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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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This Weekly's Hot Topic
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- AB 1107 (Nazarian) held in Assembly Appropriations Committee (California News)
- New ABN must be used eff. 06/21/17 (Noridian News)
- July 1st deadline for hardship exceptions from meaningful use requirements (CMS News)
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California News
- Having worked many hours with the Assemblyman and many hours of negotiations in the legislative halls of Sacramento, the California Cancer PAC is disappointed to have to report that our bill AB 1107 (Nazarian) transparency of insurance company generated pathways, was held in Assembly Appropriations Committee. Despite the good meetings MOASC & ANCO had with all Committee members and the Chair's office, we believe the politics around the bill was too much for passage at this time. We will need to think through how best to address this issue as we move forward and continue to keep you informed. The California Oncology Weekly has reported on this bill for the past 6 months.
The status on a couple more bills being monitored and opposed by the Cal Cancer PAC:
- AB 265 (Wood): Prescription drugs: prohibition on price discount. The bill will prohibit pharmaceutical manufacturers from offering a coupon for patients when there is a less expensive alternative (e.g., generic) available. The bill is author-sponsored and is supported by health plans, PBMs, and opposed by patient groups and biopharmaceutical industry. The bill continues to be amended. The bill passed the Assembly Floor with a 51-15-14 vote and now awaits action in the Senate.
- AB 315 (Wood): Pharmacy benefits management. The bill will regulate pharmacy benefit managers (PBMs) in California and require PBMs to provide information to purchasers concerning the aggregate acquisition cost from pharmaceutical manufacturers as well as aggregate rates negotiated with pharmacies. The legislation sheds new light on a significant player in the pharmaceutical supply chain. The bill is supported by organized medicine, pharmacists, consumer groups, and opposed by PBMs and health plans. The bill passed the Assembly Floor on a 58-7-15 vote and awaits action in the Senate.
- The California Medical Association (CMA) has developed resources to help physicians navigate the new out-of-network billing and payment law (AB72) that takes effect on July 1. The resources are available at www.cmanet.org/ab-72.
- Mindcotine, a startup in California, has created a prototype of an app that combines mindfulness and meditation with virtual reality to help people quit smoking. The app "combines technologies and techniques that, independently, have proven helpful to treat different disorders and conditions."
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* MLN Connects Provider News
Announcements
--New Medicare Cards Offer Greater Protection to More Than 57.7 Million Americans; EHR Incentive Programs: Submit Comments on Proposed Changes by June 13; New Quality Payment Program Resources Available; Review 2017 EHR Incentive Program Requirements
* Submitting Enrollment Applications Online-Learn How To Get Started!
* Advance Beneficiary Notice of Nonycoverage-New Version Effective June 21, 2017
* Recovery Auditor Region 4 Website and New Issues
* Diagnostic and Therapeutic Colonoscopy Final LCD-Effective July 17, 2017
* Claim Status Category and Claim Status Codes Update CR10043
* HCPCS Drug/Biological Code Changes-July 2017 Update CR10107
- Register now for forthcoming Noridian/JEMAC June webinars. Read the complete update of Noridian hosted, free web-based workshops (webinars) or go to
* 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.
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- Read MOASC President, Warren Fong, M.D.'s letter to the editor in The Hill . Dr. Fong spoke at the recent 340B Leadership Summit in Washington DC.
- Read Dr. Fong's brief to the MOASC Board regarding his conversation with California Assembly Health Committee consultant, Dr. John Gilman, regarding California legislation AB 265. Dr. Fong's Memo AB265
- SAVE-THE-DATE, for MOASC's Spotlight On series presentation by the University of California Irvine 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. Mail application with your check to: Medical Oncology Association of Southern California, P.O. Box 161, Upland, CA 91785
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- 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.
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- Senate GOP leaders plan to vote as soon as this month on the AHCA. The Senate GOP leaders plan to present Senate Republicans with options for major policy decisions for their health care bill at a closed-door meeting today. Proposals likely to be under consideration include a prolonged phaseout of the Affordable Care Act's expansion of Medicaid, and steps to stabilize the individual insurance markets.
- Food and Drug Administration is looking at ways to increase price competition for high-priced generic drugs. The effort could include having the agency prioritize applications in cases where there are fewer than three competing generic manufacturers for a treatment.
- The Illinois Department of Insurance is investigating how Blue Cross and Blue Shield of Illinois treats customers, for the first time since 1990. The review generally examines how insurance companies pay claims, respond to consumer complaints and advertise, in order to ensure they comply with consumer-protection laws and verify that an insurer is operating within regulatory bounds. State regulators have conducted several broad reviews of UnitedHealthcare of Illinois, Cigna Healthcare of Illinois, Aetna Health of Illinois and Humana Health Plan.
Examples of problems include failing to confirm to a customer in a timely manner whether a provider is covered, or failing to adequately explain why a claim was denied.
Blue Cross is the largest insurer in Illinois, covering 4.1 million people and employing almost 10,000. It also has made at least $254,000 in campaign contributions to state politicians in 2015 and 2016. If an insurer is found to have problems, it must work with regulators to fix the issue and possibly pay penalties.
- United Healthcare's Network Bulletin (June 2017) is now available online at
www.unitedhealthcareonline.org > Tools and Resources > News and Network Bulletin and features articles on a new telemedicine policy, colorectal cancer screening webinars, and an important change to the network DME providers.
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With the deadline of July 1, CMS has announced that it is now accepting hardship exceptions from the meaningful use requirements of the EHR incentive payment program for the 2016 reporting year.
Physicians who can show that demonstrating meaningful use would result in a significant hardship can apply for a one-year exception and avoid a negative payment adjustment in 2018. To be considered for an exemption (to avoid a payment adjustment), you must complete a hardship exception application and provide proof of the hardship. If approved, the hardship exemption is valid for one payment year. You would need to submit a new application for subsequent years. Physicians who have never before successfully attested to meaningful use under the EHR incentive program and are transitioning in 2017 to the new Merit-Based Incentive Payment System (MIPS) may also apply for a one-time hardship exception to avoid a 2018 payment adjustment. The exception deadline for physicians transitioning to MIPS is October 1, 2017. For more information and applications,
click here
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Affiliate Association News
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Register before June 7, 2017 and benefit from registration savings for
t
he MASCC/ISOO Annual Meeting on Supportive Care in Cancer is taking place in Washington D.C, June 22-24 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 flyer for more information.
- The ASCO Nominating Committee invites all ASCO members to recommend potential candidates for the ASCO Election for service beginning in June 2018. Visit www.asco.org/election to recommend colleagues for open positions on the Board of Directors or Nominating Committee through June 12.
- MOASC, ANCO, COA and ASCO have endorsed Barbara McAneny MD in her campaign for President-Elect of the American Medical Association (AMA). Members who are also AMA members are asked 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.
- ASH is now accepting nominations for members to participate in its seventh annual Advocacy Leadership Institute that will take place September 27-28, 201
7, in Washington, DC. This two-day workshop is an exciting opportunity for ASH members who wish to learn about legislation and health policy affecting hematology research and practice. The first day of
the Institute will include sessions featuring guest speakers from Congress and the Administration. On the second day, participants will visit their congressional delegation on Capitol Hill to apply what was learned on the first day. Nominations are being accepted through June 16. Self-nominations are welcome, and individuals may nominate more than one colleague. To submit a nomination or to learn more about this opportunity, visit the
ASH website.
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A new white paper released by the Community Oncology Alliance (COA) and the Community Oncology Pharmacy Association (COPA) continues to shine a light on the negative impact pharmacy benefit managers (PBMs)
have on the care cancer patients receive.
Compiling real stories of cancer patients and physicians, the white paper "Unaccountable Benefit Managers: Real Horror Stories of How PBMs Hurt Patient Care" presents true patient stories collected from community oncology practices over the last year. The serious, sometimes dangerous, stories told in the paper include PBMs changing prescriptions without authorization, medication being refilled for deceased patients, and patients facing weeks of delays in receiving needed medications. Read the full white paper "Unaccountable Benefit Managers: Real Horror Stories of How PBMs Hurt Patient Care."
- The ASCO Guidelines App is your go-to tool for implementing guideline recommendations into practice. Visit www.asco.org/guidelines or www.asco,org/apps to download the app.
- ANCO and MOASC encourage all members to participate in ASCO's Practice Census, the only annual survey of the entire oncology community that aims to capture and describe changes in cancer care and oncology practice over time. Be counted by going to https://apps.asco.org/oncology-practice-central/survey.
- NCCN has published updates to the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®), et.al., for: acute lymphoblastic leukemia (V1.2017); breast cancer (Stage III, Patients, V1.2017); chronic lymphocytic leukemia/small lymphocytic lymphoma (V2.2017); diffuse large B-cell lymphoma (V32017); follicular lymphoma (V3.2017); head and neck cancers (Imaging AUC); hepatobiliary cancers (V2.2017); kidney cancer (Patients, V1.2017); palliative care (V2.2017); thyroid carcinoma (Imaging AUC). For the complete updated versions of the NCCN Guidelines, et.al., please visit
NCCN.org.
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- Novartis Oncology informs ANCO and MOASC that the United States Food and Drug Administration has granted regular approval to Zykadia for patients with metastatic non-small cell lung cancer (NSCLC) whose tumors are anaplastic lymphoma kinase (ALK)-positive as detected by an FDA-approved test. Prescribing information may be accessed via
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MOASC CALENDAR
ASCO National Meeting in Chicago
June 2-6, 2017
Spotlight on ASCO
July 29, 2017
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(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)
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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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