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.
December 17, 2019
IN RECOGNITION OF THE HOLIDAYS, AND AS MOASC & ANCO OFFICES WILL BE CLOSED, THE
CALIFORNIA ONCOLOGY WEEKLY
WILL NOT BE PUBLISHED ON
DECEMBER 24, 2019 OR DECEMBER 31, 2019.
WE WISH YOU HEALTH & BEST WISHES
AT THIS TIME OF JOY.
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- Oncologist, Dr. Stephen Hahn, to lead the FDA. National News
- CVS Health launching new precision medicine strategy for payers. National News
- CMS extending Affordable Care Act open-enrollment period. CMS News
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- CancerCare
has created the "California Wildfires Patient Assistance Program" for cancer patients impacted by the California wildfires.
The program offers:
- Financial assistance to people living with cancer in active treatment who have been affected by a wildfire;
- Resource referrals to help people coping with cancer, addressing needs resulting from a wildfire's impact;
- Emotional support from CancerCare oncology social workers for people coping with cancer, their caregivers and their loved ones;
- Educational information to help patients and families manage the emotional and logistical challenges of living with cancer.
Additional emergency preparedness information for your patients and your practice, can be obtained through MOASC's Oncology Patient Emergency Network
(OPEN) program at
www.open-central.com or contact Nichole East neast@moasc.org.
- Over the last half-century, taking care of Californians' health has become the state's single largest economic activity. California's economy has transitioned from long-dominant natural resource and industrial sectors into services and technology.
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- Starting January 1, if you do not use the MBI (regardless of the date of service) for Medicare transactions Noridian will reject your claims with a few
exceptions
and Noridian will reject all eligibility transactions. See the
MLN Matters Article
for more information on getting and using MBIs.
- Noridian/JEMAC has the following updates on their website
Publications:
* National Correct Coding Initiative (NCCI)
* Open Payments: Review and Dispute Data by December 31
* Quality Payment Program: Check Your Final 2019 MIPS Eligibility Status
* Quality Payment Program: MIPS Low-Volume Threshold Criteria for 2019
* Self-Administered Drug Exclusion List-R16
*Jurisdiction E Part B LCDs and LCAs-Effective December 1, 2019
* Billing and Coding: Nerve Blockade for Treatment of Chronic Pain and Neuropathy-R2
* AUC for Advanced Diagnostic Imaging-Educational and Operations Testing Period-Claims Processing Requirements-Revised CR11268
* MLN Connects Special Edition-December 1, 2019
* Update to Medicare Claims Processing Manual, Chapters 1, 23, and 35 CR10882
Forthcoming Noridian JEMAC meetings/webinars/workshops
* Using the Medicare Beneficiary Identifier (MBI) Webinar (December 19)
* What's New in the First Quarter 2020-After Hours Webinar-(January 7)
* Basics of Provider Enrollment Webinar (January 8)
* What's New in the First Quarter 2020-After Hours Webinar-(January 14)
* New Opt-Out Process Webinar (January 15)
* Modifier 59, NCCI and MUEs Webinar (January 16)
* Medicare Part A/B Revalidation Webinar (January 29)
* Submitting Your Enrollment Online Part 1(I&A) Webinar (February 26)
* Common Error when Enrolling in Medicare Webinar (March 4)
* Submitting Your Enrollment Online Part 2 *(PECOS) Webinar (March 18)
* Rebuttal, Reconsiderations and CAPS Webinar (April 8)
* Medicare Part A/B Revalidation Webinar (April 22)
For more information and to register visit:
http://med.noridianmedicarecom/web/jeb/education/training-events
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- MOASC has secured a special PHYSICIAN'S encore webinar with the California Medicare contractor Medical Director, Arthur Lurvey, MD, FACP, FACE, who will present Getting Ready for Medicare in 2020 and 2021, January 22, 2020 at 5:30pm-PST. Physicians, NPP's and all interested staff are welcome. The webinar affords physicians to enter into live dialogue and Q&A with the California Medicare medical director. For more information, and to register for this webinar, contact the MOASC office at
moasc@moasc.org or call 909-985-9061 x1.
- Mark your calendar for the MOASC Spotlight on Hematology on Saturday, February 1, 2020, 9am to 2pm, at The Waterfront Hilton in Huntington Beach. Through a grant from MOASC, UCI brings speakers from UCI, Loma Linda and City of Hope to present the highlights from ASH's Annual Meeting & Exposition. Contact the MOASC office at 909-985-9061 ext.1 or
moasc@moasc.org or www.moasc.org
-
"Exciting Advances in Oncology"
is the focus at the
MOASC
2020 Annual Educational Symposium
and celebration of MOASC's 30th Anniversary
on Saturday, March 14, 2020 at the Hyatt Regency Huntington Beach. Speakers will highlight advances in several areas of oncology including melanoma, lymphoma, breast, colon, prostate, kidney, and lung cancers, among others. To register, contact the MOASC office at moasc@moasc.org or 909-985-9061 x1. #MOASC30
- MOASC Member, City of Hope CME presents: Immunotherapy of Cancer: CAR T Cell to Checkpoint Inhibitors March 18, 2020 to March 21, 2020 at the Waldorf Astoria, Las Vegas, Nevada. For more information click
here. To register go to
https://cme.cityofhope.org/eventinfo_11295.html
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- REGISTER for
Best of SABCS Northern California
taking place in Berkeley on January 11.
Best of SABCS
is cosponsored by ANCO and
Encore Medical Education
.
- REGISTER for the
20th Multidisciplinary Management of Cancers: A Case-based Approach
taking place in Napa on March 13-15.
- ANCO physician members should have received an e-mail instructing them on how to vote in the 2019 Annual Election that is being conducted online from now through the end of December. If you have not received an e-mail, then please contact ANCO at courtney@anco.org.
- ANCO physician members, their practice staff, and representatives from ANCO's corporate members must register to access password-protected content (e.g., The ANCO Directory, ANCO meeting materials) on the ANCO website (
www.anco.org
) at
https://anco.org/membership/already-a-member/
.
- Follow ANCO on Twitter at
@ANCO News
.
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National News
- CVS Health is launching a new precision medicine strategy for payers that will incorporate genomics and technology. The new Transform Oncology Care, a comprehensive oncology management program, will use genomic testing results at the point-of-prescribing to help patients get started sooner on the best treatment and helps match eligible patients to clinical trials, CVS Health executives say. CVS has tapped Tempus, a precision medicine technology company that uses artificial intelligence, to help with the program. Therapeutic regimens that align to National Comprehensive Cancer Network guidelines, including those matched with the results of the broad-panel gene sequencing tests, will automatically receive prior authorization approval, speeding therapy for patients, CVS said.
- Last week, the U.S. House of Representatives passed a government drug-price negotiation bill pushed by House Speaker Nancy Pelosi (D-Calif.) on a largely party-line vote. The centerpiece of House Democrats' Elijah E. Cummings Lower Drug Costs Now Act is a provision that would allow the HHS secretary to negotiate prices for up to 250 high-spend drugs with little competition. The negotiations would be bound by an index of drug prices in other developed countries. The negotiated price would also have to be offered to private payers.
- Yesterday, congressional negotiators released details on a budget deal that would delay Medicaid payment cuts to disproportionate-share hospitals for five months, stop brand drug makers from withholding samples needed for generic development, and repeal three Affordable Care Act taxes. The deal included a funding extension for several Medicare and Medicaid priorities through May 22, but did not include major legislation to address surprise medical bills or to lower prescription drug costs. Congress and the Trump administration have until midnight Dec. 20 to approve a budget deal in order to avoid another government shutdown. A budget impasse a year ago resulted in a shutdown from Dec. 22 until Jan. 25.
- Last week, the Senate confirmed Dr. Stephen Hahn to lead the Food and Drug Administration. Hahn, an oncologist and chief medical executive at the University of Texas MD Anderson Cancer Center, won confirmation to the role of FDA commissioner with a vote of 72-18.
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CMS News
- The CMS is extending the Affordable Care Act open-enrollment period for 2020 exchange coverage starting at 12 p.m. (PST) Monday, December 16 to 12 a.m. (PST) Wednesday, Dec. 18, after reports that some customers experienced technical difficulties while attempting to sign up for a plan last Sunday, December 15, the deadline to enroll.
- Group practices or individual eligible clinicians interested in applying for a hardship exception to the promoting interoperability category or an extreme and uncontrollable circumstances exception to other MIPS categories for the 2019 performance year must submit an application by Dec. 31. For more information, visit the Quality Payment Program resource library, which outlines eligibility, where to submit applications, and information on how approval will be noted.
- Yesterday, a federal judge denied hospitals' request to halt the CMS' plan to implement its so-called site-neutral payment policy in 2020. The CMS' site-neutral payment policy aims to slash healthcare spending by paying the same amount for a doctor's visit, regardless of whether it happens inside a hospital outpatient facility or a regular doctor's office. The Trump administration has argued that it makes more sense to reimburse for the services provided than to differentiate payments based on the site of care, which may contribute to hospital-provider consolidation and drive up costs for consumers. The agency estimates it would reduce federal spending by $800 million in 2020.
- How Will Your Practice be Affected by the 2020 Medicare Physician Fee Schedule?
In the latest ASCO In Action podcast, ASCO CEO, Dr. Clifford A. Hudis, discusses the updates that will affect oncologists in the 2020 Medicare Physician Fee Schedule final rule, which outlines changes to Part B reimbursement policies and the Quality Payment Program. ASCO's goal will always be "to ensure that oncologists can provide the right treatment, at the right time," says Dr. Hudis, "and we aim to help CMS implement policies that advance that goal." Subscribe to this podcast through
Apple Podcasts
or
Google Play
, and take the
ASCO Podcast Survey
to help ASCO improve its podcasts
- Read ASHs summaries of CMS's Medicare Physician Fee Schedule and Hospital Outpatient Prospective Payment System (HOPSS) final rules for CY2020.
- ASH has provided comments to CMS regarding its Proposed Decision Memo on Next Generation Sequencing (NGS) for Medicare Beneficiaries with Advanced Cancer. ASH shared its concern that the policy as drafted would limit, rather than expand, Medicare beneficiary access to NGS-based testing for cancer. Read ASHs letter.
- Earlier, CMS had published updated open payments data reported in 2018 and physicians have until December 31 to review and dispute the 2018 data reported in their name. Learn more and review your data at https://openpaymentsdata.cms.gov.
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Affiliate Association News
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- ASCO is pleased to announce the official launch of the ABIM/ASCO Medical Oncology: Learning & Assessment (MOLA), a flexible, lower stakes maintenance of certification (MOC) program that offers physicians a choice of medical oncology assessments--either a general medical oncology assessment or disease-specific medical oncology assessments (e.g., breast cancer, hematologic malignancies). Learn more at https://elearning.asco.org/pages/abim-asco-medical-oncology-learning-and-assessment.
- ASCO has partnered with the National Community Oncology Dispensing Association (NCODA) to create joint evidence-based standards for medically integrated in-office dispensing of oral anti-cancer drugs and supportive care medications.
- Please support the Community Oncology Alliance (COA) for 2020.
With COA serving as your voice in the legislative deliberations, decision-making, and negotiations in Washington, community oncologists have been able to markedly influence public policies like never before for the better of patients and practices. This year COA faced down major reforms to the ASP reimbursement system, including proposals for ASP + 3 percent and even a flat-fee add-on; provided guidance to CMS on the Oncology Care Model (OCM) and just-announced successor, the Oncology Care First (OCF) model; advocated for changes to site parity with hospital payments and the 340B program; and so much more. Importantly, COA spent an incredible amount of resources, time, and money fighting a variety of PBM and insurer issues, launching a major media campaign, undertaking legal action, and advancing legislation, all aimed at exposing and stopping PBM abuses that hurt patients and practices. COA 2020 Member Renewal Letter
- Read COA's government affairs update. This new, exclusive publication is part of COA's renewed effort to give you more regular updates on the issues COA is working on. COA GAP Update Q4 2019
- NCCN has published updated guidelines at
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Industry News
- Astellas Oncology has announced that the FDA approved Xtandi for patients with metastatic castration-sensitive prostate cancer (mCSPC).
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MOASC CALENDAR
Spotlight On Hematology
February 1, 2020
City of Hope CME presents: Immunotherapy of Cancer: CAR T Cell to Checkpoint Inhibitors
March 18-21, 2020
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(Stanford, April 2-3, 2020)
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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 MOASC and ANCO 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 2954, Alameda, CA 94501 | P (415) 472-3960 | www.anco.org
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