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 22, 2018
|
|
|
- Court overturns California's 2-year-old physician-assisted suicide law (California News)
- ARE YOU AN ONCOLOGY MEDICAL HOME? (MOASC News)
- CMS publishes updated New Medicare Card release schedule(CMS News)
- Thursday, May 24, national broadcast on TAGRISSO® (Industry News)
|
California News
- A court overturned California's two-year-old physician-assisted suicide law, though a stay is in place. For now, the law stays in place. The state attorney general was allowed five days to ask the judge to suspend his judgment while the state appeals the case. If that request is approved, as expected, dying patients will continue to have access to prescriptions for a fatal dose of medication. The dispute moves next to the Fourth District California Court of Appeal, Division Two, located in Riverside and governing Riverside, San Bernardino, and Inyo Counties. The outcome is uncertain.
- Governor Jerry Brown released his revised budget proposal for fiscal year 2018-19.
The revised budget proposal continues the Administration's commitment to using the Proposition 56 tobacco tax funding to provide supplemental payments for Medi-Cal providers. However, because claims for physician payments for the designated CPT codes were lower than expected, expenditures in the current fiscal year were also lower than expected. The total dollar amount allocated for physician payments remains unchanged from the January budget at $1.3 billion, and any funds unspent in 2017-18 and 2018-19 will rollover for expenditure in 2019-20.
Governor Brown's revised budget includes $40 million for graduate medical education (GME) as required by Proposition 56. The budget proposal also includes $55 million to support psychiatric GME programs in underserved areas, which is part of a larger package of mental health proposals that the Governor is putting forward. Budget subcommittees in both houses of the legislature will hold hearings to discuss these and other budget issues.
- AB 2863 (Pharmacy Benefit Manager clawbacks) passed out of the Assembly Committee on Appropriations and is now moving to the full Assembly for a vote. This means that your Assemblymember will be voting on this bill, so now is a good time to reach out to them via their office or the staffer that you have a relationship with or through their website and social media. This bill could be up for a vote as early as this week!
Bill language:
The maximum amount a health care service plan or pharmacy benefit manager, as defined in Section 4430 of the Business and Professions Code, may require an enrollee to pay at the point of sale for a covered prescription medication is the lesser of the following:(1) The applicable cost-sharing amount for the prescription medication. (2) The retail price.
A health care service plan or pharmacy benefit manager shall not require a pharmacist or pharmacy to charge or collect from an enrollee a copayment that exceeds the total submitted charges by the network pharmacy. If an enrollee pays the retail price instead of paying the cost-sharing amount for the prescription medication, that amount shall be applied to the enrollee's deductible and out-of-pocket maximum in the same manner as if the enrollee had purchased the prescription medication by paying the cost-sharing amount.
Link to bill:
https://bit.ly/2IHKCmS
The bill sponsor, California Chronic Care Coalition, has created two short videos on PBM's. You can find them on their Facebook page.
-
AB3087 proposes to task an independent state agency with setting payment rates for all health-care providers. AB 3087 would force physicians out of state or into early retirement, increase patient out-of-pocket costs and create state-sanctioned rationing of health care for all Californians. ANCO and MOASC continue to urge members to oppose AB3087. All physicians should contact their Assemblymembers and State Senators. Visit ACTNOW.IO/PRICEFIXING to help stop this dangerous and irresponsible legislation. Read More.
- ANCO and MOASC have taken the following positions on legislation introduced during the current session (updated): AB1860 (cosponsors) would extend the $200 per month cap on patient out-of-pocket costs for oral chemotherapy. This bill passed in the Assembly Health Committee unanimously and now moves to the Appropriations Committee.
- 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 2018-19. Please submit to nominations@cmanet.org with a completed application form, brief CV (less than five pages) and statement of interest.
- The California Medical Association (CMA) annually honors inspirational physician members during the House of Delegates. CMA is now accepting nominations for the four awards recognizing significant contributions by a Physician member who:
- Best illustrates the CMA's commitment to community and charity care;
- Demonstrates a special or unique effort toward membership recruitment resulting in CMA membership growth in their area;
- Works toward improving physician health and wellness;
- Best exemplifies the practice and ethics of a rural practitioner.
All nominations must reflect active CMA membership from a physician residing and practicing in California. DEADLINE: Monday, June 4, 2018. For more information, please contact:
Manjot (MJ) Cheema, Associate Director, Governance, California Medical Association
1201 J Street, Suite 200, Sacramento, CA 95814, (916) 551-2565, mcheema@cmanet.org
|
|
|
- In observance of the Memorial Day Holiday, all Noridian Offices and Contact Centers will be closed on Monday, May 28, and will resume regular business hours on Tuesday, May 29.
- Noridian/JEMAC has posted more updates to its website:
- Publication 100-04, Chapters 1 and 27, to Replace RARC MA61 with N382 Update CR10619. Change Request (CR) 10619 initiates both Medicare manual changes and operational changes related to the New Medicare Card. Read the complete update
- ICD-10 and Other Coding Revisions to NCDs CR10622. Change Request (CR) 10622 constitutes a maintenance update of International Code of Diseases, 10th Revision (ICD-10) conversions and other coding updates specific to National Coverage Determinations (NCDs). Read the complete update.
- RARC, CARC, MREP and PC Print Update CR10620
Change Request (CR) 10620 updates the Remittance Advice Remark Code (RARC) and Claims Adjustment Reason Code (CARC) lists and instructs Medicare Shared System Maintainers (SSMs) to update Medicare Remit Easy Print (MREP) and PC Print. Read the complete update.
- MolDX: GBA Genetic Testing Billing and Coding Guidelines - R1
The MolDX: GBA Genetic Testing Billing and Coding Guidelines coverage article has been revised and published for notice. Read the complete update.
- MolDX: ENG and ACVRL1 Gene Tests Billing and Coding Guidelines - R1
The MolDX: ENG and ACVRL1 Gene Tests Billing and Coding Guidelines coverage article has been revised and published for notice. Read the complete update.
- HCPCS Drug/Biological Code Changes - July 2018 Update - Revised CR10624
Change Request (CR) 10624 informs MACs of updated drug/biological HCPCS codes. Read the complete update.
- Upcoming Noridian/JEMAC webinars include:
* Modifier 59, NCCI and MUE Webinar, May 23.
* Reopenings Webinar, May 31.
*
QMB Program Billing Requirements CMS Training Call - Wednesday, June 6, from 10:30am - 12 pm Pacific Time. Visit the QMB Program webpage for more information. Register for CMS' Medicare Learning Network event.
*
Medical Review Findings of Care Plan Overview (CPO) Webinar - June 19
at 1 p.m. Pacific Time. Read the complete update.
* Part B, Home Health & Hospice Collaborative Webinar, June 27
|
|
|
- ARE YOU AN ONCOLOGY MEDICAL HOME?
The MOASC office receives calls and e-mails from patients requesting names of oncology practices who are an OMH. If you are, and wish MOASC to refer patients to your care, please contact moasc@moasc.org. Thank you.
- MOASC and ANCO are jointly conducting a 2018 staff salary survey. The survey will be USPS mailed, e-mailed/FAXed to all MOASC members in mid-May and is available online at www.anco-online.org/salary.html. A $50 Visa gift card for respondents is included in this year's survey. Return your completed survey no later than September 30; results will be analyzed and reported in 4Q2018.
- The deadline to RSVP
for a complimentary registration to attend the American Society of Hematology (ASH) Meeting on Hematologic Malignancies
(MHM) from September 7-8, 2018 in Chicago, is THIS Friday, May 25, 2018. Please contact the MOASC Office at moasc@moasc.org, if you are interested in a complimentary registration. The ASH Meeting on Hematologic Malignancies features the top experts in the field, comprehensive clinical content, and the opportunity to interact with colleagues in an intimate, small-group setting with no competing sessions. The program content is structured as "How I Treat" presentations, which showcase each speaker's evidence-based treatment approaches. The list of confirmed speakers and program topics can be found on the ASH website at www.hematology.org/malignancies.
- MOASC is proud to be part of the
American Life Sciences I nnovation Council (ALSIC) acknowledgment of the California recipients of the 2018 Champions of Health Care Innovation Award. The ALSIC will be awarding select members of the California Congressional Delegation with its Award. The award will be given to Rep. Ami Bera, Rep. Jeff Denham, Rep. Anna Eshoo, Rep. Valadao, and Rep. Devin Nunes-as they have shown commitment to principles which MOASC and ALSIC believe encourages innovation in the Life Sciences. As a key part of assessing which members will receive this year's awards, ALSIC looked to acknowledge members who have demonstrated leadership on some or all of the following issues:
Protecting Medicare Parts B and D from arbitrary changes that would limit patient access, harm provider participation in the program, and stifle a competitive marketplace.
Supporting federal funding for research.
Expressing concern or calling for repeal of the Independent Payment Advisory Board.
Support for the 21st Century Cures Act and its timely implementation.
  
|
|
|
- ANCO and MOASC are jointly conducting a 2018 staff salary survey. The survey will be USPS mailed, e-mailed/FAXed to all ANCO members in mid-May and is available online at www.anco-online.org/salsrvy.html. A $50 Visa gift card for respondents is included in this year's survey. Return your completed survey no later than September 30; results will be analyzed and reported in 4Q2018.
- ANCO is organizing a series of Hematologic Malignancies Updates in 2018. The first Update takes place on June 16 at the Sacramento Hyatt Regency with Gabriel Mannis, M.D.,
University of California, San Francisco,
Joseph Tuscano, M.D., University of California, Davis, Jeffrey Wolf, M.D., University of California, San Francisco, and Naseem Esteghamat, M.D., University of California, Davis. The latest research on novel treatment modalities for hematologic malignancies--leukemias, lymphomas and myeloma--along with case studies for these diagnoses will be presented. These updates are supported by AMGEN, Janssen Oncology, Jazz Pharmaceuticals, Novartis Oncology, and Seattle Genetics. Download the meeting announcement and registration form at www.anco-online.org/2Q2018HemeMaligUpdate.pdf.
|
|
|
- Life after cancer is about more than just counting years. It's about making those years count. Let's work together to lessen the burden of cancer survivorship. Join others to #CelebrateLife and raise awareness on National Cancer Survivors Day, June 3. #NCSD2018 National Cancer Survivors Day® is an annual, treasured Celebration of Life that is held in hundreds of communities nationwide, and around the world, on the first Sunday in June. On National Cancer Survivors Day®, thousands gather across the globe to honor cancer survivors and to show the world that life after a cancer diagnosis can be fruitful, rewarding, and even inspiring. NCSD offers an opportunity for all people living with a history of cancer - including America's 15.5 million cancer survivors - to connect with each other, celebrate milestones, and recognize those who have supported them along the way. It is also a day to draw attention to the ongoing challenges of cancer survivorship in order to promote more resources, research, and legislation to improve cancer survivors' quality of life.
The nonprofit National Cancer Survivors Day Foundation offers free guidance, education, networking resources, and assistance to hundreds of hospitals, support groups, and other cancer-related organizations that host National Cancer Survivors Day® events in their communities. The Foundation's primary mission is to bring awareness to the issues of cancer survivorship in order to better the quality of life for cancer survivors.
- The Patient Access Network (PAN) Foundation is a nonprofit organization dedicated to helping underinsured individuals with the out-of-pocket costs for their critical medications and treatments. PAN currently has 28 hematology and oncology assistance programs and can be a resource for your patients. The PAN Foundation's application process is quick and convenient. Patients, or their caregivers, healthcare providers and pharmacists acting on their behalf, can apply over the phone or by using our portals at panfoundation.org, and receive instant approval.
- Aetna will no longer allow contracted physicians to receive payment via check. According to a February 1 notice, Aetna is asking providers to choose one of two options to receive electronic payments - via electronic funds transfer (EFT) or through a virtual credit card (VCC). Providers who do not make a selection will be automatically enrolled in the VCC payment method. Aetna reports that it began the move to electronic payments in 2009 following the Centers for Medicare and Medicaid Services' lead and in an effort to reduce costs. Aetna was initially allowing physicians to request a hardship exemption and continue to receive paper checks. However, Aetna will no longer be allowing exemptions; providers will be required to choose to receive electronic payment via EFT or VCC.
With the VCC payment method, payors send credit card payment information and instructions to physicians, who process the payments using standard credit card technology.
This method is beneficial to payors, but costly for physicians
. Health plans often receive cash-back incentives from credit card companies for VCC transactions. Meanwhile, VCC payments are subject to transaction and interchange fees, which are borne by the physician practice and can run as high as 5 percent per transaction for physician practices. Physicians can avoid these interchange fees by enrolling in EFT.
While there is no requirement that payors continue to issue paper checks, physicians have the right to request electronic funds instead. HIPAA requires all health plans to offer standardized EFT using the Automated Clearinghouse (ACH) Network. Similar to direct deposit, ACH EFT allows health plan payments to be directly paid into a physician's designated bank account. Each ACH EFT transaction carries only one fee of about $0.34, far less than the potential 5 percent fee charged to VCC transactions. In order to receive ACH EFT, physicians should request and register for this payment method with payors.
Providers who wish to enroll in EFT can do so through EnrollHub®, the Council for Affordable Quality Healthcare's (CAQH) free multi-payor EFT portal. Physicians enrolling in EFT payment will also want to sign up to receive EFT email notifications in order to be notified whenever Aetna transmits a payment. To sign up for EFT email notifications, visit NaviNet's secured website at https://connect.navinet.net/enroll.
|
CMS News
- The Centers for Medicare & Medicaid Services (CMS) published an updated New Medicare Card
release schedule
which indicates that the agency's original roll-out schedule is slightly delayed.
According to the agency, several states, including AK, CA, DE, HI, MD, PA, OR, VA, and WV will have cards issued to beneficiaries in May, with other states to follow after June. MGMA developed the
New Medicare Card Toolkit
to help practice leaders get ready for the new Medicare cards.
- The Centers for Medicare & Medicaid Services (CMS) recently posted the electronic clinical quality measure (eCQM) annual update for the 2019 reporting period, and the 2019 performance period for
eligible professionals (EPs) and eligible clinicians, and foreligible hospitals and critical access hospitals (CAHs). Measures will not be eligible for 2019 reporting unless and until they are proposed and finalized through notice-and-comment rulemaking for each applicable program. These updated eCQMs are to be used to electronically report 2019 CQM data for the following CMS quality reporting programs:
The Hospital Inpatient Quality Reporting Program; The Medicare and Medicaid Promoting Interoperability Programs (formerly known as the EHR Incentive Programs);
Quality Payment Program: The Merit-based Incentive Payment System and Advanced Alternative Payment Models, Comprehensive Primary Care Plus;
New updates for the 2019 reporting/performance period include:
The use of clinical quality language logic; eCQM Reading Guide; and Updated eCQM Value Sets and Specifications.
CMS encourages you to submit questions and comments regarding the updated measures via the eCQM Issue Tracker.
- The CMS is accepting proposed measures for inclusion in the Medicare Promoting Interoperability program, formerly known as meaningful use. Stakeholders may submit ideas by June 29 that focus on the improvement of health data exchange and interoperability, advanced use of 2015 edition certified EHR technology, patient safety, outcomes measurement, and streamlined program effectiveness, efficiency and flexibility. EHR Intelligence
|
Affiliate Association News
- ASH is now accepting nominations, through June 1, for members to participate in the eighth annual Advocacy Leadership Institute taking place September 24-25, 2018, in Washington, DC. This two-day workshop is an opportunity for ASH members who wish to gain a better understanding of the Society and its activities, and to learn about legislation and health policy affecting hematology research and practice. 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.
- Have you or your colleagues worked to implement appropriate use strategies in your practice, institution, or hospital system? You are encouraged to apply by June 1, 2018, and 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.
- It's Not Too Late to Register for the ASCO Annual Meeting taking place June 1-5, in Chicago, Illinois. The world's premier oncology event offers access to the latest cancer care strategies and the opportunity to network with the brightest minds in oncology research, education, and care. Don't miss this year's engaging sessions, practice-changing research, and opportunities to connect with global experts in oncology care. Register today.
- June 4 is the deadline for submission of application for ASCO's Quality Training Program-being held at ASCO headquarters, July 11-12, September 20-21, and December 5, Applicants are encouraged to submit early to prepare for session 1. Once applicants are accepted, they are paired with an improvement coach who can provide feedback and help participants outline their quality improvement goals and plans so they can get the most out of the session. Learn more.
- Help steer the meeting discussion by providing input today, for t
he
ASH Summit on Emerging Immunotherapies for Hematologic Diseases, July 12 & 13, 2018. The Summit will feature interactive breakout sessions aimed at addressing important topics relevant to the design and application of immunotherapies. These small-group sessions will create a unique opportunity for attendees to steer the conversation and help chart the course for the field. Please complete a short pre-meeting surveyto help facilitate scientific discourse during the breakout sessions.
- Submit an abstract, by June 12 at 8:59 PM (PDT), for the ASCO Quality Care Symposium, September 28-29, 2018 in Phoenix, Arizona. The Symposium is the ideal venue to present your research to colleagues in the field interested in improving the implementation of quality and safety in cancer care. Through a multidisciplinary program of panel discussions, lectures and abstract presentations, the Symposium promotes innovation, collaboration, and cooperation to improve quality in oncology care.
- Registration for the
2018 National Oncology Benchmark Study (NOBS) is now open to all infusion and radiation oncology centers. THERE IS NO FEE. Whether you are a hospital, freestanding center or an oncology practice (medonc or radonc) you can be a vital participant in this valuable study! Participation guarantees you a complimentary copy of the Final Report. The more participants...the better the data for all. Following your registration, CLICK HERE TO REGISTER, you will be sent the data submission forms to your e-mail address. Please review them carefully. Proper submission of all forms is important to avoid exclusion of your data from the study. Please feel free to contact Oncology Management Consulting Group with any questions at solutions@oncologymgmt.com
.
More information on the study is available at
www.NOBStudy.com
.
- NCCN has published updates to:
- The NCCN Guidelines® for Breast Cancer Screening and Diagnosis v2.2018.
- The NCCN Templates® for Hodgkin Lymphoma Version 3.2018.
- The NCCN Framework™for Head and Neck Cancers (Lip and Oral Cavity) v1.2018 and Hepatobiliary Cancers (Hepatocellular Carcinoma and Gallbladder Cancer) v1.2018
For the complete updated versions please visit NCCN.org.
|
|
|
- In last week's California Oncology Weekly, you were asked to take a brief, five-minute survey regarding your online business purchasing. As of today, Innovatix has not received your responses. Your input and perspectives are extremely valuable, so please take a moment to complete the survey using the link below. Please complete the survey before the close of business on Friday, May 25. The information gathered from this survey will help Innovatix tailor our new programs to your business needs. Innovatix will not share your information with any outside parties beyond Innovatix and Premier. Thank you in advance for your time. Take the survey.
- AstraZeneca invites you to join them for a national broadcast presentation and interactive discussion on, "TAGRISSO® (osimertinib) as First-Line Treatment for Patients With Metastatic NSCLC whose tumors have EGFR Exon 19 Deletions or Exon 21 L858R Mutations," May 24, 2018
. Two viewing options will be available: 4:00 pm PT and 6:30 pm PT. Preregistration is required to participate. To register, please go to
AstrazenecaNationalBroadcast.com
.
TAGRISSO is indicated for the first-line treatment of patients with metastatic non-small cell lung cancer (NSCLC) whose tumors have epidermal growth factor receptor (EGFR) exon 19 deletions or exon 21 L858R mutations, as detected by an FDA-approved test.
You will receive a confirmation email with information on how to connect to the broadcast before the event.
If you have questions about this program, you may contact your AstraZeneca representative.
- Pfizer Inc. announced the U.S. FDA approved RETACRIT® (epoetin alfa-epbx), a biosimilar to Epogen® and Procrit® (epoetin alfa), for all indications of the reference product. RETACRIT is now the first and only biosimilar erythropoiesis-stimulating agent (ESA) to be approved in the U.S. For more information please contact your Pfizer representative or Alisha T. Weed, CPC, Field Reimbursement Manager, CA & HI | Pfizer Oncology alisha.weed@pfizer.com.
|
|
|
|
MOASC CALENDAR
|
(SITC, San Francisco, May 16-17)
(
Sacramento, June 16)
SAVE THE DATE
ANCO's ASCO Highlights
(Oakland, August 25)
|
|
|
|
|
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
|
|
| |
|
