California Oncology Weekly
"An Oncologists’ Source for Timely Information"
A publication of the
Medical Oncology Association of Southern California, Inc.
December 22, 2020
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Click anywhere on picture to view the past 30 years
The California Oncology Weekly will not be published next week, December 29th.
We wish you and your family a wonderful holiday season.
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Effective January 1, 2021, ESI will exclude Calquence from their formulary. MOASC News
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Multi-Cancer Early Detection Test legislation. National News
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Distribution of COVID-19 vaccine to your cancer patients. National News
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MOASC Member In The News! MOASC Board Member, Dr. Ravi Patel, Director of Medical Oncology and Hematology at the Comprehensive Blood and Cancer Center (CBCC), joined KGET News to discuss Prostate Cancer. Dr. Patel shared that early screenings are important for catching the cancer diagnosis early.
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Please share your physician and practice news for publication in the California Oncology Weekly to moasc@moasc.org. |
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MOASC is in receipt of a recent notice from ESI (PBM) regarding a formulary change and would like to know if MOASC Members and Colleagues are in receipt of same. In short, effective January 1, 2021, ESI will exclude Calquence from their formulary. A patient memo was sent out stating the product is no longer on formulary. The Over-The-Counter (OTC) option outlined in the memo is concerning and confusing as there are no OTC oncology drugs, to our knowledge. MOASC would appreciate your input on this type of formulary communication from PBMs that have implications on oncology patient access. Please feel free to share your thoughts to moasc@moasc.org. |
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Experts in use of Molecular Profiling Tests to Diagnose and Treat Cancer Patients are invited to participate in an important research study. The survey will take approximately 40 minutes to complete. Please participate at your earliest convenience. As a token of appreciation, physicians will be paid an honorarium of $240 for completing the study.
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Submit your nominations by Friday, January 8, 2021. Nominate your candidate(s) now, for the MOASC Excellence Awards. MOASC would like to recognize MOASC Members, and your staff, in the areas of Excellence in Leadership and Excellence in Healthcare for your dedication to providing quality cancer care during the Pandemic of 2020. MOASC knows you are the backbone of the oncology delivery system. Selflessly, you take on significant personal risk to ensure that your patients continue to receive the care they need. Nominations are for the practice, physician, nurse or other healthcare worker exemplifying dedication, commitment and courage to continue providing care, thereby saving countless lives and making a difference in the community. Please provide a brief summary of why you are nominating this individual or team. Awardees will be announced during the virtual MOASC Annual Oncology Summit, Saturday, March 27, 2021. Please submit your nominations by Friday, January 8, 2021. Thank you!
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MOASC Programs - Save the Dates - All Times are Pacific
San Antonio Breast Cancer Symposium®, with MOASC and ANCO, invite you to attend the Virtual Best of SABCS® USA Western Region, on January 9.
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VerdePharmHealth, a MOASC Industry Sponsor, is the first organization of its kind in the U.S., providing comprehensive multi-specialty group purchasing, clinical solutions, and healthcare technology. An introductory webinar on VerdePharmHealth services is scheduled for January 14, 12:00pm-1:00 pm.
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MOASC presents Spotlight On Hematology, February 20. Selected fellows and faculty, from the University of California, Irvine, will present the premier topics from their attendance at the 2020 Annual ASH Meeting. Through virtual conferencing, the presentations will promote collegial discourse among colleagues and networking among attendees.
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MOASC will, once again, with Neil Love, MD, Founder, Research To Practice (RTP) on March 6, 2021 to present a virtual Clinical Summit Case Presentation
The MOASC ONCOLOGY SUMMIT, ANNUAL CLINICAL EDUCATION SYMPOSIUM – Exciting Advances in Oncology, is scheduled for March 27, 2021, 7:30am – 1:30pm, at the Hyatt Regency Huntington Beach. MOASC President, Ashkan Lashkari, M.D. will moderate topics presented by experts from City of Hope and UCLA highlighting advances in several areas of oncology including genitourinary, lymphoma, thoracic, colorectal and breast cancers. Please join us for another exciting opportunity to interact with colleagues and learn from recognized speakers.
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A live, online presentation outlining Governor Newsom's 2021 budget priorities will be presented by California Finance Director Keely Martin Bosler on Tuesday, January 12, 2021 at 8:30 a.m. Due to time constraints, questions must be submitted in advance by emailing events@calchamber.com. |
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The UCLA Kaiser Permanente Center for Health Equity, in collaboration with the UCLA Jonsson Comprehensive Cancer Center, invite the submission of proposals for projects to address and improve disparities in cancer and related diseases among underserved populations in and around Los Angeles County. Up to ten grants of $5,000 each are available to support local community based organizations working in the areas of, but not limited to: colorectal cancer, lung cancer, gastric cancer and cancer survivorship. Application deadline is February 12.
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Noridian News
Check Noridian’s “Browse by Topic” for Medicare Secondary Payer (MSP) Top Errors and Remittance Advice Denial Code Resolution.
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ICD-10 and Other Coding Revisions to NCDs have been updated.
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Part A/B Quarterly Medicare Updates on January 5 & 14, will include: CMS and Noridian Updates, January 2021 Quarterly Provider Updates, Change Requests (CR), Payment and Recurring Updates, Special Editions (SE), Resources and Educational Information.
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New Provider New Biller Review Entities and Appeals Webinar on January 14, will include: Appeals Process, Forms, Noridian Medicare Portal (NMP), Post Medical Review Programs, and Resources
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Region-specific events, webinars and training for December & January are found JEA, JEB, JAF and JFB.
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Locally-hosted coverage articles listed |
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CMS News
CMS has released their annual updates to the Drug Spending Dashboards and the Medicare Part B Discarded Drug Units Report with data for 2019. The dashboards focus on average spending per dosage unit for prescription drugs in the Medicaid, Medicare Part B, and Medicare Part D programs, and track the change in average spending per dosage unit over time.
CMS requires all physicians, hospitals, and other providers submitting Medicare Part B drugs claims to report any discarded amount of a single use vial or other single use package drug on its claim for reimbursement. This report presents data on spending for discarded drug units covered under Medicare Part B.
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If Most Favored Nations (MFN) goes into effect, the list of drugs will be updated on a regular basis as new drugs make it into the top 50 on total expenditures. MOASC has joined COA, ACCC, NOSN, ANCO and more than 170 state and national organizations by signing onto the Part B Access to Seniors and Physicians (ASP) Coalition’s letter regarding the harmful MFN Model for Medicare Part B drugs. The ASP Coalition strongly opposes implementing the MFN Model and has long raised concerns about such demonstrations. It is imperative that legislation is passed to require an immediate delay of the model. Thank you for your ongoing support to preserve patient access to Medicare Part B covered services.
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Rep. Raul Ruiz, M.D. (D-CA), an emergency physician by training, recently co-sponsored H.R. 8845, the Multi-Cancer Early Detection Screening Coverage Act which would ensure prompt access to FDA-approved multi-cancer screening tests and fuel innovation in cancer screening. This bipartisan legislation ensures that Medicare can cover groundbreaking multi-cancer early detection tests as soon as they receive FDA approval.
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Below, please find a link about the distribution of the COVID-19 vaccine to your cancer patients, what Patients with Cancer, Survivors need to know about the Emergency Use Authorization of COVID-19 Vaccine
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Congress has come to an agreement on a stimulus package, which may include relief from the sequester. Congress will pass, this scaled down bill to be effective only for a quarter of 2021. It is expected this will be revisited after the new Congress is sworn in. The Congressional Budget Office estimated that the original version would cost more than $12 billion a year of relief, therefore the relief bill was scaled back. COA Executive Director, Ted Okon, remarked, “
…It was a hard fight to get any relief, this was a minor miracle that took a total team effort. COA will be back at this after the start of the New Year…” Thank you all who reached out to your members of Congress to ask for support!
The American Medical Association (AMA), has provided comments on the Most Favored Nation (MFN) Model interim final rule (IFR), published in the Federal Register on November 27, 2020 (85 Fed. Reg. 76180). The AMA strongly urges CMS to withdraw the MFN interim final rule. Whereby, the AMA has long supported efforts to address escalating prices of prescription drugs and reduce financial burdens on patients as a result of exorbitant drug prices, there are significant concerns regarding the Most Favored Nation Model and its impact on patient access to essential treatments, as well as the model’s financial impact on physician practices. Additionally, the AMA addressed concerns over the process by which the CMS is attempting to implement this program.
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After HHS failed to enforce 340B Drug Pricing Program, the American Hospital Association (AHA) and four other hospital organizations filed a law suit against the department in the US District Court for the Northern District of California, stating it lacked the authority to require pharmaceutical companies to sell 340B drugs at or below 340B ceiling price requirements. Earlier this year, major pharmaceutical groups stopped providing drug discounts to hospitals, when covered drugs were being sent to hospital contract pharmacies. Now, hospital organizations are asking the court to force HHS to require a handful of pharmaceutical companies to provide 340B-acquired drugs at the discounted prices even when the drugs are sold through contract pharmacies. Pharmaceutical companies are not willing to apply duplicate discounts on 340B drugs if hospitals already have their own in-house pharmacies. The Pharmaceutical Research and Manufacturers of America (PhRMA) states that the exponential growth in the number of contract pharmacies participating in 340B, including the largest for-profit chain pharmacies in the country, is one example of how the program has evolved away from what Congress originally envisioned. There is also little to no evidence that contract pharmacy participation in 340B has improved patients’ access to medicines.
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Affiliate Association News |
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ANCO News
Virtual Best of San Antonio Breast Cancer Symposium® – West, January 9, 2021.
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2021 Medicare Update webcast with Roberta Buell, MBA, onPoint Oncology on January 6; 12:30PM PST. Learn about Medicare’s regulations for 2021. Bobbi Buell will provide a comprehensive update of changes for Medicare reimbursement of oncology services, including fee schedule, coding/billing, evaluation and management changes for 1/1/2021, and incentive program updates.
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21st Multidisciplinary Management of Cancers: A Case-Based Approach is taking place virtually on March 12-14, 2021.
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ASH News
ASH has scheduled the Highlights of ASH series taking place virtually in March 2021. Special focus on the North American region will take place during one week of the series. More information on agenda and for registration to follow.
COA News
Registration is now open for the virtual 2021 Community Oncology Conference, April 8-9, 2021.
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Puma Biotechnology, Speaker Program invites you to their Post-SABCS Web Series for NERLYNX® (neratinib) on January 12, 13 & 14. Click on preferred date below to register.
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SeaGen cordially invites MOASC members to their upcoming ADCETRIS® (brentuximab vedotin) National Broadcast event. This broadcast will be an engaging event featuring the Chair, Scott Smith, MD, PhD, FACP, LUMC and Panelists: Elizabeth Brém, MD, UCI and Aaron Goodman, MD, UCSD, on Thursday, January 21, 2021, with 2 sessions. To register contact Stacey Dominguez at 310-560-1104 or email sdominguez@seagen.com.
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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 material contained in the California Oncology Weekly is intended as general information for 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 accepts no liability for any statements or articles herein. CPT codes are owned and trademarked by the American Medical Association. All Rights Reserved.
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