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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.
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- No-cost technical assistance on MACRA for California physicians.(California News)
- FDA Reauthorization Act of 2017 signed into law. (National News)
- DHHS has delayed the 340B final rule (CMS News)
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California News
- The price disclosure bill, SB 17 by state Sen. Ed Hernandez (D-Azusa), is now one of five measures, in Sacramento, that have been proposed to tackle prescription costs.
The California Cancer PAC is "watching" this bill as it goes through various iterations. Read the most recent
Text
of the new amendments to the bill of 7/20/2017. Current law requires health care service plans and health insurers to file specified rate information with DMHC or DOI, as applicable, for health care service plan contracts or health insurance policies in the individual or small group markets and for health care service plan contracts and health insurance policies in the large group market. This bill would require health care service plans or health insurers that file the above-described rate information to report to DMHC or DOI, on a date no later than the reporting of the rate information, specified cost information regarding covered prescription drugs, including generic drugs, brand name drugs, and specialty drugs, dispensed as provided.
- The
Institute for Clinical and Economic Review (ICER) has posted a Draft Scoping Document on chimeric antigen receptor t-cell (CAR-T) therapies for treatment of B-cell malignancies. The document will be open to public comment for three weeks until August 29, 2017 at 2pm PT. It will inform a report assessing the comparative clinical effectiveness and value of CAR-T therapies, which will serve as the basis of discussion during a March 2018 public meeting of the California Technology Assessment Forum (CTAF).
- The Health Services Advisory Group, in partnership with the California Health Information Partnership & Services Organization, is providing no-cost technical assistance to physician offices in California to help them prepare for and participate in the Quality Payment Program, established by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). Read More
- Forthcoming CMA webinars include:
* MACRA: Guidance on the Merit-Based Incentive Payment System (MIPS; September 20)
* Assembly Bill 72: How to Challenge the Interim Payment for Out-of-Network Services at In-Network Facilities (September 27).
Learn more and register at
www.cmanet.org/events
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- Noridian/JEMAC has posted more updates to its website
* MLN Connects
Announcements--CMS Releases Hospice Compare Website to Improve Consumer Experiences, Empower Patients; CMS Releases Updated Data on Medicare Hospice Utilization and Payment; SNF Quality Reporting Program Web-based Training Module Available; Beneficiary Notices: Large Print Forms Available
Claims, Pricers, & Codes
--2018 ICD-10-CM Coding Guidelines and Conversion Table Available
Publications--
Medicare Parts A & B Appeals Process Booklet-Revised
* ICD-10 Coding Revision to NCDs CR10184
* Radiopharmaceutical Fee Schedule 2017 Updates-Second Correction
* MolDX: L1CAM Gene Sequencing Billing and Coding Guidelines
MolDX: SULT4A1 Genetic Testing Billing and Coding Guidelines
The MolDX: SULT4A1 Genetic Testing Billing and Coding Guidelines coverage article has been revised and published for notice. Read the complete update
MolDX: PTCH1 Gene Testing Billing and Coding Guidelines
The MolDX: PTCH1 Gene Testing Billing and Coding Guidelines coverage article has been revised and published for notice. Read the complete update
- August Webinars - Register Now
Noridian is hosting free, web-based workshops (webinars). This article includes a listing of this month's webinar topics. Read the complete update
webinars include:
* Duplicate Claims (September 13)
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- This Friday, August 25th, the Department of Managed Health Care (DMHC) invites you to a public meeting on the development of the standard formulary template as required by Senate Bill 1052 (2015). The meeting will be held at 980 9th Street, 5th Floor, Sacramento, 95814, beginning at 10:00 a.m. and ending after the last public comment is received. Seating is limited for in-person attendance and will be on a first-come, first-served basis. Participants may also join via conference line at the phone number listed in the agenda. The purpose of the meeting is to solicit public input on the draft standard formulary template in advance of the DMHC beginning the formal rulemaking process. Click
here to view the agenda for the public meeting. Click here to view the draft standard formulary template. For additional information, please contact stakeholder@dmhc.ca.gov.
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- SAVE THE DATE! Join us for the 2017 Clinical Staff, Oncology Billing & Administrator Programs. November 8, 2017- Clinical Staff Program (Nurses, pharmacists, NPP's) and November 9, 2017- Administrators Program and Billers Program, at the DoubleTree Suites by Hilton Anaheim Resort, from 8:30am to 12:30pm. Topics to be presented and discussed are: Pharmacy Standards/USP Regulations; Immunotherapy and Targeted Therapy; MACRA/MIPS; Pain Management; A/R & Billing Updates, and more. For more
information contact the MOASC office at
moasc@moasc.org or 909-985-9061 x1.
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- The Conquer Cancer Foundation of the American Society of Clinical Oncology is now accepting applications for the 2018 Young Investigator Award (YIA). The Association of Northern California Oncologists (ANCO) is funding one 2018 YIA for a qualified northern California applicant, and urges all eligible northern California physicians to apply. The YIA is a one-year, $50,000 grant that provides research funding to promising physicians to support their transition from final years of training to faculty appointment and to encourage and promote quality research in clinical oncology. Applications in all areas of cancer research are accepted from U.S. and international applicants. For 2018, CCF has dedicated funding for the following areas: breast cancer, northern California researchers, global oncology, kidney cancer, lung cancer, pediatric cancer, sarcoma, and supportive care. Other areas of interest include cholangiocarcinoma, chronic lymphocytic leukemia, gynecological caners, and melanoma. YIA applications opened on July 1 and are due by 11:50PM ET on September 21. Eligibility criteria, award details, and the request for proposals are available on the CCF website (
www.conquer.org/YIA). For questions about the YIA or assistance with your application, please e-mail grants@concquer.org.
- ANCO's 2017 Professional Education Meeting will take place on September 6 at the San Jose Fairmont and feature talks on QPP/MACRA, ASCO's COME HOME Project, USP 797/800, and California Legislative/Regulatory Updates. Download the meeting announcement and registration form at
www.anco-online.org/ProfEduc2017.pdf.
- ANCO's 3Q2017 Hematologic Malignancies Update will take place on September 9 at the Stanford Park Hotel in Menlo Park. Watch for a meeting announcement in late July. Bruno Medeiros, M.D., Stanford University, Charalambos Andreadis, M.D., University of California, San Francisco, and Brian Sworder, M.D., Ph.D., Stanford University, will review the latest research on novel treatment modalities for leukemia and lymphoma, along with case studies for these diagnoses. These Updates are supported by Janssen Biotech, Merck, Pfizer Oncology, and Pharmacyclics. Download the meeting announcement and registration form at
www.anco-online.org/3Q2017HemeMalig.pdf.
- 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 to register your interest in receiving registration and housing information when it becomes available in the Fall.
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- Last Friday, President Trump signed into
law the FDA Reauthorization Act of 2017. The
measure will help ensure the Food and Drug Administration can continue to oversee drug and device approvals.
The FDA and the pharmaceutical industry, together, fought to ensure the package would become law before existing agreements expire at the end of September. The industry will pay more than $1 billion toward the agency's oversight efforts, per an agreement with lawmakers and the FDA. Both industry and the agency say the "user fees" are critical to keeping the lights on at the FDA.
- More than 1 million American women who have had breast or ovarian cancer are not getting a simple genetic test that will determine whether they carry a mutation that puts them at higher risk of a recurrence, according to a UCLA study published Friday. Up to 10 percent of women who have, or have had, breast cancer, and up to 15 percent of those with a history of ovarian cancer, carry inheritable mutations that put them at higher risk of the cancer returning, says the study, which was published Friday in the Journal of Clinical Oncology.
- A small pharmacy in Utah and a doctor's office in Tennessee have been implicated in an alleged kickback scheme that used San Diego County Marines to defraud the military's health insurance provider out of at least $67 million, according to court records filed in San Diego by federal authorities. The allegations add to a growing number of investigations into fraudulent prescriptions of compound medications - high-priced drugs custom-made by pharmacists to tailor to a patient's specific needs. The investigations have led to arrests in similar cases across the country and a change in how TRICARE - which serves 9.4 million active, retired and reserve military and their families - bills for such drugs.
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- The need to have end-of-life planning conversations with your critically ill patients, taking a half hour or more for those talks is covered by Medicare. CMS finalized the creation of the new codes in the 2016 physician fee schedule and allowed clinicians to bill Medicare for those conversations. The CMS rates range from $80 to $86 for the first 30 minutes and about $75 for each additional 30 minutes. The creation of this new billing code has been an important catalyst for ensuring that providers, Medicare beneficiaries and their families all know the patient's desired care for his or her final days and preventing unwanted, intensive medical interventions from being performed.
- The Department of Health and Human Services has delayed until July 2018, the 340B final rule, which would penalize pharmaceutical companies that knowingly overcharge hospitals for drugs purchased through the program. A panel that advises HHS on outpatient hospital payments wants the CMS to drop a draft rule that could cut up to $1.65 billion out of the 340B discount drug program. Yesterday, the Advisory Panel on Hospital Outpatient Payment asked the CMS to rescind its proposal to pay hospitals 22.5% less than the average sales price for drugs acquired under the program. 340B aims to reduce operating costs for hospitals that see a disproportionate share of low income patients. The outpatient payment panel was created by a federal law that dictates HHS must assess how policies affect hospitals. The panel, made up of industry leaders, has proved influential.
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Affiliate Association News
- ASH members can now sign up to report data for the Medicare MIPS through Healthmonix's MIPSPRO, a 2017 Qualified MIPS Registry. Learn more at
http://www.healthmonix.com/mips-pro/.
- ASH's Meeting on Hematologic Malignancies will be held in Chicago, IL, September 8-9, 2017.
The program's "How I Treat" presentations showcase speakers' evidence-based treatment approaches, identify cutting-edge scientific data that can be translated into new strategies for diagnosis and treatment, and address what to do in cases where there is no data. This meeting is a unique opportunity to join colleagues and top experts in treatment of hematologic malignancies in an intimate, smaller-meeting setting and discuss the latest drug developments and most relevant research findings advancing patient care today. For information related to next year's meeting, visit
www.hematology.org/malignancies !
- NCCN has published and/or updated their Chemotherapy Order Templates; Clinical Practice Guidelines in Oncology, Drugs & Biologics Compendium; Evidence Blocks; Guidelines for Patients; Imaging Appropriate Use Criteria; and/or, Radiation Therapy Compendium for hepatobiliary cancers (V3.2017);
Smoking Cessation (V2.2017).
NCCN has also published the following correction to the NCCN Chemotherapy Order Templates (NCCN Templates®): A dosing error that would lead to underdosing
of methotrexate was found on the following chemotherapy order template. This error occurred on June 27, 2017 when the chemotherapy order templates were migrated into a new computer program. This template was republished with the correct dosing on August 17, 2017 when the error was discovered. HyperCVAD (Cyclophosphamide/VinCRIStine/DOXOrubicin/Dexamethasone + RiTUXimab (Cycle A) alternating with High-Dose Methotrexate/Cytarabine + RiTUXimab (Cycle B MCL17b - High-Dose Methotrexate/Cytarabine + RiTUXimab (Cycle B) course.
Correct dosing is as follows
:
Methotrexate
200 mg/m2 over 2 hours on Day 1 followed by
800 mg/m2 IV continuous infusion over 22 hours on Day.
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- AstraZeneca
informed MOASC and ANCO that the U.S. Food and Drug Administration granted regular approval to olaparib tablets
(Lynparza, AstraZeneca) for the maintenance treatment of adult patients with recurrent epithelial ovarian, fallopian tube, or primary peritoneal cancer, who are in a complete or partial response to platinum-based chemotherapy. For more information click
here.
- Wyeth Pharmaceuticals, a division of Pfizer, informs ANCO and MOASC that the United States Food and Drug Administration has approved Besponsa for the treatment of adults with relapsed or refractory B-cell precursor acute lymphoblastic leukemia (ALL).
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MOASC CALENDAR
Professional Educational Series
November 8-9
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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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