In the December 7, 2021 California Oncology Weekly under California News we published, effective January 2, 2022, the California Department of Health Care Services was transitioning all Medi-Cal pharmacy services from managed care to fee-for-service using the Medi-Cal Rx Provider Portal. Physicians who currently prescribe medications for Med-Cal patients, were encouraged to register for the secure Medi-Cal Rx Provider Portal, as soon as possible, and ensure preparedness to avoid any disruptions in patient care. 

The MOASC Office has been in receipt of several phone calls from MOASC members regarding this transition. Please go to the link below to understand the changes and implications. MOASC would like to know how many practices are accepting Medi-Cal patients and if patients are experiencing a delay in care or your problems with claims submission. If you have concerns regarding this transition to the new portal, please contact the MOASC Office moasc@moasc.org.

MOASC Programs - Save the Dates - All Times are Pacific

We are proud to announce our inaugural Lung Cancer Webinar Series, which is slated to begin in January of 2022. The goal of this webinar series is to engage our members in lively discussion and review the latest updates in the management of lung cancer. We will hold each discussion once a month virtually and set aside one hour to review a particular topic within this ever more differentiated area of oncology. Our series will be moderated by Dr. Hatim Hussain, Assistant Professor of Medicine at USCD, and he will be joined by one to two expert discussants to provide discussion for our members to both listen to and participate in. Our first webinar scheduled for January 26, 2022, will focus on the management of metastatic EGFR mutated non-small cell lung cancer.  

1. January 26, 6:00pm, MOASC Lung Cancer Webinar Series presents “Management of Metastatic EGFR Mutated Non-Small Cell Lung Cancer," moderated by Hatim Husain, M.D., Associate Professor of Medicine at USCD, he will be joined by two expert discussants; Jonathan Goldman, M.D., UCLA and Ravi Salgia, M.D., City of Hope. 

For more information, please contact moasc@moasc.org

January 20-21, 2022 University of California San Diego presents their Multidisciplinary Head and Neck Cancer Care Conference and 5^th New Horizons in Immunotherapy. 

Cedars Sinai presents their 22nd Annual Educational Meeting in Gastroenterology, February 25-26, 2022. This two-day virtual activity is intended for gastroenterologists and all other healthcare professionals who treat patients with gastrointestinal disorders. In addition to lecture format presentations, the course will include the following interactive virtual instructional formats: debate and panel discussions, Q & A sessions, case discussions, and interactive video presentations.

MOASC is pleased to join Rockpointe in presenting “Nonmelanoma Skin Cancers: Current and Emerging Checkpoint Inhibitors for Treating Advanced Basal Cell and Squamous Cell Carcinomas.” Available until August 2022, this is an on-demand, free CME/CE-certified, webcourse available to MOASC members and to anyone who would like to participate. Members are provided with at least 3 opportunities on or around December 1, 2021, March 1, 2022 and July 1, 2022.

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There is one slot remaining in the third cohort and three slots in the upcoming expanded third cohort of AMC-097. Lead by UC Davis, this study is enrolling subjects at University of California San Diego, University of California Davis, University of California San Francisco, and Memorial Sloan Kettering Cancer Center. Eleven subjects have been enrolled and dosed on this study. This is envisioned as a trial to create the underpinnings for future cure intent studies for HIV patients without cancer.

MOASC Clinical Trial Database is on the MOASC website at www.moasc.org

Perhaps influenced by the Centers for Disease Control and Prevention policy, pointing to data that it says supports its guidance that Americans who contract Covid-19 or have not been boosted and are exposed to the virus can return to normal life after five days if they wear a mask. The California Department of Public Health temporarily revised its guidelines to allow healthcare workers who test positive for COVID-19 and are asymptomatic to return to work immediately without isolation or testing. Effective Jan. 8 through Feb. 1, the return-to-work criteria was updated because of "critical staffing shortages currently being experienced across the healthcare continuum because of the rise in the omicron variant," according to the state health department.

Medi-Cal Rx has identified a large volume of pharmacy claims denials related to Drug Utilization Review (DUR). If you are a pharmacy provider whose claim was denied with a Reject Code 88 (DUR Reject Error) or, specifically for opioid claims, a Reject Code 76 (Plan Limitations Exceeded), see below for more information.  

January 13- Medicare Part B Common Billing Errors. Medicare used claim and customer service reporting information to uncover the most common claim billing errors that lead to denials and rejections. During this webinar, you will learn how to identify and avoid duplicate billing, eligibility, and provider enrollment billing errors and how to make the proper corrections. Join this webinar to learn how you can prevent future claim billing errors.

Last Thursday, CMS proposed rules that would require all drug price concessions negotiated by Medicare Part D plans to be applied at the pharmacy counter, effective Jan. 1, 2023. The proposed rules would also require new or expanding Medicare Advantage plans to demonstrate network adequacy, and MA plans would have to provide more information on medical loss ratio calculations and report their spending on supplemental benefits.

Please keep this system outage in mind when planning your organization’s annual recertification activities. Submit questions to the Help Desk via email at openpayments@cms.hhs.gov or by calling 1-855-326-8366, Monday through Friday, from 9:00 a.m. to 5:00 p.m. (ET), excluding Federal holidays.

The CDC has reiterated guidance released last week that shortens the isolation period for COVID-19-positive, asymptomatic individuals from 10 to five days. The agency said a negative COVID-19 test is not needed in such instances after five days of isolation, citing a review of 113 studies that showed most transmission happens during the early days of infection.

HOWEVER, the American Medical Association said the CDC's latest guidance for self-isolation and testing after a positive COVID-19 diagnosis is confusing. Patients who emerge from isolation without first having a negative test result pose the risk of further transmitting the virus and overwhelming the health care system. The current shortage of COVID-19 tests "does not justify omitting a testing requirement to exit a now shortened isolation," the AMA said.

Beginning January 15, 2022, over-the-counter COVID-19 diagnostic test authorized, cleared, or approved by the U.S. Food and Drug Administration (FDA) will be able to have those test costs covered by their plan or insurance, if the individual has private health insurance coverage or is covered by a group health plan.

Pfizer, Gilead Sciences and other pharmaceutical firms increased the list prices for 460 drugs by a median of 4.9% on Jan. 1, according to nonprofit 46brooklyn Research. Gilead's Biktarvy, Pfizer's Ibrance and Vertex's Trikafta are among the medications that saw price increases at the start of the year.

It is in the best interest of medical practices to start the new year by reviewing corporate contracts, reviewing HIPAA policies and procedures, ensuring all third-party agreements are in compliance with applicable laws and regulations, reviewing the workplace policy manual and updating it as appropriate, and performing a financial audit. It is also recommended to get an independent audit of the practice's billing every year to ensure legal compliance and correct any faulty practices.

People who write advance directives when they are healthy may change their minds when they are seriously ill, writes Daniela Lamas, a pulmonary and critical care physician at Brigham and Women's Hospital. People's life and health preferences can change depending on the context, and instead of advance directives, it may be better for patients to choose a health care proxy and for physicians to discuss goals, preferences and prognoses in depth with patients who are seriously ill, Lamas writes.

ANCO, in association with the Organizing Committee of the San Antonio Breast Cancer Symposium and Encore Medical Education, will host the Best of San Antonio Breast Cancer Symposium Northern California. The Best of SABCS West Coast, will be held at The InterContinental San Francisco on Saturday morning, February 12, 2022. Hope S. Rugo, M.D., UC San Francisco, is the Regional Director for Best of SABCS West Coast.

The ASCO GI Cancers Symposium will take place both in person January 20-22, 2022 in San Francisco, CA, and online, and will offer new, practice-changing findings in GI cancer treatment, research, and care.

Get the latest information in precision hematology. Join ASH for a new webinar on January 18 as part of the Precision Hematology series. The Precision Hematology series is designed to provide clinicians and researchers in hematology foundational information on the latest technologies available for data acquisition, diagnosis, and decision-making for hematologic diseases. All webinars from this series are available on ASH Academy On Demand. 

The 2022 ASH Summit on Immunotherapies for Hematologic Diseases will offer a unique opportunity for academic, medical, industry, and federal regulatory communities to come together, share ideas, and network. Focused on fostering connections, the Summit will:

There is a call for abstracts to present at this event. Authors are encouraged to submit an abstract or studies in the following categories: Category 1: Immunotherapy (Basic Science); Category 2: Immunotherapy (Translational Research); Category 3: Immunotherapy (Clinical Research);

Registration is now open for the only official Highlights of ASH in North America. If you are unable to attend the 63rd ASH Annual Meeting in Atlanta, Georgia, or even if you plan to attend and want a refresher on the best science, you won’t want to miss this informative meeting! Join us in Seattle, San Francisco, Washington, DC, Chicago, or New York to get a synopsis of the new advances in patient care and scientific updates presented at this year's annual meeting.

COA has sought preliminary summations from Avalere and a Washington, DC firm about the proposed rule CMS just published relating to pharmacy reimbursement and DIR fees. The top-line and more in-depth preliminary summaries of the CMS rule are here. 

Save 20% on your registration through January 20, 2022 for the 2022 Community Oncology Conference. Community oncology has persevered for two years, providing high-quality cancer care to a nation consumed by COVID-19. Our doors have remained open, providing uninterrupted care to those with cancer. On March 17-18, the COA community will come together – safely – at the 2022 Community Oncology Conference to recognize the value of community oncology, network, and learn from the shining stars who are blazing the path forward for our field. I’ll be there. Will you? Registration is Open! You are invited to join thousands of colleagues on March 17-18, 2022, virtually at the Gaylord Palms Hotel in Kissimmee, Florida, for two days of learning and networking.

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.