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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.
December 13 , 2016
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California News
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The California Medical Association has released their House of Delegates 2016 House Actions,
at CMA's 145th Annual Session in Sacramento. Click here to view the final listing of the House Actions and the rankings of the major issues. The House adopted six Bylaws changes; please click here to view the new updated Bylaws. click here to access the updated Year-Round Resolution Calendar for 2017.
- Tobacco control advocates in California say the U.S. Surgeon General's new report on the risks of e-cigarettes is right on the mark. California has already taken a number of steps to restrict their use. These include banning vaping products wherever smoking is prohibited, and raising the legal age to buy e-cigarettes to 21. In addition, the state will soon will impose a tax on e-liquids that contain nicotine, thanks to the recent passage of Prop. 56
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Noridian News
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- Noridian/JEMAC has sent postcards to providers to bring awareness of the small timeframe where they can change their participation status in Medicare. The current annual election period ends on December 31.
* MLN Connects Provider News
Announcements
--Keeping Medicare's Promise with MACRA; Submit Quality Payment Program Comments by December 19; EHR Incentive Programs: Information for CY2017 and Stage 3 Program Requirements
Claims, Pricers, and Codes
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Events
--MIPS Webinar-December 13
Publications
--SNF Quality Recording Program Video Presentation-New
* Self-Administered Drug Exclusion List-R9
* Remittance Advice (RA) Webinar-December 16, 2016
* New Physician Specialty Code for Hospitalist-Revised CR9716
* Editing of Therapy Services to Reflect Coding Changes
* Medicare Deductible, Coinsurance, and Premium Rates for 2017 CR9902
* ASP Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing Files-July 2016 CR9612.
- Clerical Corrections for Noridian Medicare Portal (NMP): As of October 3, 2016 the portal offers a new "self-service" correction feature which allows providers to reopen a claim and change the modifier, diagnosis, or have a claim reprocessed without using the available redetermination. Using this new feature allows immediate submission, provides editing and confirmation, and saves time from phone or written alternative request methods. Learn more by watching Noridian's
9-minute tutorial
.
- Social Security Number Removal Initiative (SSNRI): The
Medicare Access and CHIP Reauthorization Act of 2015
(MACRA) requires CMS to remove Social Security Numbers (SSNs) from all Medicare cards by April 2019. A new randomly generated Medicare Beneficiary Identifier (MBI) will replace the SSN-based Health Insurance Claim Number on new Medicare cards for transactions like billing, eligibility status, and claim status. Prepare for this change by visiting the new overview at:
https://www.cms.gov/Medicare/SSNRI/Index.html
and the provider web pages at:
https://www.cms.gov/Medicare/SSNRI/Providers/Providers.html
.
Medicare After Hours Education
: Noridian will be presenting a webinar one evening/late-afternoon each month for six months. The goal is to supplement your work day and support professional growth and Continuing Education Units (CEUs). The evening webinar topics and dates are now available for registration. The training topic will also be available during regular business hours that week. This gives you choices for during- and after-hour attendance. Information on the times, dates, and selected topics for these opportunities are located on the Education and Training section of our website under, Schedule of Events. (
JF Part B Link
) (
JE Part B Link
)
- Noridian received the MAC Satisfaction Indicator (MSI) survey results from CMS. Noridian appreciates your participation in the MSI survey as they, by far, received the highest survey collection rate in the nation. Opportunities Noridian will pursue this year include improving Customer Service Representative Resources for answering questions, increasing details within education presentations, and offering training using additional collaboration methods. Recommendations to improve how Noridian works with you are always welcomed.
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- Oncology Revolution: Are your treatment choices still relevant in the era of Immuno-oncology and Molecularly-targeted therapies? Join us for the 2017 MOASC Oncology Summit of Nationally known and regionally based key-opinion leaders and assess your tools for thriving in an era of Personalized Medicine! We will discuss how to use the new tools of "Personalized Medicine" to guide treatment choices for Lung Cancer, Prostate Cancer and Multiple Myeloma. This will be a practically-oriented, clinically relevant discussion and you will leave with new insights into your own practice patterns and how to make sure you are embracing the future today!
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
.
- 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.
BILLING TIP:
MOASC appreciates the questions members pose to us. Here is our most recent:
Question:
It was stated that an ABN should not be used on a routine basis, but some offices use it as protection. Is this okay to use for that purpose?
Answer
:
No, the ABN cannot be used routinely. Routine ABN's are prohibited by CMS. For more information click on the link below and go to page 6 under " Prohibitions and Frequency Limits".
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- Read
Bobbi Buell's summary and analysis of the CY2017 Medicare Physician Fee Schedule, Outpatient Prospective Payment System, and coding updates for 2017 at
www.anco-online.org/BBCY2017MPFS.pdf. Join Bobbi for her annual Medicare update webcasts on:
* December 16 at 9AM PT
- 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's SABCS Highlights 2016 will take place on January 26 at The Claremont Resort in Oakland. Download the meeting announcement and registration form at www.anco-online.org/SABCSHL2016.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. Registration and housing now open at www.multicancers.org.
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ANCO's 2016 Annual Report is now available online at
www.anco-online.org/AR2016.pdf.
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National News
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- Today, President Obama signed into law the 21st Century Cures Act. No element of the 21st Century Cures Act received greater public acclaim than the $4.8 billion in new funding for the National Institutes of Health, which Congress may parcel out to the agency over the next 10 years to pursue a "moonshot" to cure cancer, investigate brain chemistry and develop individualized or precision medicine. Seen as an opportunity for hospitals to change the way they are judged when patients are unnecessarily readmitted, the law requires Medicare to account for patient backgrounds when it calculates reductions in its payments to hospitals under the Hospital Readmissions Reduction Program. Until the passage of the Cures Act, originally meant for biomedical innovation but turned into a smorgasbord of healthcare policies, thorny questions about adjusting for patient demographics had been avoided. Hospitals have been at fault if, within 30 days after discharge, patients return to the hospital for the same reason they were originally admitted. The bill raided the Prevention and Public Health Fund to offset the costs of the Cures Act, which will inevitably impact efforts to address health threats. Through the diminishment of prevention and public health and the potential weakening of Food and Drug Administration drug and device approval standards that was the initial impetus for the bill, in inflation-adjusted dollars, NIH will probably continue to shrink over the next decade even with the Cures Act funding.
It also provides important electronic health record reforms for physicians and for the first time will penalize vendors for failing to have interoperable systems.
- The Internal Revenue Service today issued the 2017 optional standard mileage rates used to calculate the deductible costs of operating an automobile for business, charitable, medical or moving purposes. Beginning on Jan. 1, 2017, the standard mileage rates for the use of a car (also vans, pickups or panel trucks) will be:
53.5 cents per mile for business miles driven, down from 54 cents for 2016
17 cents per mile driven for medical or moving purposes, down from 19 cents for 2016
14 cents per mile driven in service of charitable organizations
The business mileage rate decreased half a cent per mile and the medical and moving expense rates each dropped 2 cents per mile from 2016. The charitable rate is set by statute and remains unchanged. The standard mileage rate for business is based on an annual study of the fixed and variable costs of operating an automobile. The rate for medical and moving purposes is based on the variable costs. Taxpayers always have the option of calculating the actual costs of using their vehicle rather than using the standard mileage rates.
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- CMS will not apply the 2017 or 2018 PQRS payment adjustments, as applicable, to any EP or group practice that fails to satisfactorily report for CY 2016 solely as a result of the impact of ICD-10 code updates on quality data reported for the 4th quarter of CY 2016. This determination was made based on the fact that CMS had examined the impact to quality measures and determined that the ICD-10 code updates will impact CMS's ability to process data reported on certain quality measures for the 4th quarter of CY 2016. The Value Modifier program will consider solo practitioners and groups, as identified by their taxpayer identification number (TIN), who meet reporting requirements in order to avoid the PQRS payment adjustment (either as a group or by having at least 50% of the individual eligible professionals in the TIN avoid the PQRS adjustment) to be "Category 1," meaning they will not incur the automatic downward adjustment under the Value Modifier program. Consistent with previously communicated eCQM reporting requirements, eligible professionals must submit eCQM data corresponding to the 2015 versions of the measure specifications and value sets (2015 Annual Update) for 4th quarter 2016 reporting. For the 2017 performance period, CMS will publish an addendum containing updates relevant to the ICD-10 value sets for eCQMs in the Merit-based Incentive Payment System Program (MIPS). CMS will provide additional information on the addendum later this year.
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Affiliate Association News
- ASCO is accepting applications for its prestigious Health Policy Fellowship. This isa 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.
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ASCO's CancerLinQ Discovery is a groundbreaking offering of CancerLinQ that will provide insights through the analysis of real-world cancer care data
. CancerLinQ Discovery will provide highly curated de-identified sets of clinical data with the objective of creating new clinical knowledge and improving patient outcomes. It will derive these sets from the the rapidly-growing CancerLinQ database that now includes over 1.5 million patient records and more than 70 oncology practices that have agreed to contribute data to CancerLinQ's core quality improvement and data-sharing platform. For more information on how to participate or partner with CancerLinQ, please visit
www.CancerLinQ.org
.
- 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 gastric cancer (V3.2016), multiple myeloma (V3.2017). 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
www.nccn.org
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AMGEN
informs ANCO and MOASC that CMS has assigned a permanent HCPCS J-code to Imlygic
(J9325, 1PFU) effective January 1.
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Genentech BioOncology
informs ANCO and MOASC that the FDA has approved
Avastin in combination with chemotherapy for the treatment of platinum-sensitive recurrent ovarian cancer (psOC), representing the first new treatment option for women with psOC in the United States in more than a decade.
- Lilly Oncology informs ANCO and MOASC that CMS has assigned a permanent HCPCS J-code to Portrazza (J9295, 1mg) effective January 1.
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MOASC CALENDAR
LunchTime Series
Oncology Roundtable Teleconference
ASCO State Affiliate
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Best of 17th WCLC (International Association for the Study of Lung Cancer, San Francisco, February 4)
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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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