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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This Weekly's Hot Topics
- TODAY at 10:30am, ACCC webinar CMS Proposed CY2020 Affiliate Association News
- California Cancer Caucus partners with the California Legislative Black Caucus.California News
- Read about the Medicine Assistance Tool, or MAT, to help with prices for medicines.National News
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- Last Wednesday, MOASC President, Warren Fong, M.D. and NOSN President, Mariana Lamb represented the California Cancer Caucus at the invitation of Assemblymember 79th District, Shirley Weber, Ph.D, Chair of the California Legislative Black Caucus (CLBC). A very special luncheon briefing was held addressing one of our state's greatest health challenge - Cancer. The CLBC, in partnership with the California Life Sciences Association (CLSA), the California Cancer Caucus, the National Oncology State Network (NOSN), and the American Cancer Society Cancer Action Network (ACSCAN) hosted Cancer and the Most Underserved Community: Research and Solutions, in the Eureka Room at the State Capitol.During this briefing, topics addressed the current impact of cancer on the state, with a focus on geographical data and the health disparities in communities of color, with an emphasis on the black community. As you may know, research has shown that the black community is disproportionately impacted by cancer while simultaneously having less access to treatment. Following the overview of the current state of affairs, presentations of cutting-edge cancer discoveries and treatments coming out of our state's top research institutions and biotech companies were presented. California is the birthplace of the biotech industry and is where our world's greatest minds are coming up with life-prolonging, life-enhancing and life-saving treatments such as immunotherapy.
- Blue Shield Of California Partners With California Medical Association To Help Doctors Offer Value Based Care: Blue Shield of California unveiled new details about the technology and services company it is launching to help physician practices remain independent while giving them tools needed to succeed in value-based care arrangements. A week after Blue Shield christened the new company Altais - named after a giant star - it announced Altais is partnering with the California Medical Association and Aledade, a Bethesda, Md.-based company that helps physicians launch accountable care organizations; the company and its partners will offer independent doctors and practices tools to improve patient health outcomes while making it easier for them to focus on care instead of administrative tasks. Blue Shield also said it plans to support physicians in moving toward value-based care by investing in their practices. Read more from Shelby Livingston of Modern Healthcare.
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Announcements:
Promoting Interoperability: 2019 PDMP Bonus Measure; Beneficiary Notices Initiative Mailbox Portal; Promoting Interoperability: 2020 Eligible Hospital eCQM Flows
Publications:
New Documentation Requirements for Filing Medicare Cost Reports; Update to Hospice Payment Rats, Hospice Cap, Hospice Wage Index and Hospice Pricer for FY2020; Claim Status Category and Claims Status Codes Update; 2020 Annual Update for the Health Professional Shortage Area (HPSA) Bonus Payments; Healthcare Provider Taxonomy Codes (HPTCs) October 2019 Code Set Update; Implementation to Exchange the List of Electronic Medical Documentation Requests (eMDR) for Registered Providers via the Electronic Submission of Medical Documentation (esMD) System-Revised; Physician Fee Schedule Listening Session: Audio Recording and Transcript; OPPS and ASC Listening Session: Audio Recording and Transcript;
Events:
MIPS Value Pathways RFI Webinar-September 4; New Medicare Card: Open Door Forum-September 11; Hospice Outcomes & Patient Evaluation Tool ODF-September 12;
* Healthcare Provider Taxonomy Codes (HPTCs) October 2019 Code Set Update CR11418
* Claim Status Category and Claim Status Codes Update CR11393
Forthcoming Noridian JEMAC meetings/webinars/workshops:
* Claim Submission: Paper and Electronic Webinar (September 4)
* Drugs and Biologics-Outpatient Billing Webinar (September 10)
* Reopenings Webinar (September 12)
* Recovery Auditor Program Webinar (September 12)
* Submitting Your Enrollment Online-Part 2 (PECOS) Webinar (September 18)
* Modifier 59, NCCI and MUEs Webinar (September 18)
* Eligibility Claim Denials and Rejections Webinar (October 3)
* Common Errors on all Application Types Webinar (October 9)
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- Read the
California News
section of today's California Oncology Weekly
for MOASC's representation of oncology in Sacramento last week.
- MOASC's "Spotlight On Oncology,"
was held on Saturday, August 17, 2019, at the Waterfront Beach Resort in Huntington Beach.
Topics presented were Genitourinary Cancer Updates; Breast Cancer Updates; GI Cancer Updates: Colorectal Cancer, Hepatobiliary/Pancreas Cancers; GI Cancer Updates: Gastroesophageal Cancers; Lung Cancer Updates; Melanoma Updates.To watch the interviews of the speakers discussing their presentations, go to www.oncologytube.com/moasc. Thank you to AbbVie, Alexion, Amgen, Bayer, Biocept, Bristol Myers Squibb, Doximity, Dova Pharmaceuticals, Exelixis, Foundation Medicine, Genentech, Johnson and Johnson, Lilly Oncology, McKesson, Merck, Pfizer, Pharmacyclics, Takeda, Teva and Verastem for their generous support of this meeting.
- Mark your calendars for November 14, 2019, to attend the "MOASC Educational Series Program." This year's program will highlight administrator issues as: Protecting Data in the Healthcare Industry; Secrets of successful provider contracting; Creating a custom website to drive patient growth and make your practice stand out. The current billing & collection issues and strategies to be addressed: Billing & Coding Updates for 2020; MACRA Quality Measures Guide; MIPS; G-Codes; Claims Review; Reporting and Returning Overpayments; Medicare Fraud and Abuse Penalties; Claim Denials - Understand why the claim was denied; Medicare Appeals Processes.
- Mark your calendars NOW for the 7th Annual MOASC Oncology Summit, March 14, 2020 at the Hyatt Regency Huntington Beach. From 2014 through 2019, the MOASC Oncology Summit has highlighted cutting-edge topics presented by world-renowned physicians. From topics like: Decoding Molecular Medicine's "nibs" and "mabs" to Personalizing Cancer Care in the Era of Multiple Therapies and Diagnostic Tools to Harnessing the Power of Immunotherapy, and this year's Advancing Cancer Care in the Elderly; unlike any other, MOASC has brought to southern California physicians the most contemporary topics for presentation and discussion among colleagues. You will not want to miss our 2020 program!
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- ANCO mourns the death of ANCO member Stanley Schrier, M.D., Stanford Cancer Center. Visit http://
stanford.io/2MuLy3L
for a remembrance.
- ANCO's 3Q2019 Hematologic Malignancies Updates: Leukemias, Lymphomas, & Myeloma is taking place at the Sacramento Hyatt Regency on September 14. Register at
https://bit.ly/2X2BOiV
.
- ANCO's Annual Professional Education Meeting 2019 is taking place at The Claremont Resort in Berkeley on October 17. Register at
https://bit.ly/2Sz3OsY
.
- ANCO Institutional Member UC San Francisco invites ANCO and MOASC members to the 5th International Controversies in Breast Cancer Care Conference--When is Less More? on September 4-6 in San Francisco. According to Laura Esserman, MD, MBA-- "The program is really provocative. It is designed to make people question long held beliefs! International speakers talking about all topics that are pertinent to breast cancer. This has fun and exciting topics from imaging and genetics to issues for survivors. We have a particularly great program around imaging this year as there are many new developments to discuss. We have tried to identify the most controversial topics across early and late stage cancer, and the debate style format will be very stimulating and fun! We even have a session on why people are not swayed by data, and the FDA will come to speak about why they are interested in Real World Evidence. I would really encourage those who are interested to attend! We have a low registration price for advocates ($200) and students. " Download the
meeting flyer
!
- ANCO annually funds one
Young Investigator Award
(YIA) for a qualified Northern California early-career cancer researcher through Conquer Cancer®, the ASCO Foundation. We encourage all eligible Northern California Fellows and Trainees to apply. The YIA is a one-year, $50,000 grant that provides research funding to promising physicians to support their transition from final years of subspecialty training to faculty appointment and to encourage and promote quality research in clinical oncology. In addition, ANCO funds two
Merit Awards
for the 2020 ASCO Annual Meeting and an award to attend the 6thAnnual Scientific and Career Development Retreat in October 2020, which is by invitation only. Learn more at
https://anco.org/membership/fellow-benefits/
. For questions about eligibility and the application, please contact Conquer Cancer at
grants@conquer.org
.
- Follow ANCO on Twitter at
@ANCO News
.
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National News
- The Trump administration is appealing a court ruling that struck down its plan to compel pharmaceutical companies to disclose wholesale prices of their drugs in television advertisements. The Department of Health and Human Services (HHS) filed a notice of appeal on Wednesday, as it prepares to challenge the July federal court ruling.
- Congress is likely to take on the issues of high drug prices and unexpected medical bills when legislators return from August recess this week, according to health policy experts. Both issues have broad consensus, with legislation in the works in both chambers to address them, but another issue that may also come into the mix is the Trump administration's proposal to change how drugs are paid under Medicare Part B, as well as a need to pass appropriations bills to keep the government open. MedPage Today (free registration)
- Cost is a main reason why patients fail to take their medications, and many times neither they nor their physician know ahead of time what a prescription will cost. Many insurers offer cost-comparison information to physicians who have online prescribing software, and one consumer-friendly solution could be an app that matches patients' prescribing and benefits information with local pharmacy prices. The Associated Press
.
Launched in May 2019, the Medicine Assistance Tool, or MAT, is an online platform that helps patients, caregivers and providers with prices for medicines, including a search engine to connect patients to medicine-specific financial assistance tools. In addition, MAT has resources to help patients navigate their insurance coverage. How can you use MAT? Visit www.MAT.org to get started. Once on the website, patients and caregivers will be asked to input some basic information into the search engine including prescription medicines, age, income and current insurance coverage (if any). MAT will produce search results that identify programs and resources that might be able to help. MAT is designed to help patients, caregivers and health care providers learn more about the resources available through the various biopharmaceutical industry programs. MAT is not its own patient assistance program, but rather a search engine for many of the support programs and resources that the biopharmaceutical industry has offered for decades.
- The Office for Civil Rights (OCR) is the government's HIPAA enforcement agency. The topic of their summer 2019 newsletter is "Managing Malicious Insider Threats."
The 2019 edition of Verizon's Data Breach Investigations Report found trusted insiders were responsible for 59% of all security incidents and breaches (both malicious and inadvertent) analyzed in the report. The report also indicated that the primary motivation for incidents and breaches perpetrated by insiders was financial gain.
Click Here
for the OCR Summer 2019 Cybersecurity Newsletter online.
- Artificial intelligence could help diagnose thyroid nodules. A radiomics-based machine- learning model analyzes levels of proteins and enzymes linked to some thyroid cancers and could help clinicians tell benign thyroid nodules from malignant ones, researchers reported in the American Journal of Roentgenology. The model was highly accurate based on cytokeratin 19, galectin 3 and thyroperoxidase. Health Imaging online
.
- Data standardization, faster processing speeds, higher quality data and clearly delineated responsibilities would improve health data exchange between health care providers and insurers, says Patrick Getzen, Blue Cross Blue Shield of North Carolina's chief data and analytics officer. From the consumer standpoint, simply having access to data is not enough; patients need context as well, says AARP's Jim Barnett.
MedPage Today (free registration)
- An artificial intelligence-based fraud detection system reviewed millions of Medicare Part D records per second and successfully identified potentially fraudulent activity in a pilot project, according to Frederick Deese, CEO of Visual Connections, which developed the system in partnership with Deep Labs.
Becker's Hospital Review
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CMS News
-
CMS has published open payments data reported in 2018 at
- GAO identifies 58 billing codes for comprehensive care planning. Health care providers have a choice of at least 58 Medicare billing codes for longitudinal comprehensive care planning services, according to the results of a Government Accountability Office analysis of the Medicare Physician Fee Schedule. The GAO also found that health care providers may use prolonged evaluation and management coding when the total time spent on an encounter exceeds the typical E/M time by 30 minutes. RevCycle Intelligence
- In 2019, the Medicare Promoting Interoperability Program for eligible hospitals and critical access hospitals (CAHs) finalized a new measure under the Electronic Prescribing objective, the Query of Prescription Drug Monitoring Program (PDMP) measure, in an effort to combat the opioid crisis. A PDMP is an electronic database that tracks prescriptions of controlled substances at the State level, and they play an important role in patient safety by assisting in the identification of patients who have multiple prescriptions for controlled substances or may be misusing or overusing them. Querying the PDMP is important for tracking the prescribed controlled substances and improving prescribing practices.
In calendar year (CY) 2019, this measure is one of two bonus measures within the Electronic Prescribing objective of the Medicare Promoting Interoperability Program. The goal of this measure is to build upon the current PDMP initiatives focused on monitoring the prescribing and dispensing of opioids. In 2019, this measure is optional for the Medicare Promoting Interoperability Program - those who choose to report on this measure could earn bonus points.
For all eligible hospitals or CAHs who choose to report on this measure, additional details are below:
New:
Requires a
"Yes/No"
attestation (
recently finalized in the Fiscal Year 2020 Inpatient Prospective Payment System Final Rule
)
Five (5) bonus points awarded if an eligible hospital or CAH attests "yes" to conducting a query of a PDMP for prescription drug history for one Schedule II opioid that is electronically prescribed using CEHRT during the EHR reporting period (except where prohibited and in accordance with applicable law)
No exclusions will be available as this is an optional measure. The optional reporting status allows for additional time to develop, test, and refine certification criteria and standards and workflows, while working to combat the opioid epidemic.
- CMS has announced that clinicians who participated in the Merit-Based Incentive Payment System (MIPS) in 2018 can access their 2018 performance feedback by logging in to the Quality Payment Program (QPP) website. The information should confirm whether you or your practice will receive a positive, negative, or neutral Medicare fee schedule adjustment in 2020 based on the 2018 results. How to get feedback on your MIPS performance
- America's Health Insurance Plans (
AHIP) pushed back against a CMS proposal that would overhaul how Medicare Advantage plans are audited
, saying the agency's risk-adjustment proposal is unfair and inappropriate, violates federal law, and could weaken confidence in the MA market. AHIP President and CEO Matt Eyles said the agency doesn't have authority to use the extrapolation method it proposed to calculate risk-scoring error rates, and instead urges officials to withdraw the proposal and work with MA plan issuers to improve the data validation process. ThinkAdvisor (free registration)
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Affiliate Association News
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- TODAY, September 3, ACCC will host a webinar entitled CMS Proposed CY2020 Outpatient Prospective Payment System (OPPS) & Physician Fee Schedule (PFS) Rules: What You Need to Know on at 10:30AM PDT. Register at
-
The ASCO Oncology Practice Conference, September 5, in San Diego
will focus on the business of cancer care addressing the needs of practice administration and operations, with timely and practice strategies for the challenges faced by all those involved in the business of cancer care. Learn more and register at
https://meetings.asco.org/opc/register
.
- The ASCO Quality Care Symposium, September 6-7 in San Diego, encompasses the latest strategies and methods for quantification of patient experience, provider efficiency, clinical outcomes, and quality and safety in the cancer care field. The Symposium will include a variety of sessions that will cover the latest science in precision and personalized medicine. This meeting will bring leaders in quality improvement science together to participate in stimulating conversation with opportunities for networking among physicians, nurse practitioners, physician assistants, and others.
ASCO Quality Care Symposium
.
- Join ASH on September 6-7, 2019, for the 2019 ASH Meeting on Hematologic Malignancies, at the Fairmont Chicago, Millennium Park, to gain knowledge that can help you make an immediate impact in your practice. Top experts in the field, will present comprehensive clinical content, the latest clinical research, and opportunities to interact with colleagues in an intimate, small group setting with no competing sessions. The program content will be structured as "How I Treat" presentations, which will highlight each speaker's evidence-based treatment approaches, present cutting-edge scientific data that can be translated into new strategies for diagnosis and treatment, and address what to do in cases where there is no data. For more details, or to register, please visit the
ASH Website
.
- The first annua Leadership, Empowerment, and Development (LEAD) conference will take place on October 4th and 5th at the Loews Hotel inSanta Monica, California. This 2-day conference will focus on Enriching Experiences for Women in Hematology and Oncology through CME-certified clinical updates, career development workshops, professional networking opportunities, and one-on-one mentoring sessions. The target audience for this meeting is women in hematology/oncology careers seeking professional networking and science-based insights into the hematology/oncology landscape. Additional conference information, including the program agenda, can be found at www.LEADoncology.com. Of note, fellows can register for the conference free of charge by using the promo code FELLOWS100. If you have any questions, please contact: Patti Bunyasaranand, MS, Program Manager, Bio Ascend LLC, 404-310-1180 cell, 312-277-6893 fax bunyasaranand@bioascend.com
www.bioascend.com
.
- The Association of Community Cancer Centers (ACCC) is proud to announce its 2019 Annual Achievement Award, Clinical Research Award, and David King Community Clinical Scientist Award recipients. Learn from these esteemed oncology professionals as they share the latest data on their significant achievements during the ACCC 36th National Oncology Conference, October 30 - November 1, in Orlando. Be sure to register today to save up to $125. Early bird rates go away on September 6.
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Download the mid-year update on the MyCOA Members Portal!
This update is available exclusively to COA's members and subscribers through the MyCOA member portal:
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- Innovatix is pleased announce a new opportunity to save with Amgen USA Inc. Effective immediately, MVASI™ (bevacizumab-awwb) injection, a biosimilar to Genentech USA, Inc.'s Avastin® (bevacizumab) will be available under contract number 0021245901. CLICK HERE for detailed product, pricing information and FAQ. For more information about contract 0021245901, please contact your Innovatix representative at (888) 258-3273.
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MOASC CALENDAR
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(NCCN, San Francisco, September 27)
(NCCN, San Francisco, September 27-28)
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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.org
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