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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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- Fellows in California are invited to submit abstracts for their original research. California News
- The City of Chicago recently released a draft of the disclosure log. National News
- Participate in the Oncology Patient Engagement Trend Report survey! Affiliate News
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California News
- California has not been known to be the most "business friendly" state in the union in recent history. We recently wrote about California Senate Bill 790 passing in the California state senate that was intended to restrict pharmaceutical companies from giving gifts and incentives to medical professionals. The bill prohibits manufacturers from offering or giving a gift to a health care provider. The bill also prohibits a manufacturer or an entity on behalf of a manufacturer from providing a fee, payment, subsidy, or other economic benefit to a health care provider in connection with the provider's participation in research. Exempts the annual direct salary support for principal investigators and other health care professionals for the purposes of a bona fide clinical trial from this provision. SB 790 has generated many questions and lots of phone calls within our state. The California Life Sciences Association has created an activation site to weigh in on this bill. The CLSA website is nicely done and it makes submitting a letter very simple. The bill could possibly be heard as early as this week. Linked here, is the text of the letter CLSA is asking to be submitted.
http://califesciences.org/advocacy/takeaction/?vvsrc=%2fcampaigns%2f53411%2frespond
Send a message to your Legislators, and tell them that life sciences and medical research need to be strengthened and nurtured -- not restricted with more red tape and regulations.
Urge them to reject SB 790 today.
- The California Medical Association's (CMA) Practice Resources (July 2017) is now available online at www.cmanet.org/cpr and features articles entitled: Have you received a termination notice from Blue Cross Recently?; UnitedHealthcare to issue a new Premium Designation to physician results; Noridian to issue electronic Level 1 Medicare Redetermination Notices via web portal; The Coding Corner: CPT 2017 revises moderate sedation billing.
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The CMA and Network of Ethnic Physician Organizations (NEPO) are hosting a joint annual poster session to showcase research by medical students, residents and fellows across California.
Allmedical students, residents and fellows in the state are invited to submit abstracts for their original research, regardless of membership status. Students who serve marginalized and underserved populations are strongly encouraged to apply. Research categories include basic science, clinical research, clinical vignette, health policy, and social science research. Applicants may only submit one abstract with a 350-word limit, and must explain the relevance of their research to health policy. The deadline is August 14, 2017, at 11:59 p.m. PST. The poster session will take place Friday, October 20, 2017, in conjunction with the CMA House of Delegates and the NEPO Building Healthy Communities Summit, both being held at the Disneyland Hotel in Anaheim. Poster session participants will receive complimentary registration to attend the NEPO Summit. For more information, see the poster session flyer.
To be considered for the poster session, submit your abstract to Kerry Sakimoto,
ksakimoto@cmanet.org
.
- Billionaire biotech magnate Patrick Soon-Shiong is set to open an oncology clinic in El Segundo today, July 11, as part of a push into the health care provider space. The facility is designed to support Soon-Shiong's vision of a cancer treatment center using his proprietary immune-oncology assessment and treatment tools developed over the last decade. (Los Angeles Business Journal)
- The Department of Fair Employment and Housing (DFEH) have updates to mandatory California labor law posting requirements that affect your business. In order for your business to stay in compliance with these recent changes, the updated postings must be downloaded, printed, and then posted next to your current labor law poster.
Family Care and Medical Leave (CFRA Leave) and Pregnancy Disability Leave
:
The section on filing a complaint has been updated. The DFEH has made reformatting changes to the posters that do not change the posting obligation. You may post any version of the CFRA/Pregnancy Disability Leave notice (DFEH-100-21) from July 2015 to the present. The effective date of this notice is May 1, 2017.
DOWNLOAD IN ENGLISH
Workplace Discrimination:
The section on filing a complaint has been updated. The DFEH has made reformatting changes to the notice that do not change the posting obligation. You may post any version of the Workplace Discrimination poster (titled: California Law Prohibits Workplace Discrimination and Harassment / DFEH-E07P-ENG / formerly DFEH-162) from December 2014 to the present. The effective date of this notice is May 1, 2017.
DOWNLOAD IN ENGLISH
Rights and Obligations as a Pregnant Employee:
The DFEH has added a phone number and contact information for the hearing impaired. You may post any version of the Rights and Obligations as a Pregnant Employee notice (DFEH-100-20) from April 2016 to the present. The effective date of the notice is June 1, 2017.
DOWNLOAD IN ENGLISH
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- MOASC President, Warren H. Fong, M.D. attended the Carrier Advisory Committee meeting on June 28, 2017 in Los Angeles. Attached please find the draft notes from the meeting.
Announcements--
New Medicare Number: Prepare Your Systems for April 2018; Quarterly Provider Update; QPP: New Resources to Help Physicians Participation MIPS; QPP: New Webpage for Clinicians in Small, Rural, or Underserved Areas
Claims, Pricers, and Codes--
Events--
Publications--Evaluation and Management Services Web-Based Training Course-New
* Bladder Tumor Markers FISH Billing and Coding Guidelines-R1
* July 2017 Webinars-Register Now
* Radiopharmaceutical Fee Schedule 2017 Updates-Correction
* Chemotherapy Administration-R7
* Redetermination Requests Which Contain Multiple ICNs
- Forthcoming Noridian/JEMAC webinars include:
* Duplicate Claims (July 12)
* Noridian Medicare Portal Registration and Functionality (July 19)
* CMS 1500 Form Submission (July 19)
* Reopenings (July 20)
* Medical Oncology (July 25)
- Medicare After Hours - Evening Webinars Available for Your Professional Growth
Noridian Provider Outreach and Education (POE) staff will be presenting webinars one Thursday night a month for six months from 6 -7 p.m. Pacific Time. Read the complete update
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DHMC News
- On June 26, 2017, the Department of Managed Health Care's (DMHC) Office of Legal Services (OLS) received MOASC's email, dated June 15, 2017, requesting the DMHC look into Blue Shield's California Physicians' Service's pilot cancer program, specifically:
- Has the Department received similar letters regarding this Blue Shield diversion of care in other areas in California?
- The DMHC has not received similar letters regarding this issue.
- Does Blue Shield's "whole body approach" refer to forcing their beneficiaries into a capitated model thereby forcing every patient to be referred to the local managed care plan
- MOASC would like more details about the program and Blue Shield's future interests regarding access to care in California.
- Regarding these last two, the DMHC's Office of Plan Licensing is looking into Blue Shield's filings with the DMHC, and will respond to MOASC upon discovery.
MOASC seeks feedback and information from you regarding any such diversion of, or encumbrances upon, the cancer patient's access to your care, by Blue Shield, or any insurer in California. Please share your information with moasc@moasc.org . Thank you.
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- SAVE-THE-DATE, for MOASC's 3rd Annual Spotlight on ASCO presentation by the University of California Irvine, Saturday, July 29 at the Waterfront Beach Resort, Huntington Beach. MOASC awarded educational grants to 3 UCI Fellows to attend ASCO and present their discoveries. Faculty from UCI will round out the discussions on: ASCO Abstract Highlights, Colorectal & Gastro-Esophageal cancer, Breast cancer and Lung cancer. Contact
moasc@moasc.org
to register.
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MOASC was contacted by a member with the following issue:
A new physician started with the practice last year. This year the practice is being penalized 4% because, 2 years ago, the new physician's previous employer did not attest for meaningful use and PQRS. Now the current practice is stuck with the bill.
The practice believed the physician was attesting individually, in previous years, by their previous employer in another state. The member practice reported as individuals therefore they are only taking a penalty on the new physician's claims.
Response
:
Unfortunately, if the new physician did not report to PQRS and MU 2 years ago, and did not afterward request an informal review, all the deadlines have passed and there is no formal way for the current practice to get out of the penalty. As the new practice that this physician joined reported as individuals, the penalty for non-reporting, for the new physician, affects only the new physician's fee schedule payments. The "Payment Adjustment Toolkit" for the 2017 payment year, provided by CMS, may provide direction for future assistance, before deadlines are missed, at https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/PQRS/Downloads/2017_PA_Toolkit.pdf
This is a lesson learned as a question to ask in the hiring process.
Read more under
CMS News
in this publication.
-UPDATE:
In the June 27, 2017 edition of the California Oncology Weekly, MOASC asked for your feedback on Blue Shield's pilot cancer care program
(
Blue Shield Letter
)
. MOASC shared their concern with ASCO & COA, the CMA and the California Department of Managed Health Care (DMHC) expressing concern, noting the negative impact on the oncology community, asking for more details about the program and Blue Shield's future intents. Read the Department's response to MOASC under DMHC News in this publication.
- MOASC would like to introduce Outcome Health, an industry-leading patient engagement company, striving to improve the patient experience at the point of care. Outcome Health provides an entirely free suite of products for the patient throughout their journey from the waiting room to the infusion room. For more information go to
www.outcomehealth.com
or to request a demonstration, please contact Alison Twite at
alison.twite@outcomehealth.com
or Chad Taylor at
Chad.taylor@outcomehealth.com
.
Contact the MOASC Office
moasc@moasc.org
for a list of MOASC members already taking advantage of this free product and how they enjoy the program.
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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.
- SAVE THE DATE ANCO's
3Q2017 Hematologic Malignancies Update will take place on September 9 at the Stanford Park Hotel. Watch for a meeting announcement in late July.
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- The City of Chicago recently released a draft of the disclosure log pharmaceutical representatives will be expected to use to keep track of the interactions they have with Chicago physicians. The form requires pharmaceutical representatives to log the following information with respect to any interactions they have with physicians within city limits: HCP first name; HCP middle initial/name; HCP last name; HCP name suffix (i.e., Jr.); HCP primary business address; HCP license type (i.e., MD, DO, etc.); HCP state license number; HCP NPI (if applicable); date of interaction; location of interaction; duration of interaction; pharmaceuticals promoted; whether samples were provided, and if so, the quantity of samples given and the value of such samples; whether pharmaceutical-related materials were given, if so, the value of the materials given; and whether any other items of value or compensation were given, if so, what type and the combined value of other items. Chicago Releases Pharmaceutical Representative Disclosure Log Draft
- UnitedHealthcare's Network Bulletin (July 2017) is now available online at
www.unitedhealthcareonline.com > Tools & Resources > News & Network Bulletin and features articles entitled: Updates to Notification/Prior Authorization Requirements for Specialty Medications; Expansion of Notification/Prior Authorization Requirement for Certain Office-Based Procedures; Dosage Required for Chemotherapy Requests (Yervoy, J9228); Levoleucovorin Will Require Prior Authorization; Colony-Stimulating Factors Will Require Prior Authorization; Changes in Advance Notification and Prior Authorization Requirements.
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- Health care organizations that received meaningful use incentive payments by using eClinicalWorks software will not be required to repay the amount after the EHR vendor agreed to pay $155 million to settle government allegations that it falsely obtained EHR certification, according to an email sent by a CMS spokesperson. "CMS realizes that providers may rely on the software they use for accuracy of reporting, and CMS does not plan to audit eCW providers based on the settlement," the spokesperson said.
- It is now easier to create, verify, or look up your National Provider Identifier (NPI) using the National Plan and Provider Enumeration System (NPPES). CMS is presenting, Creating and Verifying Your National Provider Identifier, tomorrow, Wednesday, July 12, 2017, 11:00am to 12:30 pm Pacific Time. CMS experts will provide details on the improved NPPES process. A question and answer session follows the presentation. Register for Medicare Learning Network events.
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Affiliate Association News
- You, the physician practice, are being held accountable for costs of patient care. Yet there is a gap between your perception of care and your patients'. Here is how to close that gap. You are invited
to participate in the Oncology Patient Engagement Trend Report. By participating in this report you will receive answers to such vexing questions as:
What do I have to do to improve the quality of the patient experience?
How can I engage my patients in a way that saves on total costs of care?
How can I avoid downstream gaps?
How can I end up with lower costs to me and the federal system?
How can I leverage my payer contracts with this information?
This Report will inform your practice and stimulate the discussions that we all need. Your assistance, and the assistance of your care team, is greatly needed.
Please access the survey at http://www.oncologytrendsurvey.com/. Please ask your oncology office/practice manager, your NPP, oncology care manager and nurse navigator to participate in this survey.
A completed survey from each of these perspectives, from your practice, will be of great value.
You can be part of the solution, as this Report is part of the solution.
You are strongly encouraged to participate in the Oncology Patient Engagement Trend Report survey and receive an honorarium of $80 for the physician respondent, in addition to $50 each for the practice manager, NPP, oncology care manager and nurse navigator. Those who participate will also receive the final report, free.
The Report will be an important resource and a catalyst for improvements across the country in patient engagement. Care providers, payers and employers across the country will use the report's results as a benchmark and platform for increased patient engagement activities and utilization of patient engagement resources in their own markets.
Participating in the oncology trend survey at http://www.oncologytrendsurvey.com/ will help you, other oncologists and oncology practice managers manage their practice more wisely. If you have any questions, please do not hesitate to call or email Dawn Holcombe at 860-305-4510 or dawnho@aol.com . Thank you.
- Join ACCC, tomorrow, Wednesday, July 12 from 1:00-2:00 PM PDT to hear how CMS's proposed rule for updates to the Quality Payment Program (QPP) established under MACRA will impact cancer care providers. Webinar: Overview of the CMS Proposed Rule for 2018 Updates to the Quality Payment Program (QPP).Hear from legal experts about key policies included in CMS's recently proposed updates to the Quality Payment Program (QPP) for 2018, the quality-based payment system for Medicare Part B clinicians created under the MACRA. CMS is proposing additional flexibility on reporting requirements for providers in the second year of the program. Learn how the proposed rule may impact the QPP's two tracks-Merit-Based Incentive Payment System (MIPS) and Advanced Alternative Payment Models (APMs). Tune in to hear the details. Register at
- ASCO is pleased to announce that its Quality Oncology Practice Initiative (QOPI)
Qualified Clinical Data Registry
(QCDR) is now available
for CMS MIPS reporting effective July 1. By using the QOPI QCDR for MIPS reporting, practices will be able to report on one measure for one patient in 2017 to avoid cuts to Medicare reimbursements in 2019. Express your interest in participating in the QOPI QCDR by e-mailing
qopi@asco.org
. Once registration is officially open, practices will be contacted regarding the necessary steps to begin the on-boarding process. For more information, please visit
- ASCO's COME HOME program offers direct support to practices as they transition to value-based reimbursement. The program provides patients with greater access to evidence-based care, while offering practices tools to evaluate their readiness for the move to an alternative payment model as well as implementation tools to help practices make the change. ASCO is currently accepting practices for the fee-based program. Visit
http://www.asco.org/practice-guidelines/practice-support/asco-consulting-services/asco-come-home
for more information.
- ASCO and ASH oppose the Better Care Reconciliation Act of 2017, the Senate healthcare bill, and urge lawmakers to reject the measure and work on an alternative that provides key protections for patients with cancer. ANCO, MOASC, ASCO, and ASH urge members to contact their legislators in opposition to this legislation; go to ASCO's ACT Network (
http://cqrcengage.com/asco
) or ASH's Advocacy Center (
www.hematology.org/Advocacy/Campaigns/7504.aspx
) to express your opinion.
- 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
.
- ASCO recently joined a group of 20 advocacy organizations in endorsing a set of guiding principles for any efforts to change the process by which patients access unapproved therapies outside of clinical trials--known as expanded access. Principles for Access to Unapproved Therapies (
www.asco.org/sites/new-www.asco.org/files/content-files/Community-Expanded-Access-principles-June-2017-Final.pdf
) affirms the importance of established research and therapy development in providing patients access to safe and effective treatments, and outlines the specific role expanded access can play in providing unapproved therapies to very sick patients with no other treatment options.
- NCCN has published updates to the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®), et.al., for: adult cancer pain (V2.2017), bladder cancer (V5.2017), breast cancer (V2.2017), breast cancer screening and diagnosis (V1.2017), cancer- and chemotherapy-induced anemia (V1.2018), cancer-associated venous thromboembolic disease (V1.2017), gastric cancer (V1.2017), hepatobiliary cancers (V2.2017), lung cancer screening (V1.2018), malignant pleural mesothelioma (V2.2017), neuroendocrine tumors of the pancreas (V3.2017), ovarian cancer (V2.2017), pancreatic adenocarcinoma (V2.2017), prostate cancer early detection (V1.2017), uterine neoplasms-endometrial carcinoma (V2.2017). For the complete updated versions of the NCCN Guidelines, et.al., please visit
NCCN.org
.
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- Genzyme (Sanofi) is hosting an educational dinner meeting on July 13 entitled What's Behind Your Patient's Hematological Abnormalities with Seymour Pak, M.D., University of California. The meeting takes place at 6:30PM at A16 Rockridge in Oakland. RSVP to Sandra Brink at (866) 700-9297.
- Janssen Oncology informs ANCO and MOASC that the
United States Food and Drug Administration has approved the use of Darzalez in tandem with chemotherapy drug dexamethasone and
Celgene's Pomalyst for multiple myeloma patients who have already tried at least two prior therapies, including Revlimid and a proteasome inhibitor.
- Novartis Oncology informs ANCO and MOASC that the United States Food and Drug Administration (FDA) has approved Tafinlar and Mekinist administered in combination for patients with metastatic non-small cell lung cancer (NSCLC) with BRAF V600E mutation as detected by an FDA-approved test. In addition, the FDA has expanded the approval of Certinib to include the initial treatment for patients with lung cancer that has a mutation in the ALK gene.
-
Pfizer Oncology
informs MOASC and ANCO about their new updated Patient Assistance Program. Pfizer Oncology is committed to helping patient get access to the medications they need.
Pfizer Oncology Together helps provide eligible patients with financial support, regardless of their insurance coverage.
- Seattle Genetics is hosting an educational program on July 19 entitled Adcetris: Overview of Indications and Clinical Data with Mehrdad Abedi, M.D., University of California, Davis. The program takes place at 6:30PM at Ruth's Chris in Walnut Creek. RSVP to Krista Saumure at (916) 402-6846 or
ksaumure@seagen.com
.
- Teva
informs MOASC and ANCO about U.S. FDA Acceptance of Biologics License Application for Proposed Biosimilar to Rituxan® (rituximab). For more information go to
http://tevapharm.com/news/
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MOASC CALENDAR
ASCO National Meeting in Chicago
June 2-6, 2017
LunchTime Series
June 28, 2017
Spotlight on ASCO
July 29, 2017
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(ANCO Member Discount Code IBW17ANCO, San Diego, July 14-15)
(ANCO Member Discount Code ILC17ANCO,
Huntington Beach, July 27-29)
3Q2017 Hematologic Malignancies Update
(Palo Alto, September 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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