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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.
November 3, 2015
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- The open enrollment period for the third year of Covered California, California's health benefit exchange, began 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.The California Chronic Care Coalition (CCCC) is on a mission to inform patients in California about their rights as health care consumers and we need your help! Daily, patients navigate obstacles obtaining the care they need, such as: Scheduling appointments with specialists Accessing life-saving medicines Attaining tests and examinations MyPatientRights.org, is an online resource to help patients identify when, why and how to file a complaint with their health plan and/or the California Department of Managed Health Care (DMHC) to demand the care they need and deserve. The mypatientrights.org Partner Toolkit provides all the resources you need to educate your patient network about their patient rights. The information is free and easy to access. Website badge- promote on your website and encourage your networks to do the same Please contact Beth Hadley at hadleybeth22@gmail.com or 916-690-0757 for more information or to discuss ways to work together to provide these resources to your patients. - 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 mallen@micra.org. 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.
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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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- DHCS is conducting biweekly external stakeholder meetings, with no reported high severity ICD-10 billing issues from the provider community. DHCS will rapidly investigate and mitigate any issues that are identified, demonstrating the department's commitment to the transition to ICD-10 and delivering quality health care to Medi-Cal beneficiaries. DHCS reports to CMS daily, weekly, and monthly post implementation claims processing metrics. DHCS has not experienced a major increase in rejected claims, suspended claims, claims processing time, or provider calls in the first three weeks of processing ICD-10 claims. DHCS will continue to monitor these metrics and communicate with CMS through the end of March 2016, or longer if needed, to ensure continued success. In addition to California reporting no major issues with ICD-10 implementation, CMS has indicated that no other states have reported significant problems with the implementation of ICD-10. - DHCS contracts with Health Services Advisory Group to evaluate the care provided to members by Medi-Cal managed care health plans in the areas of quality, access, and timeliness. The results of these external quality review activities are presented in various quarterly and annual reports. These reports assess health plan results in required quality improvement and performance measurement activities and help both DHCS and the health plans understand where resources should be focused to further strengthen the quality of care provided. Updated reports that reflect services provided during 2013 are now available on the DHCS website. - There is a Provider Enrollment Division (PED) Conference Call with Drug Medi-Cal (DMC) Providers and Stakeholders on November 9. DHCS' PED will hold the next regularly scheduled conference call with DMC providers and stakeholders to continue PED's communication efforts related to DMC provider certification. PED reserves the second Monday of every month to provide updates on the continued certification process, upcoming events, and general guidance. Providers and stakeholders are encouraged to ask questions about the DMC application process/requirements. For conference call information, provider bulletins, and frequently asked questions, please visit the DHCS website.
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- 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 moasc@moasc.org.
- 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!
Board Job:
- Immediate full time position available for a Medical Assistant/Front Office Administrator in busy Oncology/Hematology practice. Must have a minimum of 2 years of experience. Oncology experience is a plus!
Duties include:
Use computer applications to include EMR; Answer telephones; Greet patients; Update & file patient medical records; Schedule appointments; Handle correspondence; Greet & bring patient to the exam room & maintain efficient patient flow; Take vital signs and enter them immediately into the EMR & on the flowsheet; Review current medications and document them; Take medical histories, i.e. allergies, report to MD/RN any acute complaints; Prepare patients for examinations; Assist physician during exams; Collect & prepare laboratory specimens (i.e. bone marrow slides, packaging specimen for reference lab pick up/drop off, storage of tubes); Perform basic laboratory tests; Draw blood; EKGs; Assist RN in preparing flushes, priming saline bags
Stock exam rooms & assist with inventory control; Maintain cleanliness of exam rooms and infusion room; Assist MD/PA in admin duties upon request; Input lab values on EMR & flow sheet; Reconcile pharmacy claims; Assist Pharmacy Tech.
Please email resume with salary requirements. No phone calls please.
Joanne Ferri, Practice Administrator
Compassionate Oncology Medical Group
Robert L. Leibowitz, MD
Shahrooz Eshaghian, MD
2080 Century Park E, Suite 1005
Los Angeles, CA 90067
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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 execdir@anco-online.org no later than November 13, 2015.
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- Congress included a fix to the disparity in Medicare payments to hospital outpatient departments and physician offices in their bipartisan budget deal. The site-neutral payment fix will result in lower costs for seniors, especially with cancer, the Medicare program, and taxpayers. Starting in 2017, Medicare will pay identical rates for critical cancer care services, such as the administration of chemotherapy, whether provided in physician-directed community cancer clinics or hospital outpatient departments. On Monday, November 2, the President signed the bill into law. You can read more here for a summary of the site neutrality provision and possible implications for the 340B program.
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- The Obama administration has issued a final rule that will allow physicians to bill Medicare for discussions they have with patients about end-of-life care. CMS said the rule, which takes effect next year, is "consistent with recommendations from a wide range of stakeholders and bipartisan members of Congress."
- 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.
- The Centers for Medicare & Medicaid Services (CMS), on October 30, 2015, issued a final rule updating payment policies, payment rates, and quality provisions for services furnished under the Medicare Physician Fee Schedule (PFS) on or after January 1, 2016. This major final rule with comment period addresses changes to the physician fee schedule, and other Medicare Part B payment policies to ensure that our payment systems are updated to reflect changes in medical practice and the relative value of services, as well as changes in the statute. CMS finalized a number of new policies, including several that are a result of recently enacted legislation. The rule also finalizes changes to several of the quality reporting initiatives that are associated with PFS payments, including the Physician Quality Reporting System (PQRS), the Physician Value-Based Payment Modifier (Value Modifier), and the Medicare Electronic Health Record (EHR) Incentive Program, as well as changes to the Physician Compare website on www.Medicare.gov. Click Here to download a copy or Click Here for the CMS News for a summary Fact Sheet.
- Also released by CMS on Friday, October 30, 2015, are updates to the Two-Midnight rule regarding when inpatient admissions are appropriate for payment under Medicare Part A. These changes continue CMS' long-standing emphasis on the importance of a physician's medical judgment in meeting the needs of Medicare beneficiaries. These updates were included in the calendar year (CY) 2016 Hospital Outpatient Prospective Payment System (OPPS) final rule. Click Here for more information.The CY 2016 OPPS/ASC final rule updates Medicare payment policies and rates for hospital outpatient departments (HOPDs), ASCs, and refinements to programs that encourage high-quality care in various outpatient settings.
- Alternatives are available for submitting International Classification of Diseases, 10th Edition (ICD-10) claims on and after October 1, 2015. If you are unable to complete the required systems changes or have issues with your billing software, vendor or clearinghouse, the following options are available for submitting ICD-10 compliant claims:
*Free billing software; *Provider Internet portals; *Direct Data Entry (DDE); and
*Paper claims.
For more information, review MLN MattersŪ Special Edition Article #SE1522 Click Here.
- CMS has published information to answer "What qualifier do I use for ICD-10 diagnosis codes on electronic claims?"
Answer:
* For X12 837P 5010A1 claims, the HI01-1 field for the Code List Qualifier Code must contain the code "ABK" to indicate the principal ICD-10 diagnosis code being sent. When sending more than one diagnosis code, use the qualifier code "ABF" for the Code List Qualifier Code to indicate up to 11 additional ICD-10 diagnosis codes that are sent.
* For X12 837I 5010A1 claims, the HI01-1 field for the Principal Diagnosis Code List Qualifier Code must contain the code "ABK" to indicate the principal ICD-10 diagnosis code being sent. When sending more than one diagnosis code, use the qualifier code "ABF" for each Other Diagnosis Code to indicate up to 24 additional ICD-10 diagnosis codes that are sent.
* For NCPDP D.0 claims, in the 492.WE field for the Diagnosis Code Qualifier, use the code "02" to indicate an ICD-10 diagnosis code is being sent.
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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 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.
- 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.
- 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.
- 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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MOASC CALENDAR
November 18th
MOASC Administrator's Meeting
November 5th
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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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