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.
March 13, 2018
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- This Week! The 18th Multidisciplinary Management of Cancers: A Case-based Approach returns to the Silverado Resort and Spa, March 16-18, 2018. Go to www.multicancers.org for more information. (ANCO News)
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California News
- The California Medical Association (CMA) is sponsoring AB2674 to increase penalties on DMHC regulated health plans that engage in unfair payment patterns. The legislation would require DMHC to investigate provider complaints that a health plan has underpaid or failed to pay the provider as required by State law and would require a penalty amount at least equal to the amount of the underpayment plus interest. To support CMA's efforts, please complete their survey no later than March 16 at
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- The annual MAC Satisfaction Indicator (MSI) survey will be conducted this month. The MSI measures your satisfaction with our processes and service delivery so we can gain valuable insights and determine process improvements. Thanks for your feedback in 2017. You may
read
about the changes made based on last year's survey.
- The Noridian portal offers access to view claim processing comments if a claim had a history of being reviewed for additional documentation. NMP will offer a "View Noridian Comments" link under "Related Inquiries" in the claim header. Visit the Noridian Medicare Portal End User Manual for more information.
- Noridian/JEMAC has posted more updates to its website:
* MLN Connects
News & Announcements--
New Medicare Card Transition Begins In Less than a Month; MACRA Funding Opportunity: Measure Development for the Quality Payment Program; Quality Payment Program: Submit 2017 Participation Data through March 31; EHR Incentive Programs FAQs
Claims, Prices & Codes
--April 2018 Average Sales Price Files.
The HCPCS Drug/Biological code set changes are updated on a quarterly basis. Change Request (CR) 10454 informs MACs of the April 2018 updates of specific biosimilar biological product HCPCS code, modifiers used with these biosimilar biologic products and an autologous cellular immunotherapy treatment. Read the complete update
Publications
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*The MolDX Molecular Test Registration and Claims Submission - R3 coverage article has been revised on the Noridian website. Read the complete update
* Positron Emission Tomography Scans Coverage-R13
* Appropriate use Criteria for Advanced Diagnostic Imaging Voluntary Participation and Reporting Period-Claims Processing Requirements-HCPCS Modifier QQ CR10481
- Upcoming Noridian/JEMAC webinars include:
* Compliance Program-What Every Provider Needs to Know (March 15)
* Modifier 59, NCCI and MUE Webinar (March 22, April 4)
* Electronic Claim Submission Webinar (March 28)
* Preventive Services and Screenings (April 18)
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- Please join us for MOASC's LunchTime Series presentation of Update from the State Capitol, on Wednesday, March 28, 2018 at 12:00pm PT. The presentation will address key topics, issues and trends coming from Sacramento. It's an Election Year -- What Now? California Issues in The News; Key Budget Proposals; Legislation Impacting Health Care and The Future of the Golden State for Health Care. Please RSVP at moasc@moasc.org or 909-985-9061 ext. 1. Thank you, Genentech, for sponsorship of this presentation.
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MOASC Member, UC Irvine, presents their 3rd Annual UCI Hematology Symposium on Saturday, April 21, 2018
. The program will feature regional and national experts bringing you state-of-the-art updates on sickle cell disease, modern anticoagulants, CAR-T Cell therapy, and others. New this year, we will feature a Case Conference segment with individual case presentations and interactive discussions. We hope to see you at the 3rd Annual UCI Health Hematology Symposium.
- Hear key note speaker, Sumanta Kumar Pal, M.D., City of Hope discuss
Cabozantinib + Atezolizumab in Kidney Cancer, and more!
If you missed attending this year's MOASC Oncology Summit, click the link below to view presentations. We look forward to seeing you at next year's Summit!
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- 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 for more information, to register, and arrange for housing.
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- March 11-17 marks Patient Safety Awareness Week. Established by the Institute for Healthcare Improvement, the week is designed to raise awareness around the need to remain continuously vigilant and critical of the processes employed to deliver healthcare. This year's theme is "Patient Engagement and Safety Culture", but how do we translate that into meaningful actions that will help drive patient safety?
Read More
- The House is set to vote Tuesday on a revised version of a bill aimed at allowing terminally ill patients to try experimental treatments that have not received final approval from the FDA. House Energy and Commerce Committee leaders have been working to change the so-called right-to-try measure, which passed the Senate by unanimous consent last year, as a result of concerns from advocacy groups regarding some of the Senate-passed bill's language.
- A Draft Scoping Document outlining planned reviews of three antiandrogen therapies for certain types of high risk prostate cancer, has been posted by the Institute for Clinical and Economic Review (ICER). ICER's website provides additional information on the anticipated timelines for the reviews. Prostate Cancer. The scoping documents will be open to public comment for three weeks until April 2, 2018 at 2pm PT.
- Cigna announced last Thursday of plans to acquire Express Script. The acquisition, it is said, would benefit consumers by allowing the two companies to bring together patients' medical and pharmacy histories to improve treatments and lower costs. Yet, experts are skeptical the deal will do much to transform the healthcare industry, let alone deliver any significant savings to customers. The completion of the deal would mark the end of Express Scripts as the last major independent pharmacy benefit manager, one that has focused on striking deals with drug companies to lower costs for insurers and employers. The company is responsible for the prescription plans of more than 80 million Americans.Pharmacy Benefit Managers restrict access for patients living with a chronic disease. In the COPA list-serv participants have indicated Cigna nor Aetna will contract with some providers. COA is already talking to members of Congress about this. If you are finding similar restrictions to access to care for your patients, please communicate with Ricky Newton at COA /COPA any input on this type of information, they need details! Phone: (757) 639-4855 Email: rnewton@coacancer.org.
- The Senate health committee will hold a hearing on the 340B drug discount program this Thursday, March 15.
Last week, a federal appellate court scheduled May 4 for arguments in a lawsuit brought by hospitals against the Trump administration over a nearly 30 percent cut in payments for discounted drugs under the government's 340B program. Hospital associations are seeking relief from the $1.6 billion in cuts to providers serving predominately low-income patient populations that took effect this year. The policy would have the effect of putting the hospitals' Medicare reimbursements more in line with their cost of buying the drugs. Hospitals say Congress intended for certain drugs to be discounted, while HHS said in a regulation finalizing the cuts that "it is inappropriate for Medicare to subsidize other activities through Medicare payments for separately payable drugs." HHS's arguments in the case are due March 19, with the hospitals' counterarguments due April 2.
- The
Cancer Care Planning and Communications (CCPC) Act
, H.R. 5160, will establish a new service within Medicare for comprehensive cancer care planning. The bipartisan bill is co-sponsored by Reps. Mark DeSaulnier (D-CA) and Ted Poe (R-TX).
The CCPC Act will:
Help cancer patients through the difficult process of cancer diagnosis, treatment choices, treatment management, and survivorship care by supplying them with a written plan or roadmap;
Promote shared decision-making between patients and their cancer care teams and support informed decisions, as treatment choices are becoming increasingly complex;
Empower patients with information necessary to help manage and coordinate their care through diagnosis, treatment, and survivorship.
CCPC Act fact sheet
- The proportion of hospitals and health systems that allowed patients to access their health records online increased from 27% in 2012 to 93% in 2017, according to the American Hospital Association's Trend Watch report. The findings, based on a survey conducted from November 2016 to April 2017, also found that 78% of organizations allowed patients to pay bills online in 2017, compared with 51% in 2012. An Ernst & Young survey finds that consumers are comfortable using digital technology to contact their doctors and are currently using available technology. Many doctors surveyed said they believe digital technology could improve health care, and consumers expressed interest in at-home diagnostic testing, video consultations and sharing data via smartphone.
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CMS News
- CMS launched a new initiative aimed at giving Americans greater access to their medical data, Seema Verma, administrator of the Centers for Medicare and Medicaid Services announced at a health-technology conference. The push also aims to resolve hurdles that make it difficult for health-care providers to share digital records with patients and other providers.
- To help you prepare for the transition to the Medicare Beneficiary Identifier (MBI) on Medicare cards beginning April 1, 2018, review the new information about remittance advices. Beginning in October 2018, through the
transition period, when providers submit a claim using a patient's valid and active Health Insurance Claim Number (HICN), CMS will return both the HICN and the MBI on every remittance advice. Here are examples of different remittance advices:
Find more new information on the New Medicare Card
provider webpage.
- CMS, in response to concerns from stakeholders, is re-reviewing its coding changes for the ESA National Coverage Determination. Until this review is complete and CMS makes a final determination, the MACs will will not implement the changes originally communicated. The MACs will also reprocess any claims that were processed in error (from January 1) pursuant to the originally communicated changes.
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Physicians face March deadlines for 2017 MIPS data submission
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The data submission deadline for the 2017 Merit-Based Incentive Payment System are March 16 for the "group" reporting deadline, and March 31 for most "individual physicians," through the CMS web interface, to avoid a penalty in 2019.
CMS has created a Top Ten List of things to know and do before the March deadlines, along with important dates to remember.
Key Dates:
March 31, 2018: Last day for all other
MIPS
reporting, including via qpp.cms.gov
April 1, 2018: CMS will begin providing performance feedback
January 2019: Payment Adjustments applied
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Affiliate Association News
- March is Colorectal Cancer Awareness Month.
Colorectal cancer is the second-largest cancer killer among cancers that affect both men and women. All month, Division of Cancer Prevention & Communication will be giving you information to help you Be Gutsy and lower your cancer risk! Check out all new
Screen for Life Campaign materials, how preventable colorectal cancer can be with a new blog post, and stay tuned for more entries as the month goes on. Follow DCPC's Twitter account, @CDC_Cancer, for brand new images and information about prevention, and to find out what CDC is doing to help raise the rates of colorectal cancer screenings around the nation.
- After a lot of coding and hard work, the Community Oncology Pharmacy Association (COPA) is pleased to offer you a preview of COAnalyzer,
a new benchmarking tool for managing your oncology pharmacy. Free to COA and COPA members, COAnalyzer gives pharmacies access to real-time data on how they are performing and how their performance compares to peers, including mean, median, and percentile benchmarks. A free webinar to learn more about COAnalyzer and see it in action will be held on Thursday, March 29, from 9:00am-10:00 am PST. Registration is required for this free webinar. To register follow this link:
https://coacancer.zoom.us/webinar/register/WN_q4JX1MnvSN-WOR2ICkDybw
- The 2018 Community Oncology Conference-Keeping Patients at the Center, is scheduled for April 12 -13, 2018 at the Gaylord National Harbor Hotel. The four tracks of the 2018 Community Oncology Conference really make this four meetings in one. They cover the breadth and depth of what we do every day in community oncology: Clinical; Business, Advocacy and Pharmacy. Check out the full Conference schedule to see all the great speakers and sessions: conference.communityoncology.org/2018-conference-agenda/. The discounted Community Oncology Conference room block is selling out fast. Be sure to register and reserve your room today. Join more than 1,300 oncologists/hematologists, pharmacists, practice administrators, nurses, advocates, payers, and industry partners for two days of learning and networking. Visit www.COAConference.org for details.
- Join fellow oncology physicians, researchers, and specialists at the 2018 ASCO Annual Meeting, June 1-5 in Chicago, Illinois. The ASCO Annual Meeting offers learning and networking opportunities for the entire oncology care team, now offering nursing and pharmacy CE in addition to CME and MOC for physicians.
- ASH Secretary Dr. Robert Brodsky participated in a roundtable discussion hosted by Senator Cory Booker (D-NJ) following introduction of sickle cell disease (SCD) legislation in the U.S. Senate, the Sickle Cell Disease Research, Surveillance, Prevention and Treatment Act (S. 2465), sponsored by Senators Tim Scott (R-SC) and Booker. A webcast of the SCD roundtable between Dr. Brodsky and Senator Booker is available online.
- ASCO's new checklist, Evaluating Oncology Clinical Pathways Programs, is designed to guide oncology practices in examining the pathway programs they currently use, or to evaluate pathways under consideration for future use. The checklist features questions that help practices determine if a pathway meets, partially meets, or doesn't meet ASCO's Criteria for high-quality oncology clinical pathway programs, Learn more at
www.asco.org/practice-guidelines/cancer-care-initiatives/clinical-pathways
.
- ASCO is launching ASCO Practice Central a new website that serves as an online information hub to help oncology professionals navigate a complicated and every-changing practice environment--while providing high-quality patient care. ASCO Practice Central offers oncology practices easy-to-access information, tools, and resources that are designed to foster effective business practices and support high-quality patient care. Bookmark ASCO Practice Central at
http://practice.asco.org
.
- Come early, May 31 & June 1, and expand your educational opportunities at the
2018 ASCO Annual Meeting.
(June 2 - 5). ASCO has two types of educational programs that offer innovative learning opportunities prior to the official start of the Annual Meeting. Space for these sessions is limited - register today.
- Download MGMA's free white paper entitled Business Tax Changes That Will Impact Medical Practices Under the Tax Cuts and Jobs Act by clicking
HERE.
- NCCN has published updates to the below. For the complete updated versions, please visit
NCCN.org
. Recent updates include: adult cancer pain (V1.2018), distress management (V2.2018), myeloid growth factors (V1.2018), ovarian cancer (V1.2018), T-cell lymphomas (V3.2018).
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- AstraZeneca will host a dinner program entitled Addressing Unmet Need in Patients With Non-Small Cell Lung Cancer: New Treatment Options for Unresectable Stage III Disease and Metastatic Epidermal Growth Factor Receptor Mutation Positive Disease
with Hatim Husain, M.D., Moores Cancer Center, University of California, San Diego, on March 17 at Morimoto Restaurant in Napa. RSVP to Jason Yonehiro, (415) 205-3699 or jason.yonehiro@astrazeneca.com.
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MOASC CALENDAR
LunchTime Series
March 28, 2018
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(Napa, March 16-18)
(San Francisco,
April 27-28)
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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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