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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.
May 20, 2013
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In observance of Memorial Day, the California Oncology Weekly will not be published on May 27, 2013.
National Cancer Survivors Day is June 2nd. How are you planning to celebrate?
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National News
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- The Memorial Day Congressional in-district work period is an excellent opportunity to engage your lawmakers on the two most important issues in oncology now. A majority of cancer patients receive their treatment at community clinics. Today, that care is being threatened by a payment calculation in Medicare that has made it increasingly difficult for local clinics to absorb the additional cuts imposed by sequestration. Bipartisan legislation (S. 806) introduced by Senators Pat Roberts (R-KS) and Debbie Stabenow (D-MI) - and co-sponsored by Senators Robert Casey (D-PA) and Sherrod Brown (D-OH) - would protect cancer patients' access to care in their communities and control costs for seniors and the Medicare program. Contact your Representative asking them to cosponsor HR1416. S806, the Preserve Community Cancer Care Act, has been introduced that would exempt prompt pay discounts from the ASP calculation. Oncology supports this legislation and asks that you contact your Senators to support S806 as well. ACCC has published an Oncology Drug Reference Guide that shows how sequestration is impacting drug reimbursement under Medicare Part B at www.accc-cancer.org/publications/DrugReference.asp.
-The House approved legislation to fully repeal the Affordable Care Act, last Thursday. The legislation marks the 37th time that congressional Republicans have sought to repeal, defund or dismantle the ACA. The bill, however, is not expected to pass in the Senate. Organized medicine is committed to finding real solutions to the current flawed Medicare payment system; however, the Independent Payment Advisory Board's (IPAB) goal of finding savings on an annual basis has the potential to undo much of the payment and delivery innovation currently taking place in health care. The IPAB is looking to physicians for savings. The selection and appointment of candidates to the IPAB does not ensure adequate physician representation, and the Affordable Care Act (that created the IPAB) makes it difficult for Congress to make changes to the IPAB's recommendations. ASCO, and others, are also advocating for the repeal of the IPAB.
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CMS News
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- Denials for add-on code 96361 will have the opportunity to be appealed, or resubmitted, for claims after July 1 due to revisions by CMS to the National Correct Coding Initiative (NCCI) edits for add-on codes. CMS has decided to revise the primary codes for 96361, and will include codes 96360, 96365, 96374, 06409, and 96413 effective July 1 and retroactive to April 1. If any claims are denied due to the current edit, providers can either appeal the claim or resubmit the claim after July 1. For questions, contact practice@asco.org; for more, go to ascoaction.asco.org (May-09).
- The Sunshine Act will be the subject of a CMS National Provider Call on Wednesday, May 22 at 7am PT. The National Physician Payment Transparency Program (Open Payments) Program requires manufacturers of pharmaceuticals or medical devices to publicly report payments made to physicians. Go to www.cms.gov > Outreach and Education > MLN FFS National Provider Calls > National Provider Calls and Events (2013-05-22) or
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~97RJTC3114?opendocument&utm_source=J1BL&utm_campaign=J1BLs&utm_medium=email
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California News | |
- California's secretary of state has designated the state's health insurance exchange as a voter registration hub, making California the first state to do so.
- CMA's Practice Resources (May 2013) includes articles on TRICARE authorizations and transitions, new RAC audits, and CIGNA appeals at www.cmanet.org/cpr.
- The 16th Annual California Health Care Leadership Academy--Can Physicians Control Their Own Destiny, and the Future of Medical Practice takes place in Las Vegas on May 31-June 1. Go to caleadershipacademy.com for more information and to register.
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- Several JEMAC Implementation 101 workshops will be hosed by Noridian/JEMAC (www.noridianmedicare.com/je). Important information on the JEMAC implementation will be provided and questions will be answered. For more information, go to: www.noridianmedicare.com/je/docs/jurisdiction_e_workshops_are_now_available.html
- Erythropoietin Stimulating Agents (ESA) (L29888), J1 Part B Local Coverage Determinations (LCDs) has been revised: To view, go to the 'LCDs and NCDs' Web page under the 'Medical Policies' section of the J1 Part B website.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/97SL8A6782?opendocument
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- Physician administered drug pricing update. DHCS/Medi-Cal responded to ANCO's inquiry as to its out-of-date physician administered drug pricing (based on Medicare pricing) by saying that they will update their drug reimbursement rates after due diligence and, if behind, would issue erroneous payment corrections in due course.
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-"Optimizing Your Bottom Line...Migrated Thinking Required." will be discussed at the May 29th LunchTime Series presentation. We are confronted with many new reimbursement models being contemplated by government and managed care payers. Value Based Purchasing, Episodic Care, Bundled Payments, ACOs and Patient Centered Medical Homes all contribute to the need to adapt your business practices in order to compete and insure success. John Akscin provides a look at your business processes and encourages a change in thought intensity from drugs to the entire business and operations model. The focus will be on improving Technology, Operations, and Efficiencies, as well as suggested solutions. The program will answer your questions and share successes. As with any of Mr. Akscin's programs, you will return to your business with at least three actionable solutions. Contact moasc@moasc.org to RSVP and receive handouts.
- The "MOASC Oncology Billing Program" is scheduled forFriday, October 4, 2013, 8am - 4pmatThe Courtyard by Marriott Old Pasadena. All staff, management and administration are invited to attend. Please RSVP to the MOASC Office at moasc@moasc.org, phone (909) 985-9061 x.1, or fax (909) 985-8581.
JOB BOARD:
- Infusion Nurse needed for a solo physician practice in Fountain Valley. The position requires a part time Infusion Nurse for Tuesday and Thursday infusion days. This is a long-term opportunity with competitive salary, excellent benefits and very good working conditions, to assist physician and staff in obtaining efficient delivery of quality patient care. Ability to make independent patient care evaluation/treatment decisions based on, and within, Oncology Infusion Nurse standard of practice. Registered Nurse, licensed with State Board, ONS certification. Contact Reena at 1-714-585-2874.
- Oncology Nurse needed immediately in Palm Springs area. Part time or Full time. Please fax resume to 760-601-3242.
- Billing Specialist is needed for a busy, growing 3- physician hematology/oncology practice located in Santa Monica. Practice focus is individualized, contemporary care in a compassionate setting and is integrated with a larger network of cutting-edge researchers and practitioners in the greater Los Angeles area. To apply: E-mail cover letter and resume to kralph@smhoc.net. For more information click here
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- ANCO will host a 2Q2013 Professional Education webcast on Tuesday, May 21 at 12:30PM. This webcast will introduce Noridan Administrative Services (the new Medicare/JEMAC) to ANCO members and review CMS Incentive Program timelines and reporting requirements. ANCO appreciates the support of Celgene and TEVA Oncology for this webcast. The webcast announcement was mailed the week of April 22; visit www.anco-online.org/2Q2013.html to download a copy.
- ANCO's 2013 staff salary survey was mailed to all ANCO community-based practices the week of April 29. Completed surveys (one per practice) should be returned to the ANCO office no later than July 30. Go to www.anco-online.org/salsrvy.html to download a copy of the survey.
- As a member of ANCO you now have access to participate in the MOASC Purchasing Network (MPN). MPN functions as a group purchasing organization to help participants manager the largest expense (drugs) in their oncology practices. The MPN mission is to negotiate prices and arrange for the purchases of drugs, as well as supplies and equipment, directly from manufacturers, distributors, retailers, and wholesalers for the benefit of participants. MPN's drug distribution partner is Cardinal Health Specialty Solutions and through the negotiated contract, participants receive an 8% upfront discount on generics, flexible payment terms, price matching, and quarterly rebates. MOASC membership is required to participate in MPN. Both ANCO and MOASC recognized the opportunity for significant savings and have negotiated a discounted membership rate of $200 per practice for ANCO practices to join MOASC. Please contact MPN Membership Services Manager Nikki Kaminski at (248) 302-7188 or nkaminski@moascpurchasing.com to obtain more information, schedule an appointment, or arrange an analysis of pharmaceutical costs for your individual practice and eventually transition your purchasing power to MPN and Cardinal Health Specialty Solutions.
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ASCO, ASH & COA News
- Attend the Disparities in Cancer Care Reception, at the 2013 ASCO Annual Meeting, Monday, June 3 from 7 - 8:30PM. This exclusive networking event is sponsored by ASCO's Health Disparities Committee. Register and Reserve Your Housing for ASCO's 2013 Annual Meeting Today Register and reserve housing for the 2013 ASCO Annual Meeting (May 31-June 4 in Chicago, IL). This year's theme, Building Bridges to Conquer Cancer, aims to build bridges across all segments of the oncology community by providing attendees with the knowledge to achieve the highest standard of patient care.
- Payment Reform Town Hall Meeting will be hosted by ASCO on Sunday, June 2 at 11:30AM in room S404 of McCormick Place at ASCO's 2013 Annual Meeting.
- The ASCO Nominating Committee, chaired by Kathy Miller, MD, would like to make you aware of the upcoming nomination process for the 2014 ASCO Election, which will officially begin on May 7, 2013 and last until June 6, 2013. The Nominating Committee encourages ASCO volunteers to propose nominees to ensure that ASCO has strong leadership in the future.
Any questions should be directed to ascoelection@asco.org or (571) 483-1316.
- Best of ASCO Los Angeles, August 16-17. At each of 2013 Best of ASCO® Meetings, you can expect an engaging agenda featuring high-level scientific and/or clinical abstracts as well as educational sessions led by world-class faculty. Interact with oncology experts, network with colleagues, and earn CME credit.
- Save the Date for the 2013 ASH State-of-the-Art Symposium. It's never too early to start planning to attend the 2013 ASH State-of-the-Art Symposium (SAS). One of the two locations this year is in Los Angeles, CA on October 11-12, 2013. Visit www.hematology.org/SAS13 for more information.
- ASCO's Quality Care Symposium (November 1-2, 2013 in San Diego, California) will bring together leaders in the fields of quality, health services research, and oncology outcomes to share knowledge on innovative programs and models. Designed to address critical questions and provide healthcare professionals with the tools needed to administer superior care, the two-day Symposium will feature educational sessions, panel discussions, and abstract presentations. Abstract Submission Deadline: July 2, 2013, at 8:59 PM (PDT).
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Industry News
- Tarceva has been approved for the first-line treatment of metastatic NSCLC. Astellas Oncology informs ANCO and MOASC that the United States Food and Drug Administration has approved Tarceva for the first-line treatment of metastatic non-small cell lung cancer (NSCLC) patients whose tumors have epidermal growth factor receptor (EGFR) exon 19 deletions or exon 21 (L858R) substitution mutations. This indication for Tarceva is being approved concurrently with the cobs EGFR Mutation Test, a companion diagnostic test for patient selection.
- Xofigo has been approved for the treatment of patients with castration-resistant prostate cancer. Bayer Healthcare Pharmaceuticals informs ANCO and MOASC that the United States Food and Drug Administration has Xofigo for the treatment of patients with castration-resistant prostate cancer, symptomatic bone metastases and no known visceral disease. Xofigo is an alpha-particle emitting radiopharmaceutic drug which mimics calcium and forms complexes with hydorxyapatite at areas of increased bone turnover, such as bone metastases.
- ICD-9-CM codes for Kyprolis are 203.00 and 203.02. Onyx Pharmaceuticals wants to ensure ANCO and MOASC members are aware of the narrative requirements for claims of Kyprolis. The appropriate ICD-9-CM codes for Kyprolis (J9999) are 203.00 and 203.02 and narrative fields in electronic and paper claims must state the name of the drug, its NDC number, and dose administered, and the names of the two drugs given prior to Kyprolis and state Patient shows disease progression. For more information, go to www.palmettogba.com/j1b > Browse by Topic > Drugs & Biologicals (01/23/2013).
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MOASC CALENDAR
LunchTime Series Teleconference
(May 29, 2013)
MOASC Oncology Billing Program
(October 4, 2013)
MOASC Sponsored ONS Chemotherapy and Biotherapy Course
(October 4-5, 2013)
ANCO CALENDAR
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2Q2013 Professional Education Webcast (May 21, 2013)
ASCO Highlights (August 24, 2013)
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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) 985-8581 | www.moasc.org
ANCO: P.O. Box 151109, San Rafael, CA 94915 | P (415) 472-3960 | F (415) 472-3961 | www.anco-online.org |
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