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.
 

October 20, 2015  

California News

- Governor Brown has signed AB374 into law. AB374 permits prescribing physicians to request a step therapy override determination from a health plan or insurer on behalf of a patient if doing so in the best interest of the patient.
 
- The open enrollment period for the third year of Covered California, California's health benefit exchange, begins November 1, 2015, and continues through January 31, 2016. All 10 health insurance companies that offered coverage in 2015 will continue to offer coverage in 2016, with two new health insurance companies, United Healthcare (UHC) and Oscar, entering into the marketplace for 2016 in select regions.
 
- People who fail to get health insurance in 2016 will have to pay a $695 fine, which is more than double this year's penalty. The Associated Press
 
- The Cal/OSHA Antineoplastic Drugs Advisory Meeting will be on Wednesday, October 28, 2015. The purpose of the meeting is to seek advice on a new discussion draft that is intended to meet the requirements of AB 1202 and is in response to the advice provided during the first meeting earlier. This bill requires the California Occupational Safety and Health Standards Board within the Department of Industrial Relations to adopt a standard for the handling of antineoplastic drugs, as defined, in health care facilities regardless of the setting. The bill would require the standard to be consistent with and not exceed specific recommendations adopted by the National Institute for Occupational Safety and Health for preventing occupational exposures to those drugs in health care settings. By creating a new crime, this bill would impose a state-mandated local program. The agenda for the meeting, the discussion draft and related handouts will be sent out prior to the meeting and will also be posted on Cal/OSHA's website at: http://www.dir.ca.gov/dosh/doshreg/Antineoplastic-Drugs/
If you have questions regarding this meeting, please contact Grace V. Delizo Senior Safety Engineer, DOSH Research and Standards Health Unit, at 619-278-3770 or Bob Nakamura at 510-286-7005. Thank you for your interest in this project.



Noridian News

- Noridian/JEMAC has posted the following updates to its website http://med.noridianmedicare.com/web/jeb
* MLN Connects Provider eNews
ICD-10--Use ICD-10 Now; ICD-10 Ombudsman and ICD-10 Coordination Center Support Your Transition; Qualifiers for ICD-10 Diagnosis Codes on Electronic Claims
* Self-Administered Drug Exclusions List-R3
* Use ICD-10 Now--Here is How
* Outpatient Therapy Services (October 20)
* ICD-10 (October 22)
* The ABCs of the CERT Program (October 28)
* Use PECOS to Report a Change of Information in Part B Enrollment (October 29)
* CCI and MUEs (November 20)
 
- Ask the Contractor Teleconference is Scheduled for October 27, 2015. This is rescheduled from the original October 15, 2015 ACT. Read the complete update



DHCS/Medi-Cal News
 
- DHCS/Medi-Cal now accepts the CPT code 81519 for Oncotype DX. While Medicare and most commercial plans implemented the code in January 2015, DHCS/MediCal has just updated their system. Effective October 1, DHCS/Medi-Cal will no longer accept its code S3854 for Oncotype DX. In addition, Medi-Cal has expanded coverage to include both node negative and node positive (1-3 involved nodes) disease. The new code, 81519, is exclusive to Oncotype DX, and is the only gene expression profiling test covered by Medi-Cal. Other tests are not benefits of the Medi-Cal program.
 
- In June, the California State Auditor's office released a report that found the Medi-Cal phone system for beneficiaries to be "severely deficient"; the auditor urged the Department of Health Care Services (DHCS) to make upgrades. On September 30, 2015, DHCS announced that the ombudsman phone system has been expanded. The new system is expected to improve data collection, reduce the number of dropped calls and allow patients to leave messages. Among other key findings of the June audit were that DHCS "has not consistently monitored health plans to ensure that they meet beneficiaries' medical needs-it did not perform any annual medical audits before 2012 and performed medical audits on less than half of the health plans in fiscal year 2013-14." The California Medical Association continues to monitor the situation. For the full auditor's report, click here. 

 
 
 MOASC News
   
- On Wednesday, October 28th at 12:00pm, please join MOASC's LunchTime Series presentation of "Biosimilar Clinical and Legislative Updates for Physicians and Clinical Staff," sponsored by Sandoz Biopharmaceutical. The presenters are: Andrew DeLeon, PharmD, Director of Medical Affairs- Oncology Medical Science Liaison East Team at Sandoz Inc. Andrew's professional background also includes clinical oncology practice experience as an Oncology Clinical Pharmacist specializing in Bone Marrow and Stem Cell Transplant at Baylor University Medical Center in Dallas, TX and worked at Amgen Inc. as a Senior Medical Science Liaison for the Oncology therapeutic area.   Kim Campbell, PharmD, BCOP, Director of Medical Affairs- Oncology Medical Science Liaison West Team at Sandoz, Inc. Kim's professional background includes practicing as an Oncology Clinical and Investigational Pharmacist at Arizona Cancer Center in Tucson, AZ and Oncology MSL Director at Astellas and Amgen Inc. Allison Barnett is an Associate Director of State Government Affairs for Novartis Pharmaceuticals where she is responsible for the company's lobbying activity in both California and Hawaii. Prior to Novartis, Allison was a Government Relations Director for Anthem, Inc. and was responsible for Anthem's lobbying activity for commercial and specialty markets.
To receive the webinar link and ensure enough lines are available, please RSVP to the MOASC Office at moasc@moasc.org.
 
- You are invited to the MOASC Administrator Meeting, November 5, 2015, 8:00 am to 3:30pm at the Mission Inn, Riverside. At this final meeting of the year, you'll hear from key industry stakeholders on how the industry is faring with implementation of the new code sets. Take this unique opportunity to learn from industry experts, what they know to keep your practice current and trending toward success. Discuss with colleagues what the initial impact of ICD-10 has had on operations. Some of the topics include: Key data points for a practice's health, patient surveys, embezzlement and COPA; Current Trends in Oncology, USP 797/800, Patient Support, Medi-Cal and Medicare Updates. DON'T MISS THIS VALUABLE EVENT! If you wish to reserve a hotel room at a discounted rate, please contact the MOASC Office at moasc@moasc.org.
 
- MOASC is pleased to partner with Research to Practice for the Year in Review (YIR) Meeting at the Fairmont Miramar Hotel & Bungalows, Santa Monica, on Saturday, November 21. Please click on the link for more information. http://www.researchtopractice.com/Meetings/YIR2015/CAYear in Review CME Meeting. 
 
- MOASC has openings on the Board of Directors. Physician Members who are interested in providing direction and assistance to your state oncology organization are encouraged to contact the MOASC Office at moasc@moasc.org.
 
- MOASC is also soliciting Administrators and Non-Physician Clinical Staff to fill the two positions on the board of Directors that represent your interests in the oncology practice. MOASC believes that the administrator and clinical staff bring fresh ideas and new points of view. Thank you for your participation & SUPPORT!
 
- California Partnership for Access and Treatment has notified MOASC of a great resource on the cost and value of prescription medicines. The link below is full of infographics that explain the role new medicines play in the overall reduction of health care costs. Please take a moment to review the document and please share with your patients. Prescription Medicines - Costs in Context
 
- Effective January 1, 2015, AB219 (the Health Care Coverage: Cancer Treatment Act) limits a patient's total co-payment and coinsurance for an oral cancer medication to $200 per 30-day supply. Some private payor pharmacy benefit plans may be in violation of the provision of AB219. If you are finding this to be the case with any payor or their PBM, please let the MOASC office know the name of the health plan and PBM company at moasc@moasc.org. Thank you.  
 
Job Board:
- A busy Oncology/Hematology, two physician, medical practice with IV Treatment Suite, located in Laguna Niguel has an opening for a per diem/travel Oncology RN. One of their RN's will be out approximately 6 weeks the beginning of 2016. OTN Nucleus drug management system/Allscripts EHR are a plus. Chemotherapy mixing/administration experience with strong IV skills required. Interested candidates are asked to contact Elaine Ann Daly, Manager, (949) 499-4540 or edaly@wagneroncology.com


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ANCO News
 
- ANCO's Molecular Diagnostics & Clinical Decision Making takes place at The Claremont Resort on October 24. Faculty from industry, payers, and local institutions will discuss the science of molecular diagnostics, reimbursement for molecular diagnostics, and the use of molecular diagnostics in clinical decision making using case studies. For more information, visit www.anco-online.org/MolDx.pdf.
 
ANCO's last Hematologic Malignancies Update for 2015 takes place on November 7, 2015. Join Brian A. Jonas, M.D., Ph.D., UC Davis, Michaela Liedtke, M.D., Stanford University, and Gregory P. Kaufman, M.D., Stanford University, to learn the latest about treatment modalities for acute leukemias, myelodysplastic syndromes, and myeloma and discuss case studies for each diagnosis. The program takes place at the Stanford Park Hotel in Menlo Park. Go to www.anco-online.org/4Q2015HemeMalig.pdf for more information.
 
- Marin Cancer Care will host Improving the Service Experience of Cancer Patients and their Families with Leonard L. Berry, Ph.D., Texas A&M University, on October 22. Professor Berry is author of Management Lessons from Mayo Clinic: Inside one of the World's Most Admired Service Organizations. Register at www.maringeneral.org/LenBerry.
 
- ANCO is pleased to be a sponsor of the 16th Multidisciplinary Management of Cancers: A Case-based Approach which returns to the Silverado Resort and Spa, Napa, on March 18-20, 2016. The meeting is presented in collaboration by the Stanford Cancer Institute, UC Davis Comprehensive Cancer Center, and UCSF Helen Diller Family Comprehensive Cancer Center. For more information, visit http://cme.stanford.edu/multicancers.

- ANCO is surveying practices to learn early lessons from the transition to ICD-10. Download and complete the survey at www.anco-online.org/EarlyLessonsICD10.pdf. CMS ICD-10 resources are available online at www.cms.gov/Medicare/Coding/ICD10/index.html?redirect=/icd10; ASCO ICD-10 resources are at www.asco.org/practice-research/icd-10; ASH ICD-10 resources are at www.hematology.org/Clinicians/Practice-Policy/2325.aspx; and, CMA ICD-10 resources are at www.cmanet.org/icd10. 
 
- Effective January 1, 2015, AB219 (the Health Care Coverage: Cancer Treatment Act) limits a patient's total co-paym,went and coinsurance for an oral cancer medication to $200 per 30-day supply. It has been brought to ANCO's attention that some private payor pharmacy benefit plans may be in violation of the provision of AB219. Read more about and take ANCO's AB219 survey at www.anco-online.org/AB219Survey.pdf.
 
- Four seats on the ANCO
Board of Directors are up for election in 2015. ANCO seeks nominations for candidates to stand for election to these seats. This year's election will be conducted via mail ballot in December. Candidates with the top four vote totals will serve for three years (i.e., from 2016-2018, inclusive). The ANCO Board of Directors governs the Association, developing advocacy strategies and policies, approving educational meeting proposals and activities, and considering membership benefits. The Board meets in person approximately once each year in the San Francisco Bay Area and via bimonthly teleconference. Expenses associated with attending Board meetings are reimbursed. Communication with the Board is also conducted via FAX broadcast and e-mail. You may nominate an ANCO member (including yourself) to stand for election to the Board via FAX to the ANCO office at (415) 472-3961 or e-mail to execdir@anco-online.org no later than November 13, 2015.


 
MOASC Purchasing Network News 

- The mission of MPN Precision Medicine Advisory Board is to serve as an expert resource for the California oncology community in order to assist healthcare providers with education, guidance, and access to genomic molecular information in order to reach a consensus on practical definitions of clinical utility and to outline the information needed to form treatment strategies that target the molecular underpinnings of the specific disease in each patient. MPN has a unique opportunity to educate, guide, and launch a statewide dialogue among all stakeholders in order to reach a consensus on practical definitions of clinical utility and to outline the information needed by payers to support reimbursement for fully informative genomic profiling assays used in targeted cancer therapy. MPN and Foundation Medicine will be offering a series of educational webinars to assist healthcare providers and their support teams with education, guidance, and access to genomic molecular information.
DON'T MISS THE FOLLOWING OPPORTUNITIES TO LEARN MORE!
October 22nd @ 12:00 pm (PST)  Defining Clinical Utility.
Please contact Lesli D. Lord at 214.578.9589 Lord.Lesli@gmail.com for more information.



National News

- This Friday, the House of Representatives is expected to vote on a reconciliation package that would roll back parts of the Affordable Care Act. Some conservative lawmakers say the bill doesn't go far enough because it wouldn't repeal Medicaid expansion or subsidies for state-based exchanges. Morning Consult
 
- A federal judge denied a request by the Obama administration to appeal a decision that gives the House of Representatives the right to sue the administration over its executive actions to implement the Affordable Care Act. CNN



CMS News 

- CMS has a created a new webpage onto EHR Incentive Programs website that contains all the program requirements and resources for previous years of the EHR Incentive Program. Go to www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/index.html?redirect=/ehrincentiveprograms for more information.
 
- Beginning in 2013, the Centers for Medicare and Medicaid Services (CMS) began pre-payment audits that included random audits, as well as audits that target suspicious or anomalous data. 3 States were also instructed to implement a similar audit process for incentive payments made under the Medicaid meaningful use program. If you are selected for an audit for the Medicare incentive program, you will receive an initial request letter from the auditor. The request letter will be sent electronically from a CMS email address and will include the audit contractor's contact information. To see an example of an audit notification letter, go to the CMS website: http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Downloads/SampleAuditLetter.pdf 



Affiliate Association News
 
- Research to Practice for the Year in Review (YIR) Meeting will be at the Fairmont Miramar Hotel & Bungalows, Santa Monica, on Saturday, November 21. Please click on the link for more information.
 
- Interested in becoming involved in the leadership of ACCC and helping to shape the future direction of the organization? ACCC is now accepting nominations for the 2016 Board of Trustees election. If you or someone you know is interested, please send in a nomination (including the nominee's name and program affiliation) to Careen Campbell at ccampbell@accc-cancer.org
or via FAX at (301) 770-1949. Nominations must be received by November 30.
 
- Don't wait to register now to ensure the best available housing for the premier event in hematology! ASH invites you to attend the 57th ASH Annual Meeting and Exposition from December 5-8, 2015, at the Orange County Convention Center in Orlando, FL. This year's meeting will debut some new offerings and continue to showcase the full spectrum of hematology, from discoveries to new therapies to outcomes analyses. Register as an individual.
Register as a group. To register as an individual, you must sign in using your current ASH username (moasc@moasc.org) and password.
 
- ASCO's new Health Policy Fellowship program has opened its application period. The Program aims to provide physicians with the necessary skills to shape cancer policy and ASCO is actively recruiting oncologists in the early phase of their careers who have shown a keen interest in acquiring stronger health policy skills and have leadership, civic, policy, or advocacy experience. For more information, go to www.asco.org/advocacy/health-policy-fellowship; applications are due by December 15.
 
- To underscore ASCO's commitment to a lifelong learning experience, ASCO will convene a learning cohort representing ASCO's target audience and membership.  This group will engage with ASCO on a regular basis over a nine month period beginning this November to provide feedback on ASCO's CME program portfolio as well as highlight resources/strategies outside of ASCO products and services that are used to address learning needs.  The Learning Cohort is currently being selected, and are including community oncologists and other oncology health care professionals from all geographic regions of the US. If you are interested in participating, or know of colleagues who are ASCO members that may be good participants who can provide valuable feedback, please contact Allyson Baer, MA at571-483-1388 or at allyson.baer@asco.org to be included in this new initiative. There is some financial incentive for participating.
 
- ASCO has introduced a new Genetics Toolkit to provide oncology professionals with tools and resources to assist them in effectively integrate hereditary cancer risk assessment into practice. For more information, go to www.asco.org/genetics-toolkit.
 
- ASCO has announced a new study which provides compelling evidence that a simple tool can help predict which patients with cancer may be in their final year of life. The tool, known as the Surprise Question, was found to predict the risk of cancer death within one year better than factors such as cancer type or stage alone. This study will be presented at the upcoming 2015 Palliative Care in Oncology Symposium in Boston. read press release 
 
- ASCO's Practical Tips for the Oncology Practice (6th Edition) is now available at www.asco.org in eBook format.
 
- Be a part of ASCO's new collaborative learning network, PracticeNET, to gain valuable insights into your practice's business operations and quality of care. This new initiative, from ASCO's newly formed Clinical Affairs Department, uses existing data from your practice management system to offer customizable reports that measure practice-wide and individual performance against a national database of other PracticeNET participants. For more information, and to enroll, visit asco.org/practicenet. 
 
- COA PAC is a political action committee (PAC) founded by community oncologists for community oncology. Funds raised within COA PAC are used to contribute to campaigns of individuals seeking elected office to the United States Senate and House of Representatives. COA PAC supports individuals who have demonstrated an interest in community cancer care and in preserving and enhancing the nation's cancer care delivery system for cancer patients.
A suggested initial contribution is at least $1,000; however, many oncologists have made an initial contribution of $2,000. Contributions cannot exceed $5,000 per year. COA PAC has a Community Oncology Leadership Club that recognizes contributions. If you want elected officials who support community oncology and the patients served, you need to support their election campaigns. COA PAC is the only independent PAC dedicated solely to community oncology. Community oncologists need to be far more active as evidenced by the list below of the top 60 healthcare professional PACs in 2014. COA PAC ranked 51st, behind many other more specialized areas of medicine. COA PAC makes the most of the funds raised, but community oncology is lagging behind many other areas of medicine in making an impact. It is up to you and your fellow oncologists to contribute to increase support for community oncology. www.CommunityOncology.org 
 
- The National Comprehensive Cancer Network (NCCN) is making available the NCCN Scale in October. The NCCN Scale is a tool to aid cancer patients make more informed choices by helping to assess the costs of medical treatments juxtaposed against their benefits. The NCCN Scale will make use of the so-called evidence blocks that "assign a score of up to five points for each of five measures--price, effectiveness, safety, quality and consistency of clinical data." In its October launch, the NCCN Scale will provide ratings for drugs used to treat multiple myeloma and chronic myeloid leukemia. Before 2016, the Scale is expected to have also included ratings for other types of cancer.



Industry News
 
- Genomic Health informs ANCO and MOASC that DHCS/Medi-Cal now accepts the CPT code 81519 for Oncotype DX. While Medicare and most commercial plans implemented the code in January 2015, DHCS/Medi-Cal has just updated their system. Effective October 1, DHCS/Medi-Cal will no longer accept its code S3854 for Oncotype DX. The new code is exclusive to Oncotype DX, and is the only gene expression profiling test covered by Medi-Cal - other tests are not benefits of the Medi-Cal program.  Medi-Cal has expanded coverage to include both node negative and node positive (1-3 involved nodes) disease.
 
- AstraZeneca is pleased to promote the LVNG With lung cancer event in San Diego on October 24, 2015 for patients with lung cancer and their loved ones or caregivers. The event is this Saturday; please make sure your patients can register as soon as possible to be able to attend.  LVNG with lung cancer is an unbranded initiative from AstraZeneca to support, motivate and connect people with lung cancer and their loved ones.  It was developed based on the feedback of over 100 patients, their loved ones and healthcare professionals. The initiative is being promoted through three channels: a newspaper, a live event and a dedicated Web site https://www.lvng.org/. Below find links to a flyer, and document with a copy you can use to promote the event on your practice Web site, through social media (Facebook and Twitter) and other channels that you see fit, to make sure the information goes to the people that would benefit the most from attending the event. 
LVNG Events    LVNG Advocacy

- Boehringer Ingelheim Pharmaceuticals informs ANCO and MOASC that its "Let's Test" website provides information to assist with biomarker testing. In the age of personalized medicine, oncologists can routinely order biomarker tests for their patients with advanced NSCLC and use the results to consider more tailored treatment. Learn more at www.letstestnow.com.
 
- Participants will receive a $300 honorarium for their time. Dr. Mark Fuller from kc2 Medical Communications www.kc2med.com a health care, education and research company, is in the process of arranging in person interviews with practice managers/ billing specialist to be held on Oct 22nd and 23rd in LA. The team would like to speak with you about a potentially new oral oncolytic that will have an enormous amount of testing and potential hospitalization for patients prescribed on the drug. They want to understand the dynamics that are involved in coordinating care and in the end they hope to create a brochure to pass out to hospitals/clinics, etc. If you are interested, contact: Judy Kelly, RN, BSN, kc2 Medical Communications, V 724-935-6616 F 866-715-4923 JudyK@kc2med.com, www.kc2med.com.


 

In This Issue
  1.  

 

 MOASC CALENDAR

 

LunchTime Series
October 28th  
November 18th

 

 

MOASC Administrator's Meeting

November 5th 

 

 

 

 

 

 

 

ANCO
CALENDAR

   

(October 24; Oakland) 

 

(November 7; Palo Alto)

 

(January 7-9; San Francisco) 

 

ASCO's 2016 Cancer Survivorship Symposium 

(January 15-16; San Francisco)

 

(January 21-23; San Francisco) 

 

(March 18-20; Napa) 

 

 

 

 

 

 

 

 

 

 

 

 
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