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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.
October 27, 2015
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- As a reminder, CAPP (Californians Allied for Patient Protection defenders of MICRA) is hosting a reception in honor of Assembly Member Freddie Rodriguez on Wednesday, November 4 from 4:30 p.m. - 6:00 p.m. The event is being held at the offices of NAMM California/PrimeCare Medical Network located at 3990 Concours, Suite 500, Ontario, CA 91764. There is no cost to attend and there will be no solicitation for contributions at the event. Please join your colleagues, bring a colleague and share the invitation with your colleagues. RSVPs can be given to Marissa Allen at 916.448.7992 x 4 or [email protected]. California's New 'Right-To-Die' Law Faces Challenges, Delays. While Gov. Brown signed California's new physician-assisted death law earlier this month, it cannot take effect until 91 days after the current special sessions end. That means the law cannot go into effect until April 2016, at the earliest. Meanwhile, opponents are gathering signatures to repeal the law. - 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.
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- Today! October 27, 2015 Noridian is conducting "Ask the Contractor" teleconference. This is rescheduled from the original October 15, 2015 ACT. Read the complete update ICD-10--Learn How to Assign an ICD-10-CM Diagnosis Code with MLN Connects Videos; 5 Ways to Check Your Claim Status; Contact List for ICD-10 Questions Announcements--MACRA Request for Information: Comments Accepted through November 17 * ICD-10 News: Checking Your Medicare FFS Claim Status * CCI and MUE Workshop (November 20)
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- According to Modern Healthcare, all hospitals -- except for public safety-net facilities -- are required under federal law to obtain pre-authorization from Medi-Cal before admitting fee-for-service beneficiaries. The majority of Medi-Cal beneficiaries have been moved to managed care in recent years, but up to three million individuals still are in fee-for-service coverage, including beneficiaries who are:
Dually eligible for Medicare and Medi-Cal;
Enrolled in home- and community-based programs; and
Residents in long-term care facilities.
Fee-for-service beneficiaries are more likely to be hospitalized for conditions that can be treated on an outpatient basis. Under a prior waiver, California's 21 designated public hospitals have been piloting a new method allowing them to skip the pre-authorization process for admitting fee-for-service Medi-Cal beneficiaries. Instead, the hospitals follow national clinical guidelines to determine whether a fee-for-service beneficiary should be hospitalized.
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- Thank you for joining MOASC! Your membership now includes access to our private online forum. To access this new feature, please login to http://www.moasc.org and update your password. You will find your username and temporary password below. Once your password has been updated, click the "Member Forum" tab at the top of the screen to start interacting with other MOASC members. If you have any questions on how to use this new feature, please feel free to reach out to us at [email protected] for assistance."
Once the password is created, you'll be able to post questions/comments.
Thank you!
- 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 [email protected].
- Please join us for the MOASC Administrator Meeting, November 5, 2015, 8:00 am to 3:30pm at the Mission Inn, Riverside. At this last 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 [email protected].
- 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 [email protected].
- 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 [email protected]. Thank you.
MOASC is in receipt of CMA's interpretation of the bill. "... In reading the bill, it would appear that Medicare Part D plans are not subject to the requirements. The bill is limited to fully insured plans regulated by the DMHC or DOI. Medicare Part D plans are regulated by CMS and fall under federal law for any similar limitations. Should patients have to pay more than the $200, it might be that the patient is hitting the "donut hole" dollar amount, which could require him/her to pay more for prescription medications.
But, if there are any instances where a fully insured plan that is an HMO or PPO here in CA is not complying with the requirements of the bill, we would certainly be interested in hearing more about that. Please let me know if you are aware of any instances."
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 [email protected].
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- 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.
- 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.
- 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. 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 [email protected] no later than November 13, 2015.
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- Democrat lawmakers say they are struggling to get Republican lawmakers on board to prevent a 52% spike in Medicare Part B premiums. Senate Democrats, led by Sen. Ron Wyden of Oregon, have introduced legislation that would freeze Medicare's Part B premium and deductible for 2016, but its prospects are uncertain. Unless Congress intervenes, Part B premiums will rise for 16.5 million people nationwide in 2016, according to AARP data. This accounts for only 30% of people with Part B coverage as most beneficiaries will be spared.
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- CMS has opened a preview period for the 2014 quality measures that will be reported on the Physician Compare website later this year. Physicians can access the preview site now through November 6 via the PQRS portal-Provider Quality Information Portal.
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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 [email protected] 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.
- ASCO convened a MACRA implementation meeting of leaders from ASCO's Clinical Practice Committee, Government Relations Committee, Quality of Care Committee, and State Affiliate Council to create a blueprint for the Society's involvement in the new law's implementation. MACRA replaces the sustainable growth rate formula for updates to the Medicare physician fee schedule and lays out far-reaching changes and an ambitious implementation schedule that will profoundly impact oncology practices.
- 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.
- CancerLinQ™ is a cutting-edge health IT platform that securely connects and powerfully analyzes real-world cancer care data from many data sources. Guided by ASCO's expertise and mission to support all cancer physicians-in every community and every setting-and powered by the SAP HANA platform, CancerLinQ equips oncologists with a vast network of information to improve the quality of patient care and maximize outcomes.
CancerLinQ will improve the care for all cancer patients and provide valuable tools to enhance practice efficiencies. We hope you can join this effort to empower oncologists everywhere to deliver high-quality care to their patients.
When your practice joins CancerLinQ, designated users will have access to view, query, and visualize:
* Data for individual patients they are treating
* Data specific to their practice
* Aggregated de-identified data on all patients from all CancerLinQ practices
Between now and June 1, 2016 if your practice signs a participation agreement you will receive the following additional benefits:
Waived connection fee (a $50,000 minimum value)
Waived user fees for 5 years
Opportunity for national recognition alongside your professional society (ASCO)
Open line of communication to help develop the next wave of CancerLinQ functionality
For more information and to set up an informational meeting, please contact :
Duane Heitkemper, BSc, CNMT, RT, (N)
Jeff Szykowny
External Relations Specialist
571-242-9499 (direct)
American Society of Clinical Oncology
2318 Mill Road, Suite 700, Alexandria, VA 22314
www.cancerlinq.org
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Industry News
- Janssen Biotech informs ANCO and MOASC that the United States Food and Drug Administration has approved Yondelis for the treatment of patients with unresectable or metastatic liposarcoma or leiomyosarcoma who received a prior anthracycline-containing regimen.
- In honor of Halloween, here are some ICD-10 codes pulled from some of Hollywood's scariest films.
Texas Chainsaw Massacre: W29.3XXA, Contact with chainsaw, initial encounter
Paranormal Activity: R44.0, Auditory hallucinations
The Shining: R44.1, Visual disturbances
American Psycho: W27.0XXA, Contact with workbench tool, initial encounter (In this case, an axe.)
An American Werewolf in London: L68.2, Localized hypertrichosis (a.k.a. werewolf syndrome)
The Blair Witch Project: Y92.828, Other wilderness area as the place of occurrence of the external cause
Carrie: F40.230, Fear of blood, and W55.49XA, Other contact with pig, initial encounter
Dracula: S11.83XA, Puncture wound without foreign body of other specified part of neck, initial encounter
Nightmare on Elm Street: F51.5, Nightmare disorder
Alien: V95.40XA, Unspecified spacecraft accident injuring occupant, initial encounter
Jaws: W56.41XA, Bitten by shark, initial encounter
The Exorcist: R46.0, Very low level of personal hygiene
Courtesy of WebPT.com
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MOASC CALENDAR
October 28th
November 18th
MOASC Administrator's Meeting
November 5th
ANCO
CALENDAR
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(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)
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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) 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 |
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