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.

  
August 26, 2014
California News

 

 

- California's Department of Managed Health Care (DMHC) has issued fines at more than twice the rate of recent years against health plans that did not pay providers in a timely manner. California health plans have long been required to pay providers in a timely manner (i.e., within 45 days of receiving a claim).

 

- A California legislative committee ordered an audit to determine whether the state is providingMedi-Cal managed care plan beneficiaries adequate access to health care services. The audit will gauge whether Medi-Cal's managed-care provider directories include an adequate number of physicians who are accepting new patients through the program and whether state lawmakers have been properly overseeing the directories.

 

Early Field Poll results released last week have Prop. 46 at 58% "Yes," 30% "No." It is important to stress that these numbers are consistent with what was expected from early polling. Do not let these numbers deter you from the excellent education and fundraising efforts already underway. Please continue to stress the importance of defeating Prop. 46 to your neighbors, family, friends, patients and colleagues in the weeks left between now and Election Day. Earlier this week, radio and television ads created and produced by the "No on 46" campaign began running across the state in both English and Spanish. These ads mark the beginning of what is certain to be one of the biggest and most visible campaigns in California history, with both sides of this issue determined to win the minds of voters before Election Day. The ads, "Risk" (TV) and "Real Story" (radio) are introductory pieces highlighting who has sponsored and funded Prop. 46. The spots factually outline how health consumers, taxpayers and state and local governments will have to pay more if this initiative is not defeated on Election Day. You can view the television spot here and hear the radio here. In addition to television and radio ads, a new online video was launched last week that can be viewed at www.NoOn46.com. You are  encouraged to share this video on your social media pages, office websites and through your networks. The website is also set up to allow for direct contributions to the "No on 46" campaign. Across the state, law firms are pouring thousands of dollars into the "Yes" campaign's coffers. The House Of Medicine must step up and do the same. If you haven't already done so, please visit the "contribute" page on the No on 46 website and support to the campaign effort. Your donation will go directly toward educating potential voters about the risks posed by Prop. 46. Every dollar counts and nothing is too small. The facts about Prop. 46, specifically is that it will cause medical lawsuits and payouts to skyrocket, threaten the personal information of millions of Californians and jeopardize patients' access to their trusted As a reminder, you can visit the campaign website and request campaign material be sent to your hospital or office.. 

 

 

Noridian News


 

- Noridian/JEMAC's website (med.noridianmedicare.com/web/jeb) has posted the following updates: Draft LCDs Published for Review and Comments (including ESAs and MolDx), September Web-based Workshops, and PET Scans Coverage-R4.

 

 

DHCS/Medi-Cal News

 

 

Medi-Cal is experiencing technical difficulties: 1) Accepting claim attachments; 2) with the 835 files created on August 6, 13 and 20, and; 3) verifying the status of volsers. As a result, providers and submitters are unable to obtain a volser status through Transaction Services. Systems personnel are aware of these problems and are working on a resolution. Medi-Cal apologizes for the inconvenience. Please go to http://www.medi-cal.ca.gov/sysstat.asp for future updates.

 

During the month of July, some providers may have seen an incorrect increase in their checkwrite's "Claims in Process Amount" on the Transaction Services area of the Medi-Cal website. Due to the erroneous counts under the "Claims in Process Amount," providers may have been expecting an inaccurate amount due. This issue has since been fixed and now the "Claims in Process Amount" reflects accurate information

 

 

MOASC News

 

 

Physicians may lose up to 9% in Medicare revenue come 2017! You cannot afford to miss the LunchTime Series Webinar, tomorrow, Wednesday, August 27, 2014.  

12:00pm - 1:30pm PST.  "Medicare Physician Fee Schedule (PFS) 2015 Proposed Rule, the Value Based Modifier and Changes to Physician Quality Programs." Presented by: Kelly Davies, Healthcare Policy & Advocacy Director,Southern CA, Strategic Customer Group, Johnson & Johnson Health Care Systems Inc. For more information on the 2015 proposed rule, click here, and "Eliminating Collection Costs While Reducing Accounts Receivables by More Than 61%," presented by: Shawn Ecksel,Vice President, Sales and Development

USPAY.  

To RSVP contact Danielle Overman at [email protected].

 

MOASC is always looking for ways to help our members - please take a few minutes to fill out this brief survey regarding your MOASC membership. The mission of MOASC is to ensure access to quality and affordable care for cancer patients within their communities.  Thank you for your time. Take the survey now!!

 

- MOASC Office is in receipt of communication from membership regarding delayed reimbursement from Anthem Blue Cross Wellpoint. If you too are experiencing delayed or reduced reimbursement on your Anthem Blue Cross Wellpoint claims, please let the MOASC Office [email protected] know. We will present and seek recompense for membership from them. Thank you.

 

- The MOASC Oncology Nurse Program is scheduled for Friday, September 19, 2014 and will be held at The Sheraton Pasadena. Topics include: Oral Adherence; Compassion Fatigue - Building Resilience in Oncology Nurses; The Art of Active Listening (AAL). Please RSVP to Danielle Overman at [email protected] by Friday, September 12, 2014.

 

- MOASC's membership period is July through June, JOIN today! MOASC's sole mission is to ensure access to quality and affordable care for cancer patients within their communities.

Contact the MOASC Office at [email protected] or 909-985-9061 ext. 1. 

 

Like us on Facebook Follow us on Twitter View our profile on LinkedIn

 

 

ANCO News

 

 

- ANCO is organizing a Hematological Malignancies Update on September 27 in Menlo Park with Bruno Medeiros, MD, Stanford University, and Joseph Tuscano, MD, UC Davis. The latest research on novel treatment modalities for ALL, AML, CLL, and NHL, along with case studies for each diagnosis will be presented. Watch for meeting announcements in mid-August.

 

- ANCO and the SullivanLuallinGroup have cooperated on Patient Surveys for the past several years and another Patient Survey is planned for 2014. ANCO will use its negotiating leverage to offer members expert and reliable Patient Surveys at steep discounts. ANCO funds the set-up fee so that members may participate at discounted per physician rates. An announcement of the 2013 ANCO Patient Survey will be mailed, e-mailed, and FAXed to all ANCO community-based member practices by the end of May. For more information, please visit www.anco-online.org/pxsrvy.html.

   

 
CMS News 

 

 

- CMS, in an e-mail to COA President Bruce Gould, M.D., amongst others, says it has developed a provisional design of a new oncology payment model. While the model is not final, CMS wanted to share the provisional design elements with interested stakeholders. If CMS decides to move forward with an oncology model, the CMS Innovation Center will publish the final model with additional detail regarding participation in the model, and will post a Request for Applications on the Innovation Center website. In the meantime, view the provisional model at http://associationdatabase.com/aws/OHOS/asset_manager/get_file/83335?ver=1.

 

- CMS is not doing enough to make sure Medicare provider payment audits are not duplicated according to a Government Accountability Office report. The reported noted that while CMS has stepped up its oversight of its contractors, it must do more to ensure that auditors are not completing duplicative reviews.

 

- Following CMS's decision to adhere to September 30 as the public launch date for its first report on the Open Payments Program, ASCO is urging CMS to proceed with caution and to provide the public with complete information and context about the data that will be made public. ASCO strongly supports transparency in health care, but the Society is concerned that a lack of context will contribute to misconceptions about the nature of the payments, because not all payments have the same implications. The public needs to understand that, for example, payments for research support important clinical research collaborations between physicians and industry that result in new treatments for patients. In addition, CMS announced that approximately 33% of the records will be withheld from the launch due to data errors and inconsistencies. For more information about the Open Payments Program, visit http://www.asco.org/about-asco/physician-payments-sunshine-act.

 

-CMS has made available the latest edition of the MLN Connects Provider eNews. MLN Connects Provider eNews for August 21, 2014.  MLNConnects™ National Provider Calls,

"PQRS: How to Avoid 2016 Negative Payment Adjustments for CMS Medicare Quality Reporting Programs," Wednesday, September 17; 10:30-12pm Pacific Time. To register, visit MLN Connects™ Upcoming Calls. Space may be limited, register early. 

 

 

Affiliate Association News


 

 

- View a video about ASCO's proposed innovative patient-centered payment system for cancer care at www.asco.org/advocacy/physician-payment-reform).

 

- The COA Board of Directors has approved a statement on the 340B program that is posted at http://www.communityoncology.org/site/blog/detail/2014/07/30/estimate-the-impact-of-the-2015-proposed-medicare-fee-schedule.html.

 

- CMS has approved ASCO's Quality Oncology Practice Initiative (QOPI) as a pathway for oncologists to meet the agency's quality reporting requirements. Starting in the Fall of 2014, oncology practices registered with QOPI will have the opportunity to fulfill CMS's PQRS or QCDR reporting requirements through QOPI. Go to www.asco.org/advocacy/cms-approval-new-platform-making-qopi�-partcipation-easier for more information. Join ASCO for a free webinar about CMS Reeporting, QOPI, and how to meet PQRS requirements through QOPI on September 8 at 1PM. Register here.

 

- If you completed your final subspecialty training between 2005 and 2010 and want to shape the future of ASCO as well as the practice of oncology, then ASCO's Leadership Development Program is for you. Participants in this year-long program will learn valuable leadership skills and gain extensive exposure to the roles and mission of ASCO, its Leadership, and the Society's powerful place in developing the future of cancer care. This program requires a time commitment for travel and training. To learn more about ASCO's Leadership Development Program and to apply by September 26, 2014, please visit www.asco.org/leadership.

 

- ASCO has free educational materials on the Affordable Care Act's clinical trials coverage provision that requires private insurers to cover the routine patient costs associated with participation in approved clinical trials. Go to www.asco.org/ClinicalTrialsCoverage to access these educational materials.


- ACCC has launched a new online Oncology Drug Database providing quick access to
information on oncology drug coding, billing, and reimbursement at http://www.accc-cancer.org/drugdatabase/.

 

- ACCC's 31st National Oncology Conference takes place October 8-10 in San Diego. Explore the agenda and register for this meeting atwww.accc-cancer.org/oncologyconference.

use code MOASC when registering). CME will be available and the agenda will include a thought-provoking array of plenary sessions and workshops. Room block available at the historic Mission Inn and Spa ($129 a night). Featured Speakers: Rishi Manchanda M.D., M.P.H

Author of the book "The Upstream Doctors: Medical Innovators Track Sickness to Its Source"

Sandra R. Hernandez M.D., President & CEO, The California Healthcare Foundation. To register or for more information, please visit www.ethnicphysicians.org or contact Liza Trujillo Kirkland, NEPO program Manager at 916.779.6643 or [email protected]

Please inquire regarding special medical student pricing.

  

 

Industry News

 

 

- Genentech BioOncologyinforms ANCO and MOASC that the United States Food and Drug Administration (FDA) has approved Avastin for the treatment of persistent, recurrent, or metastatic cervical cancer, in combination with paclitaxel and cisplatin or paclitaxel and topotecan.

 

- Millennium
informs ANCO and MOASC that the United States Food and Drug Administration (FDA) has approved Velcade for retreatment in patients with multiple myeloma.

 


   

 

In This Issue
California News
Noridian News
DHCS/Medi-Cal News
MOASC News
ANCO News
CMS News
Affiliate Association News
Industry News
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MOASC CALENDAR

  

MOASC Lunchtime Series Teleconference

(August 27, 2014)

 

MOASC Oncology Nurse Program

(September 19, 2014)

 

MOASC Administrators Program 

(October 22, 2014)

 

MOASC Advisory Summit 

(November 14, 2014)

 

 

 

ANCO CALENDAR

   

Hematological Malignancies Update (September 27, Menlo Park)

 

ASH Annual Meeting (December 6-9, San Francisco)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 
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-online.org