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.
 
 
May 23, 2017
 
This Weekly's Hot Topics
  • ACT NOW to STOP Gov. Brown from stealing your money! 
    California News
  • Welcome MOASC's newest Board Member, Dr. Himani Singh! MOASC News
  • Support Barbara McAneny, M.D. for President-Elect of the AMA.! ANCO News

 


California News 

Gov. Brown released the 2017-18 May revised budget last week, and it still takes tobacco tax revenues (from Proposition 56) away from increasing provider reimbursements to fill gaps in the General Fund. This is completely unacceptable!

It is important that you  act NOW!

- The California Medical Association is launching a letter-writing campaign to California's legislative elected officials. You are provided a template to write your Assemblymember and Senator, urging them to oppose a budget that uses Prop 56 funding for any other purpose other than improving access by improving provider reimbursements.
Identify your Senator and Assemblymember by entering your residential address at http://findyourrep.legislature.ca.gov.
Ask your patients to do the same!
Download and open this Word doc, then enter information relevant to your legislative representative (both Assembly and Senate) and practice.
Please take the time to personalize and sign the letter.
Print, sign and mail to:
Legislator Name
State Capitol
Sacramento, CA 95814
Email grassroots@cmanet.org stating that a letter was sent on your behalf.
A roster with legislative information is also available for your reference.
If you have any questions, please contact Yna Shimabukuro at yshimabukuro@cmanet.org.
Thank you,

California's latest attempt at creating a state-run health care system faced a critical juncture yesterday, Monday. Senate Bill 562, titled the Healthy California Act, went before the state Senate appropriations committee in Sacramento. The bill lays out a plan to provide universal single-payer health coverage for California, had passed the California Senate health committee in April. SB 562 would establish a nine-member board to oversee health care in the state and create a trust fund to help pay for the program. What it doesn't include is a detailed plan to show where the rest of the funds would come from. The bill could cost Californians more and faces substantial hurdles to enact. But it promises to provide everybody in the state - including those here illegally - with care that in most cases would be superior and easier to access than what they have now. "It's the only way to guarantee health care for every Californian in a sustainable way, especially given efforts in Washington to roll back coverage," said Michael Lighty, director of public policy for the California Nurses Association. The union is sponsoring the measure.
 
AB 265 - Co-Pay card ban bill is in appropriations committee and could soon make its way to the floor for a vote. Since the introduction of the bill there have been several amendments, however there are still a few issues outstanding that could impact patients' ability to access medications that their provider prescribed. One issue still outstanding is that cancer patients that have gone thru the insurance requirement of step therapy, and/or prior authorization, cannot use a co-pay/discount card.
MOASC encourages you to send a letter to Assemblymember Wood (Health Chair), asking for further amendments for issues outstanding. Thank you for sending a letter earlier, this follow up letter could thank the author for working on the bill to include amendments and suggest that he consider two additional amendments that would allow patients greater access to medications. (see outstanding issues listed below).
What AB 265 does (as amended 5/18/2017):
- Allows patients to use copay coupons for branded medicine (medicine with no generic available).
- Allows copay coupons for single tablet drug treatments for HIV or AIDS.
- Manufacturers can offer free medicine.
- Independent charity patient assistance programs are exempted.
Issues outstanding:
- Prohibits copay coupons for a generic drug when there is a less expensive drug available on the formulary.  For example, a patient could not use a copay coupon for a branded generic if the generic version was on the formulary for a lower copay.  They would see their copays increase from $4 to $60 in many cases.
- Prohibits patient assistance programs from providing discounts on medicine to patients with insurance.
Would these outstanding issues be important enough that YOU would weigh in? Would you have time to send in a letter this week? AB265.  Please contact moasc@moasc.org if you have any questions regarding this bill. Thank you!
 
- CMA is hosting a webinar entitled How California Physicians Can Access Free Technical Assistance for MACRA Transition on May 31 at 12:15PM. Register for the webinar at www.cmanet.org/events.
 
The California Medical Association's (CMA) Board of Trustees is seeking applications or nominations for members interested and willing to serve on CMA's Standing Councils and Subcommittees for 2017-18. The Committee on Nominations will also contact each Council/Subcommittee Chair for evaluation of their respective committee members, and Component Medical Societies may also inquire about a member's performance.
Term Length/Duration : One (1) year
Time Commitment : Up to four (4) meetings per year with one (1) potentially in-person. Council meets as needed.
Requirements : Member of the CMA in good standing.
Staff Contact : Michelle Chapanian, (916) 551-2054, mchapanian@cmanet.org
DEADLINE: June 13, 2017.
Please submit to nominations@cmanet.org with a completed application form (PDF or Word), brief CV (less than five pages) and statement of interest.



Noridian News
 
Noridian/JEMAC has posted the following updates to its website http://med.noridianmedicare.com/web/jeb:
* MLN Connects Provider News
Announcements --Clinical Laboratories: Lab Data Due May 30; SNF Quality Reporting Program: Submission Deadline Extended to June 1
Claims, Pricers & Codes --2018 ICD-10-PCS Files Available
Events --
Publications--Updated Manual Guidelines for Electronic Funds Transfer Payments and Change of Ownership MLN Matters Article-New
* Draft LCDs Published for Review and Comments
* Redetermination Requests Now Accepting Electronic, Digital and/or Digitized Signatures
* NMP22 Bladder Check Test for Monitoring Bladder Cancer Article Retirement-Effective May 15, 2017
* There is Still Time to Evaluate Our Services! Read the complete update
* MRI and CT Scans of the Head and Neck Draft LCD Published for Review and Comment
* Advance Beneficiary Notice of Nonycoverage-New Version Effective June 21, 2017
* New Waived Tests CR10055
*MolDX: Oncotype DX Genomic Prostate Score for Men with Favorable Intermediate Risk Prostate Cancer Draft LCD Published for Review and Comments. The draft Local Coverage Determination (LCD) has been published for review and comment on the Noridian website. Read the complete update
* MolDX: EndoPredict Breast Cancer Gene Expression Test Draft LCD Published for Review and Comments. The draft Local Coverage Determination (LCD) has been published for review and comment on the Noridian website. Read the complete update
 
Forthcoming Noridian/JEMAC May 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  here or at  http://med.noridianmedicare.com/web/jeb/education/training-events
* Noridian Medicare Website Tour for Part B Providers (May 23)
* Mammography, Pap Test, Pelvic Exam, and Cervical Cancer with HPV Tests (May 31)
* Supplemental Medical Review Contractor (SMRC, May 31)
* Noridian Medicare Portal Registration and Functionality (June 7, 14)
 
Effective June 21, 2017, providers MUST use the most recent version of the Advance Beneficiary Notice of Noncoverage (ABN) Form CMS-R-131 with the March 2020 expiration date. If the new form is not used on or after this date, any new ABN executed on the old form will be considered invalid and would result in provider liability if Medicare denies the claim. For more information please go to  https://www.cms.gov/Medicare/Medicare-General-Information/BNI/ABN.html



  MOASC News

MOASC Board of Directors and Officers are pleased to announce MOASC's newest Board Member, Dr. Himani Singh. Dr. Singh recently moved from New York to California and is currently working with North County Oncology in Oceanside.
Her main focus is "...providing compassionate, quality cancer care and giving patients the knowledge to make the most empowered decisions about their cancer diagnoses." She is Board Certified, with experience delivering care to underserved populations and working effectively with multidisciplinary teams of all sizes. Her background encompasses solid oncology, hematologic malignancies, benign hematologic disorders and cancer survivorship. She is seeking to be a partner to patients in the midst of embarking on treatment plans, always keeping their interests at the forefront.  Please join us in welcoming Dr. Singh to the MOASC Board!
 
MOASC's LunchTime Series presentation of, The QOPI® Reporting Registry - 2017 MIPS and Beyond! Is scheduled for next Wednesday, May 31st at 12:00pm. This webinar is a quick overview of the pieces of MACRA for 2017 and requirements for successful 2017 MIPS reporting. Tools for the QOPI Reporting Registry offers to help providers successfully complete their 2017 reporting. You will explore the various options practices have to participate in the 2017 MIPS reporting through the QOPI Reporting Registry. Presented by Whit Lloyd, ASCO's QOPI Practice Integration & Support Administrator. RSVP to  moasc@moasc.org  or call 909-985-9061x1.
 
SAVE-THE-DATE, for the MOASC and the University of California Irvine presentation of the 3rd Annual Spotlight on ASCO, Saturday, July 29 at the Waterfront Beach Resort, Huntington Beach. Topics to be addressed, at this time are: ASCO Abstract Highlights, Colorectal & Gastro-Esophageal cancer, Breast cancer and Lung cancer.
 
Renew your MOASC Membership TODAY! Continue your investment in your association.  We truly appreciate your devotion to serving the California oncology community! In an uncertain economy combined with the rapid changes to healthcare and its delivery, you are required to stay one-step ahead and keep informed. In order to achieve success, you need the right tools and resources; MOASC is the association that can bring those tools to you and your practice.
You have read, in this publication, of MOASC's successful collaborative efforts in Sacramento and Washington DC. 
Renew your membership in two ways:
1.       Print the application HERE . M ail application with your check to:   Medical Oncology Association of Southern California , P.O. Box 161, Upland, CA  91785
2.       Go to www.moasc.org and pay via PayPal.

 

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ANCO News  
 
- ANCO urges all members to support and ASCO has endorsed Barbara McAneny, M.D., in her campaign for President-Elect of the American Medical Association (AMA).  She is a medical oncologist/hematologist from New Mexico and would be the first oncologist elected to serve as AMA President. Dr. McAneny is an active ASCO volunteer who has served on the ASCO Board of Directors (2005-2008) and as a liaison to the AMA House of Delegates (2002-2013). She has also long been active in the AMA, and is past Chair and member of the AMA Board of Trustees. ANCO asks all members who are also AMA members to reach out to their AMA delegates and encourage them to vote for Dr. McAneny for President-Elect in the June 2017 election. For more information, visit  www.barbaramcaneny.com .
 
ANCO's ASCO Highlights 2017 will not take place in 2017 in lieu of our encouragement of members to attend ASCO's Best of ASCO in San Francisco ( http://west-boa.asco.org ; June 16-17). However, ANCO will host an event on June 15 entitled The State of Cancer Care with Wes Kidder, M.D., and Margaret Tempero, M.D., University of California, San Francisco, at the San Francisco Marriott Marquis.  Download the meeting announcement/registration form at  www.anco-online.org/ANCOatBOA2017.pdf .



National  News

-The House Energy and Commerce health subcommittee advanced the FDA user fee reauthorization bill after adopting an amendment aimed at preventing massive price increases on drugs without generic competition. The so-called "bad actor" provision is not included in the Senate version of the bill.
 
- The Department of Justice released news on May 18, 2017 regarding a whistleblower case being settled by two Southwest Missouri health care providers.  The allegations settled arose from a lawsuit filed by a whistleblower , a physician, who was employed by one of the Defendants, under the qui tam provisions of the False Claims Act . The defendants, submitted false claims to the Medicare Program for chemotherapy services.  These services were rendered to patients referred by oncologists whose compensation was based in part on a formula that improperly took into account the value of their referrals of patients to the infusion center operated by the Defendants. Federal law restricts the financial relationships that hospitals and clinics may have with doctors who refer patients to them.  Click Here to read more about this case. 
 
The Department of Justice's increased focus on investigating alleged fraud in the Medicare Advantage program is likely to change the way insurers do business, according to lawyers who specialize in False Claims Act suits. The Justice Department in recent weeks has filed complaints in two Medicare Advantage fraud suits against UnitedHealth Group. The federal government and whistle-blowers allege the insurer presented false claims to the Medicare program and received at least $1 billion in unjustified payments stemming from inflated patient risk scores. The agency is also investigating Aetna, Health Net, Humana and Cigna's Bravo Health to determine if they have been engaging in medical up-coding.



CMS News

Subscribers of the PQRS listserv are encouraged to sign up for the new CMS Quality Payment Program listserv.  The Quality Payment Program is part of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) and includes two tracks - Advanced Alternative Payment Models (APMs) and the Merit-based Incentive Payment System (MIPS).
MIPS will replace three Medicare reporting programs:
EHR Incentive Program (Meaningful Use)
Physician Quality Reporting System
Value-Based Payment Modifier
The Quality Payment Program listserv will provide news and updates on:
New resources and website updates
Upcoming milestones and deadlines
CMS trainings and webinars
The Quality Payment Program's first performance period opens on January 1, 2017 and closes December 31, 2017. Participation in MIPS can start as early as January 1, 2017 or as late as October 2, 2017. The first payment adjustments based on performance go into effect on January 1, 2019. Subscribe to the Quality Payment Program listserv to receive reminders for all of these important deadlines.
To subscribe, visit the Quality Payment Program website and select "Subscribe to Email Updates" in the footer. The Education & Tools page includes program resources to help you learn more about eligibility and how to participate.



Affiliate Association News 

ASCO has endorsed Barbara McAneny MD in her campaign for President-Elect of the American Medical Association (AMA). ASCO invites members who are AMA members to reach out to their AMA delegates and encourage them to vote for Dr. McAneny for President-Elect in the June 2017 election. For more information about Dr. McAneny and her positions on important healthcare policy issues, visit www.barbaramcaneny.com.
 
Have you or your colleagues worked to implement appropriate use strategies in your practice, institution, or hospital system? If so, ASH encourages you to submit a nomination to be one of this year's three ASH Choosing Wisely Champions.  Presented in cooperation with the ABIM Foundation, the Choosing Wisely Champions initiative was created to recognize the efforts of practitioners who are working to eliminate costly and potentially harmful overuse of common tests and procedures, and to provide annual meeting attendees with an opportunity to learn about projects that might be translated to their own practices. Clinicians, researchers, or trainees at all levels in both academic and community settings are encouraged to apply by June 1.
 
- ASCO recently submitted comments to CMS on measuring and comparing oncologists and other health care providers based on cost under QPP MIPS . It expressed concerns with the proposed method of creating "episodes of care" or "episode groups" to determine the cost of cancer care. The significant variation in conditions and disease states within cancer care creates significant difficulties in designing episodes of care that fairly and accurately attribute costs to oncologists. Read ASCO's full comment letter at  www.asco.org/sites/new-www.asco.org/files/content-files/ASCO-Comments-Episode-Groups-04.24.17.pdf .
 
ASCO's COME HOME, an oncology medical home program provides readiness assessment tools to help practices evaluate whether or not they are ready to transition to the MIPS or to an APM within QPP, as well as implementation tools to help practices actually make the change. For more information, please visit  http://www.asco.org/practice-guidelines/practice-support/asco-consulting-services/asco-come-home .
 
ACCC has launched The Financial Advocacy Boot Camp, a free online training program designed for all those who work to assist cancer patients in navigating financial issues related to their cancer treatment. Learn more at  http://accc-cancer.org/resources/FinancialAdvocacy-bootcamp.asp .
 
2017 ASCO Annual Meeting  is June 2-6 at McCormick Place, Chicago.  Don't miss engaging education sessions, discussing practice-changing research, and connecting with global experts in oncology. View all session details, including faculty, presentation titles, and times in the  preliminary program.   Register and reserve your hotel . Limited hotel rooms are available. Join ASCO today and save even more!
 
The MASCC/ISOO Annual Meeting on Supportive Care in Cancer is taking place in Washington D.C, 22-24 June 2017. The MASCC/ISOO content is geared to the full range of specialties and allied professions, enabling the whole oncology team to come together to discuss issues of mutual interest on a global platform. As it aims to address some of the 'hottest topics' in Supportive Care in Cancer, the outstanding scientific program of the 2017 MASCC/ISOO Meeting will include plenary sessions on financial toxicity, precision medicine, and immunotherapy side effects. The MASCC/ISOO 2017 scientific program has been accredited with 19.5 AMA (American Medical Association) PRA category 1 credit(s)TM for physicians and 19.5 ANCC (American Nurses Credentials Center) contact hours for nurses. Open this flyerfor more information. Register before 7 June 2017 and benefit from registration savings!
  
NCCN has published updates to the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®), et.al., for: adult cancer pain (V2.2017); bladder cancer (V4.2017); non-small cell lung cancer (V6.2017); ovarian cancer (V1.2017); pancreatic cancer (V1.2017) and thyroid carcinoma (V2.2017) .  For the complete updated versions of the NCCN Guidelines, et.al., please visit  NCCN.org .



Industry News 
 
- Astrazeneca informs MOASC and ANCO that the US FDA has  granted accelerated approval to  IMFINZI™ (durvalumab) for the treatment of patients with locally advanced or metastatic urothelial carcinoma who have disease progression during or following platinum-containing chemotherapy, or whose disease has progressed within 12 months of receiving platinum-containing chemotherapy before (neoadjuvant) or after (adjuvant) surgery. To learn more, please visit  www.imfinzi.com
 
Merck informs ANCO and MOASC that the US FDA has approved Keytruda for patients with locally advanced or metastatic urothelial carcinoma who have disease progression during or following platinum-containing chemotherapy or within 12 months of neoadjuvant or adjuvant treatment with platinum-containing chemotherapy. In addition, the FDA has approved Keytruda for patients with locally advanced or metastatic urothelial carcinoma who are not eligible for cisplatin-containing chemotherapy.
 
Novartis Oncology informs ANCO and MOASC that the US FDA has approved the Kisqali Femara Co-Pack for the treatment of hormone receptor-positive, human epidermal growth factor receptor-2 negative (HR+/HER2-) advanced or metastatic breast cancer in postmenopausal women.
 





In This Issue
MOASC CALENDAR
 

ASCO National Meeting in Chicago
June 2-6, 2017
 
 
Spotlight on ASCO
July 29, 2017
 
ANCO  
CALENDAR
   
The State of Cancer Care (San Francisco, June 15)

(San Francisco,
June 16-17) 

(ANCO Member Discount Code IBW17ANCO, San Diego, July 14-15)

(ANCO Member Discount Code ILC17ANCO,
 Huntington Beach, July 27-29) 

12th Annual Congress: Hematologic Malignancies (NCCN, San Francisco, October 6-7)


 
 
 
 
 
 
 
 
 
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