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 24, 2015  
California News

- 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.
 
- 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.
 
- Physician profiles have been available to the public on the Medical Board of California's website at www.mbc.ca.gov/Consumers/ since 1997. CMA encourages physicians to check their profiles for accuracy and to advise the Board of any corrections, especially changes to their address of record. If you believe the information on your profile is incorrect, then contact the 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

- The California Medical Association (CMA) annual publication, New Health Laws, contains a list of the most significant health laws of interest to physicians for 2016. Go to www.cmanet.org/resource-library/detail?item=signficiant-new-california-laws-of-interest1
for more information.   

- CMA's Practice Resources (November) is now available online at features articles entitled Be Prepared for Covered California changes in 2016; Anthem Blue Cross providers can now update demographics electronically; Noridian/JEMAC conducting numerous prepayment reviews; United Healthcare to offer webinars to physicians participating in Core Network; Ask the expert: If an exchange patient is in the 90-day grace period and fails to pay the premium, is the plan required to pay for services provided?; Providers who refer, order or prescribe for Medi-Cal must enroll in DHCS; Blue Shield fee schedule changes took effect November1; and, The Coding Corner: Decision for treatment calls for separate E/M reporting.


 
Noridian News
 
- Noridian/JEMAC has posted the following updates on its website (http://med.noridianmedicare.com/web/jeb):
* MLN Connects Provider eNews
Announcements--EHR Incentive Programs Stage 3 Final Rule: Submit Comments by December 15
Claims, Prices, and Codes--ICD-10 Transition: Clarifications about NCDs and LCDs
* Immune Globulin Intravenous (IVIg) LCD-R4
* Laboratory NCD Edit Software Changes-January 2016-Revised CR9352
* 2016 Medicare Physician Fee Schedule Now Available
* New Waiver Tests CR9416
* Authoritative Sources Used in Determination of "Medically-Accepted Indication" of Drugs and Biologicals Used Off-label in Anti-Cancer Chemotherapeutic Regimen CR9386
* Screening for Lung Cancer with LDCT CR9246
* Transitional Care Management Workshop (December 8)
* Local and National Coverage Determination Workshop (December 9)
* Incentive Programs Workshop (December 10)
* Quarterly Provider Updates Workshop (December 15)
* Incident to, Non Physician Practitioners, Locum Tenens, and Reciprocal Billing Workshop (December 16)
* Screening Services Workshop (December 18)


 
DHCS/Medi-Cal News

- Cancer patients who are enrolled in California's Medicaid program have lower survival rates and are less likely to receive recommended treatments, compared with those who have other types of insurance, per a new study by researchers from UC-Davis' Institute for Population Health Improvement, Study: Cancer Outcomes Worse Among Medi-Cal Beneficiaries.


 
 MOASC News
 
- 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 
 
- 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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ANCO News
 
- ANCO's Medicare Reimbursement for Oncology 2016 and Beyond webcast with Roberta Buell, M.B.A., onPoint Oncology, will take place on January 6, 2016 at 12:30PM. Download the meeting announcement/registration form at www.anco-online.org/MedicareUpdate2016.pdf.
 
- ANCO's SABCS Highlights 2015 will take place on January 13, 2016 at The Claremont Resort in Oakland. Faculty from Stanford (Carol Marquez, MD), UC Davis (Helen K. Chew, MD), and UC San Francisco (Michael Alvarado, MD) will present and review the clinically most relevant results presented at December 2015's San Antonio Breast Cancer Symposium. Download the meeting announcement/registration form at www.anco-online.org/sabcshl2015.pdf.
 
- 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 encourages all members to complete its Anthem Cancer Quality Program (pathways) survey at www.surveymonkey/r/V92MLKK.
 
- ANCO is surveying practices to learn early lessons from the transition to ICD-10. Download and complete the survey at
- 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. 
 


National News
 
- The House Energy & Commerce Committee's Health Subcommittee held a hearing on November 17, 2015, to discuss a proposal by the Food and Drug Administration (FDA) that would broaden FDA authority on the regulation of laboratory developed tests (LDTs).
As part of the 21st Century Cures initiative, the Committee has heard from a wide range of interested parties about the important role diagnostic tests play in the advancement of precision medicine. Following a July 2014 roundtable on the topic, the FDA informed Congress of FDA's intent to issue draft guidance documents that would alter the regulatory landscape for the review and oversight of LDTs. The draft guidance has served as a catalyst for conversations about the "ideal" modern regulatory framework for these unique and evolving tests and services.
In December 2014, the Energy & Commerce Committee issued a white paper, asking for feedback on what roles the FDA and the Centers for Medicare and Medicaid Services (CMS) should play in the framework. This November 17th hearing was the first time that FDA and CMS testified together for a comprehensive understanding of their areas of expertise, their current responsibilities, and what their responsibilities should be moving forward.
Currently, CMS has authority from the Clinical Laboratory Improvement Amendments (CLIA) to inspect labs and lab equipment to ensure that tests are being completed properly. However, in this system, no pre-market evaluation is done to ensure the clinical validity of the tests themselves, which brings the FDA into the issue, as they claim to have better expertise than CMS in pre-market evaluations.
 
- Read ASH's comments to the Food and Drug Administration (FDA) on its proposed rule for the non proprietary naming of biologic products, specifically biosimilars. ASH's comments noted support for the FDA's decision to require biologics and biosimilars to have unique names that would include a suffix in order to minimize inadvertent substitution of products not determined to be interchangeable by the FDA, facilitate proper and safe use of these treatments, and enable better tracking of prescriptions and any adverse events associated with these products. ASH also encouraged the FDA to develop a policy that requires notification to the prescribing physician and patient prior to any substitution of any type of biosimilar, including those deemed "interchangeable."



CMS News 

- CMS is extending the 2014 Informal Review period. Individual eligible professionals (EPs), Comprehensive Primary Care (CPC) practice sites, PQRS group practices, and Accountable Care Organizations (ACOs) that believe they have been incorrectly assessed the 2016 PQRS negative payment adjustment now have until 8:59 p.m. Pacific Time on December 16, 2015 to submit an informal review requesting CMS investigate incentive eligibility and/or payment adjustment determination. This is an extension from the previous deadline of December 11, 2015.  All informal review requestors will be contacted via email of a final decision by CMS within 90 days of the original request for an informal review. All decisions will be final and there will be no further review. All informal review requests must be submitted electronically via the Quality Reporting Communication Support Page (CSP) which will be available September 9, 2015 through December 16, 2015 at 8:59 p.m. Pacific Time. 
Please note: Informal review will experience downtime December 3, 2015 through December 7, 2015. If you plan to file an informal review request, please do so outside of this window.
Please see 2014 Physician Quality Reporting System (PQRS): Incentive Eligibility & 2016 Negative Payment Adjustment - Informal Review Made Simple (available on the PQRS Analysis and Payment webpage) for more information.  For additional questions regarding the informal review process, contact the QualityNet Help Desk at 1-866-288-8912 (TTY 1-877-715-6222) or Qnetsupport@hcqis.org Monday-Friday from 7:00 a.m. to 7:00 p.m. Central Time. To avoid security violations, do not include personal identifying information, such as Social Security Number or Taxpayer Identification Number (TIN), in e-mail inquiries to the QualityNet Help Desk.
 
- Read ASH's analysis of the CY2016 Medicare Physician Fee Schedule at www.hematology.org/Advocacy/Policy-News/2015/4639.aspx; read Bobbi Buell's summary of the final rule at www.anco-online.org/BB-MedicareFinalRules.pdf; and, the California Medical Association (CMA) will host a webinar on December 2 entitled Medicare 2016: New Rules, Policies and Procedures. Go to http://www.cmanet.org/events/detail/?event=medicare-2016-new-rules-policies-and0 for more information.

- The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) introduced significant changes, on an ambitious timeline, to how Medicare will pay oncologists for the care they provide--and now is the time to understand and prepare for these changes. Besides repealing the Sustainable Growth Rate formula for reimbursement related to the Medicare Physician Fee Schedule, MACRA's goal is to move Medicare toward a value-based practice environment that ensures high-quality, affordable health care. ASCO has released a set of principles and detailed guidance to CMS as it implements the Merit-based Incentive Payment System (MIPS) and Alternative Payment Models (APMs) under MACRA at www.asco.org/advocacy/asco-releases-principles-developing-sustainable-medicare-payment-system-clinical-oncology. For an introduction to MACRA, read MACRA: Transforming Oncology Practice at www.asco.org/advocacy/asco-action-brief-macra; for ASCO MACRA resources, bookmark www.asco.org/macra.
 
- On Friday, CMS issued the proposed annual Notice of Benefit and Payment Parameters for 2017, governing participation in the Health Insurance Marketplaces. The proposed rule seeks comment on proposals that will provide continued choice and competition for consumers, and a vibrant and growing market for affordable, quality health plans.  The proposed rule seeks to improve the consumer experience, both when individuals shop for health insurance and when they use it. To protect consumer access to health care providers and delivery organizations, the proposal asks states to establish a provider network adequacy standard for health plans in the federal Marketplace. CMS is evaluating additional efforts to support transparency and informed consumer decision-making as it relates to provider network adequacy, and is requesting comment on whether designating network strength - for instance, indicating whether a plan has a broad number of doctors or health facilities in their network to choose from or not -- could improve the consumer experience in future years.  

The proposed rule was placed on display at the Federal Register today, and can be found at:

https://s3.amazonaws.com/public-inspection.federalregister.gov/2015-29884.pdf  and on 12/02/2015 available online at http://federalregister.gov/a/2015-29884
 


Affiliate Association News  
  
- The American Society of Clinical Oncology (ASCO) encourages its members to vote in its 2016 General Election. This year's ballot includes candidates for eight leadership positions, as well as a proposed amendment to the ASCO Bylaws.
Eligible ASCO members can vote now through December 3 at asco.org/election. The open positions for the 2016 ASCO Election are:
ASCO Board of Directors      
ASCO Nominating Committee 
President-Elect            Nominating Committee-Community Oncologist
Board of Directors-International Oncologist            Nominating Committee-Undesignated Specialty (2 seats)
Board of Directors-Pediatric Oncologist
Board of Directors-Undesignated Specialty (2 seats)
Detailed information on all candidates and the proposed Bylaws amendment is available at asco.org/election.
For questions related to the ASCO Election, please contact ascoelection@asco.org.
 
- 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.
 
- 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!  
 
- 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.
 
- 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.
 


Industry News
 
- Novartis informs MOASC and ANCO of their Patient Assistance Now Oncology (PANO) program. PANO helps patients access their medication. As part of the program, your patient will be assigned to a Patient Support Counselor who knows their story, owns their case, and follows up whenever necessary. Please go to Novartis's new reimbursement patient assistance at www.hcp.novartis.com.

- Johnson & Johnson Health Care Systems Inc. informs MOASC and ANCO that YONDELIS® (trabectedin) is indicated for the treatment of patients with unresectable or metastatic liposarcoma or leiomyosarcoma who received a prior anthracycline-containing regimen. Please see full Prescribing Information for YONDELIS®. 
 
- AMGEN informs ANCO and MOASC that the United State Food and Drug Administration has approved Imlygic for the local treatment of unresectable cuteness, subcutaneous, and nodal lesions in patients with metastatic melanoma recurrent after initial surgery.
 
- AstraZeneca informs ANCO and MOASC that the United States Food and Drug Administration has approved Tagrisso for the local treatment of patients with metastatic epidermal growth factor receptor (EGFR) T790M mutation-positive non-small cell lung cancer (NSCLC), as detected by an FDA-approved test, who have progressed on or after EGFR tyrosine kinase inhibitor therapy.
 
- Janssen Biotech informs ANCO and MOASC that the United States Food and Drug Administration has approved Darzalez for multiple myeloma patients who have received three or more prior lines of therapy, including a proteasomeinhibitor (PI) and an immunotherapy agent or who are double refractory to a PI and immunotherapy agent.
 
- Takeda Oncology informs MOASC and ANCO of FDA approval of the first oral proteasome inhibitor for multiple myeloma NINLARO® (ixazomib). NINLARO is indicated in combination with lenalidomide and dexamethasone for the treatment of patients with multiple myeloma who have received at least one prior therapy. NINLARO® (ixazomib) was recently approved by the U.S. Food and Drug Administration. Takeda Oncology has just launched a new comprehensive support program for NINLARO® (ixazomib) patients and their healthcare providers. NINLARO 1Point offers an array of access and coverage services. The NINLARO 1Point dedicated case management team can deliver personalized services that help patients and providers navigate coverage requirements for NINLARO, streamline product access, and connect to helpful resources. For more information on access, coverage, and available support and services, contact a NINLARO 1Point case manager at: 1-844-N1POINT (1-844-617-6468), Option 2, Monday-Friday, 8AM-8PM ET Or visit NINLARO 1Point at NINLARO-hcp.com/1Point.



 
In This Issue
California News
Noridian News
DHCS/Medi-Cal News
MOASC News
ANCO News
National News
CMS News
Affiliate Association News
Industry News
  1.  

 

 MOASC CALENDAR

 

LunchTime Series
December 9th 

 

 

 

 

 

 

 

 

 

 

ANCO  
CALENDAR

  

 

(January 7-9; San Francisco)

 

ANCO's SABCS Highlights 2015  

(January 13; Oakland) 

 

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