October 6, 2020

October is Breast Cancer Awareness Month

Breast cancer is the most common cancer in women. Although rare, men, on average over the age of 50, get breast cancer too. According to the National Breast Cancer Foundation, in 2020, an estimated 2,620 men will be diagnosed with breast cancer this year in the U.S. During October women and men are encouraged to learn the facts about breast cancer and why screening should be a regular part of your health care. CDC Breast Cancer Awareness.

“My experiences with MOASC staff are excellent, they are very professional, responsive to members’ needs, provide very good updated information crucial to our practice and office operations, and are a very efficient staff. It’s a real pleasure to be part of the organization…” Carlos Say, M.D., Atwater, CA. 

* MOASC PROGRAMS - SAVE THE DATES  All Times are Pacific

Title: “It’s Precisely the Time for More Precision in Genomic Testing and Targeted Treatment of NSCLC” Presented by: Jacob Sands, M.D., Dana-Farber Cancer Institute

Description: In this activity, oncology experts discuss the roles of genomic testing and targeted treatment in lung cancer. Practical guidance for expanding molecular testing for genomic alterations occurring in non–small cell lung cancer with FDA-approved targeted therapies is explored. Provider Statement: This CME/MOC/CC/CNE/CPE activity is jointly provided by Medical Learning Institute, Inc. and PVI, PeerView Institute for Medical Education.

Support Statement: This activity is supported by independent educational grants from AstraZeneca, EMD Serono, Inc., Lilly, and Novartis Pharmaceuticals Corporation. View the invitation HERE.

Register now for MOASC’s 30^th Annual Educational Series. The virtual Administrator Track will be on November 4 View the agenda. The virtual Billing Track will be on November 12 View the agenda. MOASC has secured the professionals to provide attendees with the tools and resources to tackle the challenges of addressing patient care, protecting staff, safety and surviving financially during this most unique time. Register Here.

Please welcome and thank these Series partners when they visit your practice.

In consideration of the COVID-19 pandemic, MOASC extended membership through the end of September. MOASC’s membership drive started October 1 with renewing member dues prorated through June 2021. If you have any questions please contact the MOASC Office at moasc@moasc.org. Thank you.

A bill that will allow California to manufacture cheaper versions of generic drugs including insulin has been signed into law by Gov. Gavin Newsom. The law requires the state's Health and Human Services Agency to seek partnerships with drugmakers to make medicines cheaper and more accessible. Newsom signs law allowing Calif. to make low-cost drugs

Gov. Gavin Newsom paved the way for nurse practitioners in California to practice medicine independent of doctors by signing AB 890. Newsom’s signature will allow nurse practitioners to practice independently in 2023. They would have to operate under a doctor’s supervision for a minimum three-year transition period before embarking on their own practices. Nurse Practitioners Can Open Practices in 2023

Governor Newsom vetoed AB2100 (Wood) which would have made the necessary changes to implement Governor Newsom’s Executive Order N-01-19 regarding the Medi-Cal pharmacy benefit fee-for-service (FFS) transition without causing undo harm or burden to patients. Additionally, it would have authorized the Department of Health Care Services (DHCS) to provide a disease management payment, or similar payment, to Medi-Cal provider pharmacies that dispense specialty drugs to Medi-Cal beneficiaries. Governor’s veto message.

The Centers for Disease Control has published the National Breast and Cervical Cancer Early Detection Program.

HHS said it will distribute an additional $20 billion in aid to help health care providers affected by the COVID-19 pandemic. The new funding is meant to blunt the impact of financial losses and increased operating costs caused by the pandemic. Reuters

Outlining a planned review of the comparative clinical effectiveness and value of CAR-T treatments and a monoclonal antibody drug for multiple myeloma, the Institute for Clinical and Economic Review (ICER) has posted a Draft Scoping Document. 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 to 

publiccomments@icer-review.org and must be received by 2 pm PT on October 13, 2020. ICER's Patient Participation Guide and Manufacturer Engagement Guide provide additional guidance for submitting public comments. Following the public comment period, a revised scoping document for each review will be posted on or about October 21, 2020.

Reminders for Extension Filers-Oct. 15. The IRS YouTube channels provide short, informative videos on various tax related topics in English, Spanish and ASL.

Anthem and UnitedHealthcare last week discontinued waiving copayments and deductibles for patients who wanted to avoid going to doctor's offices or emergency departments. Health insurance companies are starting to roll back policies adopted when the COVID-19 pandemic began to encourage the use of telehealth services. United Healthcare has published their 2021 Telehealth Policy Updates.

Effective Jan. 1, 2021, United Healthcare is launching the Accumulator Adjustment Medical Benefit program for commercial plans. This program helps align employer specialty medical drug costs with members’ out-of-pocket costs and deductibles. Through a two-step process, the program requires providers to submit member cost-share reimbursement information, received from drug manufacturers when coupons or copay cards are submitted for specialty medical drug claim. Providers can review the process and all the Accumulator Adjustment Medical Benefit program details on UHCprovider.com.

UnitedHealthcare is updating a number of temporary provisions around originating site requirements and cost share waivers that were established as part of the COVID-19 response. Full details of the changes are available in the Summary of COVID-19 Dates by Program guide and on the COVID-19 Telehealth pages.

NCCN has published updates to the NCCN Chemotherapy Order Templates (NCCN Templates^®) for Thyroid Carcinoma to reflect the currently published NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines^®) for Thyroid Carcinoma v2. https://www.nccn.org/about/news/ebulletin/ebulletindetail.aspx?ebulletinid=3958&utm_source

The “Meet The Professors” virtual series is spanning several months with 3-5 sessions per week. http://www.researchtopractice.com/upcoming-events

Agios Pharmaceuticals, cordially invites MOASC Members to their upcoming webinar about TIBSOVO® (ivosidenib): A Targeted Therapy for IC-Ineligible Patients with Newly Diagnosed AML and Patients with R/R AML with an IDH1 Mutation, on Thursday, October 22, 2020 at 6:00 PM-PDT. Presented by: Gary Schiller, MD, Professor of Medicine, David Geffen School of Medicine, UCLA Ronald Reagan, UCLA Medical Center, Los Angeles, CA. 

AstraZeneca cordially invites MOASC Members to their upcoming webcast series in support of the PAOLA-1 launch. They will hold expert discussions on LYNPARZA® (olaparib) and LYNPARZA + bevacizumab as Maintenance Monotherapy or Combination Therapy in Advanced Ovarian Cancer: Results From Key Clinical Trials. The next program will be on October 22. View the multiple dates and invitation  here.

Bristol Myers Squibb announced that Opdivo (nivolumab) 360 mg every three weeks plus Yervoy (ipilimumab) 1 mg/kg every six weeks (injections for intravenous use) was approved by the U.S. Food and Drug Administration (FDA) for the first-line treatment of adult patients with unresectable malignant pleural mesothelioma (MPM).¹ This approval is based on a pre-specified interim analysis from the Phase 3 CheckMate -743 trial in which Opdivo + Yervoy (n=303) demonstrated superior overall survival (OS) versus the platinum-based standard of care chemotherapy (n=302) (Hazard Ratio [HR]: 0.74 [95% Confidence Interval [CI]: 0.61 to 0.89]; P=0.002), with a median OS (mOS) of 18.1 months (95% CI: 16.8 to 21.5) versus 14.1 months (95% CI: 12.5 to 16.2), respectively.¹ 

Immunomedics Inc. would like to inform MOASC Members about CMS first announcement on the new TRODELVY C-code in August for a October 1, 2020 effective date, CMS informed the public of the C-code having a 10mg billing increment for hospital outpatient billing with C9066

However, on 9/24/2020, CMS issued Transmittal 10373 to announce a revised billing increment for TRODELVY (sacituzumab govitecan-hziy). The revised billing increment associated with TRODELVY’s C code (C9066) is now 2.5 mg. Here is the transmittal from CMS https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/Transmittals/r10373cp

On 9.30.2020 Noridian mistakenly announced the new C-code for TRODELVY as having a 180mg billing increment.  https://med.noridianmedicare.com/web/jfb/article-detail/-/view/10534/billing-and-coding-chemotherapy-administration-r25. Please see full Prescribing Information, including Boxed Warning.

Incyte Corporation cordially invites all healthcare professionals to attend a virtual program entitled, Identifying the Clinical Characteristics of Advanced Polycythemia Vera, Wednesday, October 21, at 6:30pm Pacific. Please register online by October 14 at http://bit.ly/inc7240 [links.sphase.com]

Innovatix invites MOASC Members to ACT NOW AND SAVE! Effective October 1, 2020, pricing for GAMUNEX®-C (Immune Globulin Injection [Human), 10% Caprylate/Chromatography Purified) under Grifols USA, Inc. will increase. CLICK HERE for detailed product and pricing information. For more information about our agreement with Grifols, please contact your Innovatix representative at (888) 258-3273.

Innovatix is pleased to announce a new opportunity to save with Amgen USA Inc. Effective immediately, AVSOLA™ (infliximab-axxq) for injection, a biosimiliar to Johnson & Johnson Health Care Systems, Inc.’s Remicade® (infliximab), will be available under contract number 0021912500. Click here for detailed product and pricing information and here for an FAQ with additional details. For more information about Innovatix’s agreement with AstraZeneca Pharmaceuticals, LP, please contact your Innovatix representative at (888) 258-3273.

Please plan to join Premier Alternate Site Programs’ Virtual Meeting & Expo on October 12 – 13, 2020 and register today! Click here for the current agenda and as a reminder this event is FREE to current Members, Sponsors, and Affiliates. 

Pfizer Cordially invites MOASC Members to an informational program, being presented virtually by ANDREW SEIDMAN, M.D. Attending Physician, Breast Medicine Service, Medical Director, Bobst International Center, Memorial Sloan Kettering Cancer Center, Professor of Medicine, Weill Cornell Medical College. Topic: Make a First-in-Class Oral Therapy Your Partner of Choice for the Treatment of Adult Patients With HR+/HER2- Metastatic Breast Cancer on Tuesday, Oct 13, 2020 at 12:30 PM Pacific Time. 

Seattle Genetics cordially invites MOASC Members to their upcoming series of Educational Programs to review data from ECHELON-1, a superiority trial comparing ADCETRIS+AVD to ABVD. This trial introduces a bleomycin-free regimen for adult patients with previously untreated Stage III/IV classical Hodgkin lymphoma (cHL).¹ Also discussed will be the latest data from the North American subset analyses. Presented by: Andrew Evens, DO, MSc, Rutgers Cancer Institute of NJ, New Brunswick, New Jersey. To register contact Stacey Dominguez at sdominguez@seagen.com or 310-560-1104

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.