergers in the country. The sides clashed over how to define the commercial insurance market and what the merger could mean for the future of value-based payment models. Anthem and Cigna are proposing a $54.2 billion deal that would scramble the health insurance industry by combining two of the "big five" national insurers. Two others-Aetna and Humana-are defending their own merger that is being challenged by the DOJ. That case will be heard next month.
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COA and ASCO believe that the Medicare Part B experiment (demo) on cancer care may not come to fruition.
Late last week, top Democrats, including incoming Senate Minority Leader Chuck Schumer and House Minority Leader Nancy Pelosi, requested that the Obama administration not release the final rule implementing this perverse experiment on seniors' cancer care via drug reimbursement cuts. Combined with the fact that Friday was the last day the rule could have been released and implemented under the Obama administration - there is a 60-day hold period from the date a rule is released to when it can be put into effect - COA is extremely optimistic that the Medicare Part B experiment on cancer care is dead. There is a small chance the Part B experiment could still be released. The controversial program, proposed in March, aimed to test a new way to reimburse hospitals and doctors' offices for some prescription drugs and to shift providers to a value-based payment model.
- A newly launched interface that expands on the CMS' Quality Payment Program website lets providers automatically share electronic Medicare Quality Payment Program data, as well as develop apps for their practices, and collect and maintain QPP measures. Acting CMS Administrator Andy Slavitt said the QPP aims "to make it easier and less expensive to participate, so clinicians may focus on seeing patients."
- Read the various
summaries of the CMS Final MACRA rule
:
- 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
- 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). 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.
- A collaboration between ASCO and the American Board of Internal Medicine (ABIM) enables participants of ACSO's Quality Oncology Practice Initiative (QOPI) to receive Maintenance of Certification (MOC) Practice Assessment points from ABIM. For more information on ABIM MOC, eligibility, and requirements, please visit
http://university.asco.org/practice-assessment-activities.
- NCCN has published updated NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) with NCCN Evidence Blocks™ for chemotherapy-induced anemia (V2.2017), chronic myeloid leukemia (V1.2017), colon cancer (chemotherapy order templates), melanoma (V1.2017, chemotherapy order templates), myelodysplastic syndromes (V2.2017), non-small cell lung cancer (V3.2017), 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.
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- 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.
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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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