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"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 W
eekly's Hot Topics
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- 2017 Administrator & Oncology Billing Programs, November 8th & 9th (MOASC News)
- The growing IV fluid shortage (National News)
- Reimbursement cut for separately paid drugs under the 340B Drug Pricing Program (CMS News)
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California News
- The California Health Information Partnership & Services Organization (CalHIPSO) can help practices with 15 or fewer physicians with free assistance to prepare and participate in the Medicare QPP. For more information, visit
http://www.anco-online.org/CalHIPSO&QPP.pdf.
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- Noridian/JEMAC has posted more updates to its website:
* MLN Connects
Announcements--MIPS Virtual Group Election Period Ends December 1; MIPS: Participate in Field Testing of Episode-Based Cost Measures by November 15; Physician Compare Preview Period Extended to December 1; New Medicare Card: Provider Ombudsman Announced; CMS Offers Medicare Enrollment Relief for Americans Affected by Recent Disasters; Physician Fee Schedule Final Policy, Payment, and Quality Provisions for CY2018; Hospital OPPS and ASC Payment System and Quality Reporting Programs Changes for 2018; Quality Payment Program for Year 2
Claims, Prices & Codes
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Events
--SNC Value-Based Purchasing Program FY2018 Final Rule Call-November 16
Publications--
General Equivalence Mappings FAQs Booklet-Revised; Medicare Fraud & Abuse: Prevention, Detection, and Reporting Web-Based Training Course-Reminder; QRUR Webcast: Audio Recording and Transcript-New; ICD-10-CM/PCS the Next Generation of Coding Booklet-Revised; Diagnosis Coding: Using the ICD-10-CM Web-Based Training Course-Reminder; Medicare Home Health Benefit Web-Based Training Course-Reminder; SNF Billing Reference Booklet-Reminder; Items and Services Not Covered under Medicare Booklet-Reminder
* Chemotherapy Administration-R10
* Non-Covered Services LCD-R18
* November Webinars-Register Now
- Upcoming Noridian/JEMAC webinars include:
* Modifier 59, NCCI, and MUE Webinar (November 29)
Visit https://med.noridianmedicare.com/web/jeb/education/training-events for more information.
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- TOMORROW & THURSDAY is the 2017 Administrator & Oncology Billing Programs, November 8th & 9th, in
Anaheim. The program will highlight MACRA quality reporting scores and how not to miss your bonus through MIPS in 2019.
On Wednesday, November 8th
, The Administrator's will hear Benchmarking and Revenue Cycles, t
he Impact of Rising Healthcare Costs and Systems Thinking Approach® to Strategic Management with Loren Tarantino.
On Thursday, November 9th
, the Biller's
will be presented A/R Billing Updates and Medi-Cal Updates. For more information, contact the MOASC office at
moasc@moasc.org
or 909-985-9061 x1.
- MOASC President, Warren Fong, M.D. attended the California Medical Association House of Delegates, October 20-22, 2017. Read his report HERE.
- MEMBER ONCOLOGIST CLOSING PRACTICE, DRUG STOCK AVAILABLE
. A MOASC member is closing their practice and has leftover stock available. If you are interested in purchasing some of leftover stock of chemo meds, please contact moasc@moasc.org for the list of drugs and information.
- City of Hope will present The Fourth Annual Gayle Brinkenhoff Breast Cancer Symposium on Tuesday, November 14, 8 am to 4pm. For more information: cme@coh.org or (626)218-5622.
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- Four seats on the ANCO Board of Directors are up for election in 2017. ANCO seeks nominations for candidates for these seats. This year's election will be conducted via mail ballot in December. Candidates with the top four vote totals will serve for three years (i.e., 2018-2020, inclusive). Nominate an ANCO member (including yourself) to stand for election to the Board via e-mail/FAX to the ANCO office at execdir@anco-online.org/(415) 472-3961.
- 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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- ASCO & COA are aware of the growing IV fluid shortage, along with other drugs in short supply. While over the past few years ongoing drug shortages have not generally risen to the critical levels that they did earlier this decade, your national organizations are concerned that recently they have seen an upsurge in shortages, including IV fluids, electrolytes, and some forms of morphine, among others. They are collecting information from around the country and will be meeting with the United States Food and Drug Administration to determine what solutions they have or are planning to resolve this problem. In the interim, the American Society of Health-System Pharmacists and the University of Utah Drug Information Service have developed a document with suggestions for management and conservation of small-volume parenteral solutions (SVPs) at
- Anthem Blue Cross will conduct post-payment coding reviews of professional claims billed with modifiers 25, 62, 80, 81, AS, and 91 beginning in 4Q2017. Additionally, Anthem will conduct post-payment coding reviews of E&M services billed during a global surgery period. If you have questions, then please contact CAContractSupport@anthem.com.
Chart Review
- UnitedHealthcare's Network Bulletin (November 2017) is now available online at www.unitedhealthcareonline.com > Tools & Resources > News & Network Bulletin and features articles on opioid guidance and resources, Network Bulletin revisions that include article summaries and easier navigation, improvements to the Provider Administrative Guides, and new prior authorization and notification app will be fully deployed.
- United Healthcare recently made changes that may affect coverage or reimbursement for genetic and molecular testing.
* Effective November 1, 2017, United Healthcare is implementing an online Prior Authorization program for genetic and molecular testing
* Additional information can be obtained at
https://www.uhcprovider.com/en/prior-auth-advance-notification/genetic-molecular-lab.html
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CMS News
- CMS, in its final rule on the 2018 HOPSS, has finalized a proposal to cut reimbursement for separately paid drugs under the 340B Drug Pricing Program from ASP plus 6% to ASP minus 22.5%. Rural Sole Community Hospitals, PPS-exempt Cancer Hospitals, and Children's hospitals will be exempt from this policy in 2018. In addition, CMS finalized proposed revisions to the 14-day rule for molecular pathology and advanced diagnostic laboratory tests. Learn more at www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2017-Fact-Sheet-items/2017-11-01.html.
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Affiliate Association News
- ASH invites you to attend their presentation of, Improving MDS Outcomes from Diagnosis to Treatment: A Multidisciplinary Approach, November 8, 2017 at the Westin Bonaventure Hotel & Suites, Los Angeles. This comprehensive, MDS-focused summit is a unique learning experience that encourages attendee interaction. Spread the word about this chance to improve MDS outcomes in your community through active learning for the entire care team! Learn More.
- ASH will host a webinar on MIPS and Reporting for MIPS on November 13 at 10AM. The webinar will provide a specialized MIPS reporting plan for hematologists. If you are interested in attending this webinar, then please e-mail Leslie Brady at lbrady@hematology.org.
- Year in Review
, moderated by Neil Love, M.D., is a multi-tumor regional symposia series
focused on the application of emerging research information to the care of patients with common cancers, is scheduled for Saturday, November 18, 2017 at the Fairmont Miramar Hotel in Santa Monica, CA. To register go to
- Journal of Oncology Practice
(JOP) continues to accept submissions for its Quality in Action article category.
These unique manuscripts are brief, structured reports of quality improvement (QI). Quality in Action manuscripts are peer reviewed and, if accepted, published as MEDLINE-indexed online articles.
Recently published articles include:
- Save the Date for #COA2018. The 2018 Community Oncology Conference is April 12-13 at the Gaylord National Hotel & Convention Center, just outside of Washington DC. To learn more about the Community Oncology Conference, visit: http://www.coaconference.org/.
- The 2018 ASCO Annual Meeting, is scheduled for June 1-5, in Chicago, Illinois. This year's Presidential theme developed by Dr. Bruce Johnson is Delivering Discoveries: Expanding the Reach of Precision Medicine. Bookmark am.asco.org and check back often for updates.
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NCCN has published updates to the below.
For the complete updated versions, please visit NCCN.org. Recent updates include: AIDS-related Kapsi sarcoma (V1.2018), acute lymphoblastic leukemia (V5.2017), adolescent and young adult cancers (V2.2018), central nervous system cancers (V1.2017), chronic myeloid leukemia (V2.2018), melanoma (V1.2018), non-small cell lung cancer (V9.2017), soft tissue sarcoma (V1.2018), uterine neoplasms-endometrial carcinoma (V1.2018), vulvar cancer (V1.2018).
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- AstraZeneca informs ANCO and MOASC that the United States Food and Drug Administration has approved Calquence as a treatment for adults with mantle cell lymphoma who have received at least one prior therapy.
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Genentech informs
MOASC and
ANCO that the
United States Food and Drug Administration has approved ZELBORAF
® (Vemurafenib) for patients with Erdheim-Chester disease (ECD) with BRAF V600 mutation. ZELBORAF is not indicated for treatment of patients with wild-type BRAF ECD. For more information contact
Jennifer Fraga at
fraga.jennifer@gene.com
or the Genentech Customer Service Department at 1-800-551-2231, Monday through Friday, 6:00AM to 5:00PM PST.
- Merck
informs ANCO and MOASC that the United States Food and Drug Administration has approved Keytruda
for use in patients with advanced gastric (stomach) cancer that is PD-L1 positive.
- Tesaro informs ANCO and MOASC that the United States Food and Drug Administration has approved Varubi IV for delayed nausea and vomiting associated with cancer chemotherapy.
- Kite Pharma announced that YESCARTA™ (axicabtagene ciloleucel), was approval by the US Food and Drug Administration on October 18, 2017. YESCARTA™ is a CD-19-directed genetically modified autologous T cell immunotherapy indicated for the treatment of adult patients with relapsed or refractory large B-cell lymphoma after two or more lines of systemic therapy, including diffuse large B-cell lymphoma (DLBCL) not otherwise specified, primary mediastinal large B-cell lymphoma, high grade B-cell lymphoma, and DLBCL arising from follicular lymphoma. YESCARTA™ is not indicated for the treatment of patients with primary central nervous system lymphoma. Please see Important Safety Information below, and accompanying full Prescribing Information, including BOXED WARNING and Medication Guide.
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MOASC CALENDAR
Professional Educational Series
November 8-9
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(San Francisco, February 8-10)
(San Francisco, January 25-27)
(San Francisco, February 8-10)
(Napa, March 16-18)
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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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