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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 17, 2015
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- ANCO and MOASC respectfully request feedback from their membership, regarding experiences with Anthem Pathways. Please click on the link and respond as soon as practical, at https://www.surveymonkey.com/r/V92MLKK. Thank you.
- The Medical Board of California is asking physicians who need to renew their medical licenses in the next few months to do so early to avoid delays associated with scheduled upgrades to the BreEZe online licensing system. Licenses expire on the last day of the licensee's birth month during the second year of a two-year term. Renewal notices are sent out 90 days in advance of the expiration date. Individuals hold a professional license with December 2015 or January 2016 expiration dates who wish to renew their licenses are strong encouraged to renew as early as possible, preferably before the end of November 2015.
- Physician profiles have been available to the public on the Medical Board of California's website since 1997, as required by Business and Professions Code sections 2027 and 803.1. The California Medical Association encourages physicians to periodically check their profiles for accuracy and to advise the board of any corrections, especially changes to their addresses of record. Making sure your information is accurate is important. Patients use the website to confirm their physician's information. The medical board has launched a new public information campaign further encouraging patients visit the board's website to verify their physician's license status. The board also cautions physicians against using their home addresses as their address of record, because the addresses become widely available to the public on the Internet. You may designate a post office box as your address of record but, by law, you also must provide the medical board with a street address. If you designate a P.O. Box as your official address, the medical board will not make public your street address. If you believe the information on your profile is incorrect, please contact the medical board at webmaster@mbc.ca.gov or (800) 633-2322.
- 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.
- Please see the below announcement regarding California Colorectal Cancer Coalition's (C4) Mini-Grant Request for Application (RFA) for 2016. The deadline is quickly approaching (December 1). If your organization is planning on submitting a grant application, please be aware that there are currently three FIT contract options that you should consider when developing your budgets. Please visit C4's website (www.cacoloncancer.org) for additional details on how to access this information. Please contact Margaret Hitchcock with C4 if you are interested in responding this RFA, or if you would like more information. 530-400-8159 hitchcock.margaret2@gmail.com
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* MLN Connects Provider eNews
Calls and Events--Clinical Diagnostic Laboratory Test Payment System Proposed Rule Call-Last Chance to Register; Medicare Quality Reporting Programs: 2016 Physician Fee Schedule Call-Register Now
Announcements--Physician Fee Schedule: Policy and Payment Changes for CY2016; Hospital Outpatient and ASC: Policy and Payment Changes for CY2016; 2016 Value Modifier: Informal Review Deadline Extended to November 23; 2016 PQRS Payment Adjustment: Informal Review Deadline Extended to November 23; New FAQs on Participation in EHR Incentive Programs; CMS Seeking Comment on MACRA Episode Groups by February 15
Claims, Pricers, and Codes--Colorectal Cancer Screening Claims Processing Issue
Products--Medicare FFS Claims Processing Guidance for Implementing ICD-10-Revised
* Prolonged Service in the Office or Other Outpatient Setting, 99354 Widespread Service Specific Probe Review Notification
* Positron Emission Tomography Scans Coverage-R1
* Medicare Participating Physician Directory Information
* Payment Reduction for CT Diagnostic Imaging Services CR9250
* 2016 MPFS Available Soon
* CCI and MUE Workshop (November 20)
* Incentive Programs Workshop (December 10)
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- According to a study by UC Davis researchers, DHCS/Medi-Cal beneficiaries diagnosed with cancer are less likely to receive recommended treatment and have lower survival rates, compared with those with other types of insurance. Read the Institute for Population Health Improvement report at https://www.ucdmc.ucdavis.edu/iphi/. - On November 3, the California Department of Managed Health Care (DMHC) announced it had fined two of the state's largest health plans for inaccurate Covered California provider directories. Blue Shield of California was fined $350,000, while Anthem Blue Cross was fined $250,000. These two insurers account for almost 60 percent of patient enrollment in Covered California. Both insurers are also utilizing networks for their exchange/mirror products that are significantly narrower than their regular PPO networks. These narrowed networks, combined with inaccurate provider directories, have led to significant confusion and frustration for both physicians and patients.
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- Please join MOASC's LunchTime Series presentation of, "From Private Practice to Hospital-Based: Assessing Your Position," on Wednesday, December 9th at 12:00pm, Pacific. Walter E. Birch, Director, Practice Management and Resources, ASCO Clinical Affairs Department, will discuss pros and cons of the physician: institution relationship, compensation, operation, decision making and the future.Please RSVP to the MOASC Office at moasc@moasc.org.
- If you missed MOASC's last meeting of the year, some of the handouts are available from the key experts & industry stakeholders on how oncology is faring and what you need to know to move into 2016. If you would like copies of the handouts, 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. Applicant 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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- Download the presentations from ANCO's 4Q2015 Hematological Malignancies Update at www.anco-online.org.
- Download the presentations from ANCO's Molecular Diagnostics & Clinical Decision Making meeting at www.anco-online.org.
- 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.
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- November is Lung Cancer Awareness Month. Please see the announcements below to find resources and tools to raise awareness about lung cancer in your community.
Free Materials and Resources for Tobacco Cessation
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- As the Social Security Administration previously announced, there will no Social Security cost of living increase for 2016. As a result, by law, most people with Medicare Part B will be "held harmless" from any increase in premiums in 2016 and will pay the same monthly premium as last year, which is $104.90. Beneficiaries not subject to the "hold harmless" provision will pay $121.80, as calculated reflecting the provisions of the Bipartisan Budget Act signed into law by President Obama last week. Medicare Part B beneficiaries not subject to the "hold-harmless" provision are those not collecting Social Security benefits, those who will enroll in Part B for the first time in 2016, dual eligible beneficiaries who have their premiums paid by Medicaid, and beneficiaries who pay an additional income-related premium. CMS also announced that the annual deductible for all Part B beneficiaries will be $166.00 in 2016. Premiums for Medicare Advantage and Medicare Prescription Drug plans already finalized are unaffected by this announcement. The Medicare Part A annual deductible that beneficiaries pay when admitted to the hospital will be $1,288.00 in 2016, a small increase from $1,260.00 in 2015. CLICK HERE FOR MORE DETAILS REGARDING 2016 FROM THE FEDERAL REGISTER OR COPY THIS LINK IN YOUR BROWSER: https://s3.amazonaws.com/public-inspection.federalregister.gov/2015-29181.pdf
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Affiliate Association News
- ASCO encourages members to donate to the 2016 Clinical Practice Committee/State Affiliate Council Young Investigator Award in the month of November to take advantage of the 2:1 match! Every dollar donated in the month of November will be matched by Conquer Cancer Foundation (CCF) Board member Raj Mantena, RPH. Support the tradition of sponsoring a young investigator. Please donate today!
- 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.
- ANCO and MOASC encourage all members to vote in the 2016 ASCO Election at www.asco.org/election. Voting is now open through December 3.
- 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.
- If you are working in a practice or cancer clinic or hospital outpatient department, you are invited to onPoint Oncology's 2016 MEDICARE UPDATE WEBINAR(S) on December 10 and 11, 2015 at 9:00am Pacific time. All you have to do to register is fill out a 20-question survey. On the last page, there will be a link to the invitation! Thank you in advance for your participation!!! Again the link is right here.
- 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. ASCO is actively recruiting oncologists in the early phase of their careers who have 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.
- 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.
For more information and to set up an informational meeting, please contact:
Duane Heitkemper, BSc, CNMT, RT, (N)
External Relations Specialist
571.344.9499 (direct)
Jeff Szykowny
External Relations Specialist
571-242-9499 (direct)
American Society of Clinical Oncology
2318 Mill Road, Suite 700, Alexandria, VA 22314
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- Genentech BioOncologyinforms ANCO and MOASC that the United States Food and Drug Administration has approved Cotellic to be used in combination with Vemurafenib to treat advanced melanoma that has spread to other parts of the body or cannot be removed by surgery, and that has a certain type of abnormal gene (BRAF V600E or V600K mutation).
- Pfizer has made a major change to the patient assistance program, Pfizer Rx Pathways. Pfizer has doubled the allowable income levels for patients to receive Pfizer medications at no cost. In response to the ongoing challenges patients face in paying their out-of-pocket costs for their prescription medicines, Pfizer announced last week that it will immediately double the allowable income level for its patient assistance program, so that even more patients in need could be eligible to receive their Pfizer medicines for free. With this change, more than 40 medicines offered for free through the program will now be available to eligible patients earning up to 4 times the Federal Poverty Level (FPL) adjusted for family size. Through its Pfizer Rx Pathways program, Pfizer offers patients, including those with health insurance and those without, a range of individual services to help them gain access to Pfizer medicines. In the last five years alone (2010-2014), Pfizer has helped nearly 2.5 million uninsured and underinsured patients get access to more than 30 million Pfizer prescriptions, making it the most comprehensive program of its kind.
Pfizer has been helping patients gain access to the Pfizer medicines they need for more than 25 years. Through Pfizer Rx Pathways, Pfizer can also help connect patients to other assistance services the company offers if they are not eligible to receive their medicines for free.
Patients, health care providers and patient advocates can visit www.PfizerRxPathways.com to learn more about Pfizer's programs, including eligibility criteria and how to apply, and to download applications or program brochures. Pfizer Rx Pathways is a joint program of Pfizer Inc. and the Pfizer Patient Assistance Foundation™.
If you have any questions please contact Keith Borgschatz, Alliance Development Manager
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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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