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California Supreme Court issues decision for physicians to challenge peer review hearing officers. California News
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CMA seeking physicians to help shape regulation implementing Assembly Bill 890 California News
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2020 MIPS performance feedback for the period is now available Medicare News/CMS News
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Ask your Congressional representatives to cosponsor H.R. 3258 National News
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ICER to assess the comparative clinical effectiveness and value of plinabulin and trilaciclib for the prevention of chemotherapy-induced neutropenia National News
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UC Davis is conducting a Medical Oncologist Survey ANCO News
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MOASC proudly congratulates Charter Member, Linda D. Bosserman, M.D. for her service as ASCO’s Editor-In-Chief of the Journal of Oncology Practice (JCOP). Since January 2019, Dr. Bosserman expanded the publication’s priorities of care delivery and quality improvement while adding two new ones addressing issues of equity and value.
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Never fight an insurance company again! Impiricus is a new platform for Oncologists to access resources and get patients on therapy. Get access to grants, samples, information and more. Submit prior authorization and patient assistance requests in under 30 seconds with Impiricus’ digital interface. Impiricus’ does all the hard work, but keep you in the loop. Free Figs and Medelita white coats when signing up at: https://impiricus.com/impiricus-concierge/ (use sign up code MOASC).
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MOASC Programs - Save the Dates - All Times are Pacific
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September 8, 2021 at 5:30pm-PT. In recognition of Ovarian Cancer Awareness Month, MOASC, in collaboration with PeerView, presents a virtual conference on“Enhancing Personalized Medicine in Advanced Ovarian Cancer.” Listen to expert guidance on integrating the latest updates on PARP inhibitors and novel therapeutic innovations into your clinical practice.
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September 22, 5:30-6:30 PDT, MOASC will host a live webinar on Prostate Cancer Awareness, with panel discussions of initial treatment of Metastatic Castration Sensitive Prostate Cancer/Increase in newly diagnosed; current thoughts on radiation for primary tumor in Metastatic Disease and new treatments in Castration Resistance Disease in conjunction with genomic testing/PARP inhibitors presented by: Ashkan Lashkari, M.D., MOASC President; Christopher DeSantis, California Urological Association; John Lam, M.D., Kaiser Permanente, Los Angeles; Nataliya Mar, M.D., Assistant Professor, UCI and Steven N. Seyedin, M.D., Assistant Clinical Professor, UCI. This event is complementary but registration is required.
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September 25, 2021, Cedars Sinai invites GI Nurses and Interdisciplinary Professionals to their 2021 Annual Seminar for GI Nurses and Associates.
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SAVE THE DATE! MOASC’s “Spotlight On Oncology” is scheduled for Saturday, October 2, 2021 from 8am – 12pm. MOASC Board member, Jason Zell, MD will moderate discussions on: Melanoma presented by Omid Hamid, MD; Genitourinary Cancer presented by Nataliya Mar, MD; Upper Gastrointestinal Cancer presented by Jennifer Valerin, MD; Lower Gastrointestinal Cancer presented by May T. Cho, MD; Lung Cancer presented by Misako Nagasaka, MD, and Breast Cancer presented by Rita S. Mehta, MD.
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October 29-30, The University of California San Diego invites you to their inaugural Delivering Discoveries: Updates in Oncology CME conference. The diagnosis and management of cancer patients is increasingly complex and requires multidisciplinary management. This 1.5 day event will address all aspects of cancer from basic science research, advances in clinical care, to community-based approaches that optimize prevention and interception.
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The California Supreme Court recently issued an important decision that clarifies a physician's ability to challenge peer review hearing officers for impermissible bias. CMA filed an amicus brief in the case, in support of neither party, that sought to provide the court with the appropriate background, procedural understanding, and evidentiary foundation to fashion a robust, clear, and contextualized hearing officer impartiality standard.
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CMA is asking physicians to lend their voices to help shape the regulations implementing Assembly Bill 890 (Wood), which became law on January 1, 2021, and authorizes two new types of nurse practitioners. AB 890 recognized and authorized California nurse practitioners (NPs) to practice at the top of their competence without physician supervision and with a defined scope of practice. The implementation of AB 890 affords the state to expand access to care. The report, Aligning Nurse Practitioner Statutes, highlights California codes related to NP practice that would benefit from alignment with AB 890 in order for the state to reap the full benefits of this extra NP capacity. The report delineates a comprehensive and thorough review of the California codes related to NP practice that would benefit from alignment with AB 890. The report includes a table with these statutes and the corresponding analyses. The report also uses several examples in priority areas to underscore the importance of statutory alignment as, Access to Care, Opioid Crisis and Care of Older Adults. Under AB 890, NPs could independently treat patients in long-term care facilities. However, existing language in the Health and Safety Code limits their contributions.
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DHCS recently announced a January 1, 2022, implementation date for the Medi-Cal Rx program. Earlier this year, DHCS delayed the planned go-live date of April 1, 2021, to give the agency time to review new conflict avoidance protocols submitted by Magellan Health, Inc., the project’s contracted vendor. Medi-Cal Rx is an initiative aimed at improving health care delivery by standardizing the Medi-Cal pharmacy benefit under one delivery system.
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The Appropriations Committee Suspense hearings were conducted last week. Each year, these hearings are to review and cost out the many bills presented. Following are status some bills of interest.
SB 310 (Rubio), sponsored by ANCO, authorizes a cancer drug recycling program to ensure timely access to treatment. The bill moved out of Appropriations with author’s amendments. The amendments were technical in nature and gave the Board of Pharmacy ability to review documents and bar any physician from participating if they violated the law.
AB 347 (Arambula) seeks to provide doctors and patients more authority over step therapy protocols put in place by insurers. The bill moved out of Senate Appropriations with some unfortunate amendments to the clinical peer section of the bill. The ongoing success of this bill over the objection of health plans even as amended is remarkable.
SB 380 (Eggman) seeks to eliminate the sunset date regarding the End of Life Option Act and amend some of the patient protections included in the original bill. The bill passed out of Committee with amendments to add back in a sunset date. One of the requests from advocates concerned that the program needs additional oversight and review and more data transparency. The new sunset date will be January 1, 2031.
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Effective October 1, 2021 Noridian will be changing the process for webinar participants to earn American Academy of Professional Coders (AAPC) CEU’s. The CEU certificate will no longer be provided with the handouts during the webinar.
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September 8, Additional Documentation Request (ADR) Pre-Pay A/B
This medical review data-driven webinar educates providers on what to do with prepay Additional Documentation Requests (ADRs) and the timeframes involved with valuable resources.
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September 9, End Stage Renal Disease (ESRD) A/B Coverage. This webinar is intended for Medicare Part A and B Providers and will include: • Medicare Eligibility and Enrollment • Coverage Regulations - Items and Services • Coding and Reimbursement Guidance • CMS and Noridian Resources.
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September 22 – 23 Noridian Virtual Fall Symposium. Come experience meeting and engaging with your provider education Part A and B team members, where you may pick and choose which sessions you're interested in attending. Each session will be 55 minutes long and you will be required to sign up for each session provided.
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CMS News
Merit-based Incentive Payment System (MIPS) performance feedback, including scores and payment adjustment information, for the 2020 performance period is now available for review on the Medicare Quality Payment Program (QPP) website. The 2020 MIPS scores will determine whether a physician will receive an incentive, neutral payment adjustment or a penalty for Medicare services in the 2022 payment year. In response to advocacy from the AMA and affiliated state medical organizations, CMS applied an automatic Extreme and Uncontrollable Circumstances hardship exception and reweighted the Cost Performance Category to zero in 2020 due to the COVID-19 pandemic. The 2020 final score should reflect these COVID-19 flexibilities. Please note the information you see now may be changing. CMS said that it will be updating MIPS performance feedback and final scores for some clinicians for performance year 2020 and the associated MIPS payment adjustment information for payment year 2022 due to errors already identified. Because of these expected changes CMS will also be extending the targeted review period, which usually goes through October 1. MIPS eligible physicians are encouraged to review their MIPS feedback closely. If a physician believes there is an error, CMS allows appeals through a targeted review process. Contact the QPP at (866) 288-8292 or QPP@cms.hhs.gov with questions.
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The Centers for Medicare and Medicaid Services (CMS) released a proposed rule on the Medicare Physician Fee Schedule (PFS) updates for calendar year (CY) 2022. The PFS Proposed Rule announces planned policies for the sixth and future years of the Quality Payment Program (QPP) established by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). Comments are due September 13, 2021 by 2:00pm PDT/5:00 pm EDT
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CMS posted technical updates to the Monoclonal Antibody COVID-19 Infusion and COVID-19 Vaccines and Monoclonal Antibodies webpages to reflect updates to the Emergency Use Authorization (EUA) for casirivimab and imdevimab, a COVID-19 monoclonal antibody.
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CMS has published revised ICD-10 health care code sets, providing an easy guide for health care providers, suppliers, medical coders, and billing and claims staff when submitting inpatient and outpatient claims for diagnoses, procedures, medical equipment, supplies, and drugs. These are simple code explanations, required by HIPAA and are resources to advance health equity and help eliminate health disparities.
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The push is still on! Ask your Congressional representatives to cosponsor H.R. 3258! The Timely Access to Cancer Treatment Act of 2021 (TACT Act) was recently introduced and still needs congress’ attention.
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The Institute for Clinical and Economic Review (ICER) announced that it will assess the comparative clinical effectiveness and value of plinabulin (BeyondSpring Pharmaceuticals) and trilaciclib (Cosela™, G1 Therapeutics) for the prevention of chemotherapy-induced neutropenia. BeyondSpring Pharmaceuticals announced the submission of a New Drug Application (NDA) for plinabulin, and the FDA is expected to respond by late 2021. The assessment will be publicly discussed during a meeting of the California Technology Assessment Forum (CTAF) in April 2022, where the independent evidence review panel will deliberate and vote on evidence presented in ICER’s report. All interested stakeholders are encouraged to submit comments and suggested refinements to the scope to ensure all perspectives are adequately considered. Comments can be submitted by email and must be received by 2pm PDT on September 14, 2021.
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The federal Office of the National Coordinator for Health Information Technology (ONC) is hosting a series of webinars to discuss the information blocking requirements of the 21st Century Cures Act. The first webinar is a physician-focused presentation covering key aspects of the regulations focused on information blocking on Sep 14, 2021 10:00 AM PDT.
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While the federal government has purchased hundreds of millions of doses of the COVID-19 vaccine and is providing those at no cost, vaccinating providers are still able to be reimbursed for administering the vaccine. While physicians who participate in the Centers for Disease Control and Prevention (CDC) COVID-19 Vaccination Program contractually agree not to seek reimbursement from patients, health plans and insurers are required to reimburse for COVID-19 vaccine administration regardless of whether the services are provided by an in or out of network provider. For uninsured patients, providers can be reimbursed through the U.S. Department of Health and Human Services’ Provider Relief Fund.
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The CDC has published their annual Morbidity & Mortality Weekly Reports (MMWR) recommendations for the use of flu vaccines in the U.S. during the 2021-2022 flu season.
Read about what’s new for flu vaccines this season, including when is the best time to get a flu vaccine… ideally by the end of October.
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UnitedHealthcare has made changes to its recently updated Advanced Practice health Care Provider policy (APHC) that required nurse practitioners (NPs), physician assistants (PAs) and clinical nurse specialists to bill under their own NPIs, virtually eliminating the ability to bill for services as “incident-to” the physician services and limiting reimbursement for such services to 85% of the physician fee schedule.
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Affiliate Association News |
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The Association of Community Cancer Centers (ACCC) today announced the launch of a new content series for cancer care practitioners: Returning to Practice in the COVID-19 Era. The series is designed to help cancer care professionals navigate the uncertain environment of caring for patients with cancer and immunocompromised patients during the continued threat of a global pandemic, while vaccination rates remain alarmingly low and masking and social distancing mandates change daily. The project teaches multidisciplinary cancer care teams what to anticipate as they resume pre-pandemic services, specifically for patients with hematologic malignancies including chronic lymphocytic leukemia (CLL), acute myeloid leukemia (AML), and multiple myeloma (MM).
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Read ACCC’s blog article, Legislation Aims to Ease Patient Access to Oral Oncolytics.
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The ACCC Community Oncology Research Institute (ACORI) is holding the ACORI Call to Action Summit on September 13 -14, 2021
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September 11 @ 9:00am - 12:30pm PDT, ANCO's second offering of Hematologic Malignancies Updates: Leukemias, Lymphomas, & Myelomas 2021 will take place online. Faculty will present the latest research on treatment modalities for hematologic malignancies—leukemias, lymphomas, and myeloma—along with case studies for these diagnoses. Registration limited to 50 HCP and a limited number of representatives from sponsoring companies.
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UC Davis is conducting a Medical Oncologist Survey. If you are a medical oncologist, we'd like to invite you to participate in a survey about genetic counseling and for the chance to win an iPad. Please contact jachuynh@ucdavis.edu with any questions.
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ASCO News
The ASCO Quality Training Program (QTP) summer 2021 course continues! Meeting 2: September 13-14, 2021 (Virtual); Meeting 3: December 10, 2021 (Hybrid Virtual and In-Person).
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Young Investigator Award (YIA) and Young Investigator Award Drug Development
Application Deadline is September 23, 2021. The YIA provides funding to promising investigators to encourage and promote quality research in clinical oncology
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ASH News
The 2021 ASH Meeting on Hematologic Malignancies will take place September 10-11, at the Hilton Chicago and online as a virtual meeting. Hear top hematology experts present cutting-edge science, provide out-of-the-box treatment approaches, and answer challenging patient care questions during topic-based “How I Treat” presentations and panel discussions. Those who register for the in-person experience will also receive complimentary access to the meeting’s virtual platform.
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ASH is committed to educating its members on how to become effective advocates for hematology research and practice, by hosting the final of their new series titled the ASH Advocacy Webinar Series. Registration is free and open to all interested. On 10/4 Working with Advocacy Groups and Coalitions: How to Amplify Your Voice in Washington will be presented from 1-2pm PDT.
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COA News
COA has worked diligently to ensure community oncology was prepared for the return of patients to waiting rooms and treatment facilities. Unfortunately, the country is currently experiencing a resurgence of cases due to the Delta variant of COVID-19. COA continues to work to secure support and make your voice heard in Washington. From working with legislators to introduce important bills, like the Timely Access to Cancer Treatment Act, to keeping members informed about cancer screening trends to hosting Advocacy Chats on important issues, the Member Update captures all the information you need to know about the first half of 2021. If you want to know more about COA and their important work on behalf of community oncology practices, professionals, and patients, this is the perfect document to share, and organization to support. www.communityoncology.org
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NCCN News
The National Comprehensive Cancer Network® (NCCN®) announced significant updates to: Cancer and COVID-19 Vaccination guidance. This is the fourth version of NCCN’s COVID-19 vaccination guide and incorporates the latest data plus recent approvals from the FDA and CDC regarding a third mRNA vaccine dose for immunocompromised people.
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Astellas’ Pharma Support Solutions SM Program offers access and reimbursement support to help patients overcome challenges to accessing Astellas products.
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Incyte Corp. strives to provide assistance to physicians and patient education through their patient webinar programs. Please share this invitation with your patients and their caregivers who have been diagnosed with myeloproliferative neoplasms (MPN), including Polycythemia Vera, Essential thrombocythemia and Myelofibrosis. They will hear from Incyte Oncology Clinical Nurse Educators about MPNs. There are four live webinars, September 1,2,21 & 22 to choose from. Thank you.
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Oncopeptides announced that CMS has provided a permanent J code for Pepaxto (melphalan flufenamide). The Code, J9247, “injection, melphalan flufenamide, 1mg” will go into effect on October 1, 2021.
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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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