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.
 

December 1, 2015  

California News
 
- 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.
 
- 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 [email protected].
 
- Stanford Study Finds Barriers to End-of-Life Care Across Ethnicities . A study finds that Asian, black and white Californians over age 50 value end-of-life care. However, the majority say they have experienced barriers, such as financial issues and poor provider communication, to obtaining such care.
 
- The Department of Managed Health Care (DMHC) protects the health care rights of more than 25 million Californians and ensures a stable health care delivery system. The Department has helped more than 1.6 million Californians resolve health plan problems through the Help Center. Information and assistance is available at www.HealthHelp.ca.gov or by calling 1-888-466-2219. The next DMHC Financial Solvency Standards Board (FSSB) meeting will be held on December 9, 2015, 10 a.m. - 1 p.m., 980 9th Street, Conference Room, 2nd floor
Sacramento, CA 95814. Members of the public may participate in the meeting in person or by calling toll-free at 1-888-603-9632 and entering participant passcode: 6149438. For the agenda and more information please visit: http://www.dmhc.ca.gov/AbouttheDMHC/FinancialSolvencyStandardsBoard.aspx. Thank you for your continued interest in the Department of Managed Health Care.
 
- Below is the first editorial endorsement for the tobacco tax initiative that is slated to appear on the ballot next November. It's very uncommon for a paper to come out this far in advance of Election Day on an issue. They have taken a strong stance that advocates for greater access to care and reduced smoking. Please visit www.SaveLivesCalifornia.com to sign up for regular campaign updates and to follow the coalition on Facebook and Twitter.
                                                                                                                            
- The California Department of Industrial Relations (Cal/OSHA) has updated the California Safety and Health Protection on the Job posting. Previously, employers are required to notify the nearest Cal/OSHA office of any serious injury or fatality; however, "illness" has been added to the list. This update is a mandatory labor law posting requirement that affects your business. In order for your business to stay in compliance with this recent change, the updated posting must be downloaded, printed, and then posted next to your current labor law poster. IMPORTANT- Action needs to be taken immediately to update your labor law postings.The address for the Headquarters in Santa Ana, CA has been removed from the Cal/OSHA Consultation Services section. The revision date has also been updated.



Noridian News
 
- Noridian/JEMAC has posted the following updates on its website (http://med.noridianmedicare.com/web/jeb):
* MLN Connects Provider eNews
Announcements--2016 Value Modifier Informal Review Deadline Extended to December 16; 2016 PQRS Payment Adjustment: Informal Review Deadline Extended to December 16
Events--
Medicare Quality Reporting Programs: 2016 Physician Fee Schedule Call-Register Now  * Feedback Requested-Noridian Customer Satisfaction Survey
* 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)
* Preventive Services Workshop (December 18)



DHCS/Medi-Cal News

- A significant increase in the number of beneficiaries enrolled in California's Medicaid program since 2014 has added pressure to the 214 areas in the state with physician shortages. Such "doctor deserts," three-quarters of which are in rural areas, have one physician per 3,500 residents, compared with the statewide average of one doctor per 1,000 residents.


 
 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 time. 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 [email protected]. 
    
 
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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
 
- USP Compounding Committee has announced its intention to publish the Proposed Handling Hazardous Drugs as a 3-digit Chapter.  The official implementation will not be until July 1, 2018.  You can read about it on USP.org at:http://www.usp.org/frequently-asked-questions/hazardous-drugs-handling-healthcare-settings
 
- The GOP Doctors Caucus says it will work with House Speaker Paul Ryan to delay Stage 3 of the meaningful use program and grant a blanket hardship waiver for the 2015 Stage 2 reporting period through the legislative process. The caucus says doctors would benefit from the changes. GOP Lawmakers Ask House Speaker To Help Fix Meaningful Use
 
- The Senate will attempt to vote on a partial repeal of the Affordable Care Act this week through the reconciliation process. Senate Republican leaders shared the bill with colleagues last night, which includes provisions to roll back Obamacare subsidies and wind down the states' Medicaid expansion plans over the next two years.
 
- On November 19, 2015, the Senate Committee on Veterans' Affairs heard S 2170 (Ernst), a bill that would expand veterans' access to services if delivered via telemedicine.  S 2170would allow a Veteran Affairs (VA) provider and private providers contracting with the VA to treat veterans regardless of whether the provider or patient is in a federally owned facility.  Currently, while a VA physician needs only one state license to practice across state lines, both the provider and patient must be in a federally owned facility at the time of the visit. S 2170 would greatly expand a VA patient's access to services and would allow a patient to receive services delivered via telehealth in the home.  A similar bill was introduced earlier in the year by Representative Rangel (D-NY),HR 2516, however, that bill would have included any possession of the United States and the territories.  S 2170 would only apply to states. The bill has bipartisan support and Committee Chair Johnny Isakson (R-GA) stated his support of the bill.  To read more about it, download CCHP's analysis of the legislation.



CMS News 

- The CMS said it will reprocess ICD-10 claims with National Coverage Determination and Local Coverage Determination errors automatically and at no cost to providers. The agency also said that it is waiting to reprocess some claims with errors resulting from LCDs until Medicare Administrative Contractors have updated criteria needed to process the claims. Full Story:EHR Intelligence
 
- For a second time, the Centers for Medicare & Medicaid Services (CMS) has extended the deadline for eligible individuals and groups that believe they have been incorrectly identified for the 2016 Physician Quality Reporting System (PQRS) negative payment adjustment to submit an informal review request. read article. On October 30, 2015, CMS issued the final rule that updates the payment policies and payment rates for services furnished under the Medicare Physician Fee Schedule (MPFS) on or after January 1, 2016. The rule changes several of the quality reporting initiatives associated with MPFS payments, including the Physician Quality Reporting System (PQRS). Major highlights include: Individual eligible professionals (EPs) and group practices that meet the criteria for 2016 PQRS satisfactory reporting/participation will avoid the PQRS negative payment adjustment in 2018; PQRS group practices can participate in 2016 PQRS via the Qualified Clinical Data Registry mechanism in 2016; There are 281 measures in the PQRS measure set and 18 measures in the group practice reporting option (GPRO) Web Interface for 2016. Please note that the 2018 PQRS payment adjustment is the last adjustment that will be issued under the PQRS.  The final rule was published in the Federal Register on November 16, 2015. For more information about participating in PQRS in 2016, visit the CMS PQRS website

- With the publication of the 2016 Medicare Physician Fee Schedule, effective January 1, 2016, there has been a change in the rules regarding billing 'incident to' services to Medicare. There are many myths and confusions about 'incident to' billing. And 'incident to' billing has been the basis for false claims liability. The settlement in the summer of 2014 for $1.33 million by a private practice cardiology group for compensation within the group in 2007 and 2008 happened because in 2007, despite more than 40 years of permitting it, CMS published an about face that said diagnostic testing may never be billed incident to. We are aware of practices that permit physicians to be given credit for global billing, allocating the technical component revenues to the ordering physician or even the interpreting physician. Both are wrong and non-compliant. Read the full Note here
 
- CMS has approved ASCO's Quality Oncology Practice Initiative (QOPI) has a qualified clinical data registry, a pathway for oncologists to meet the agency's current quality reporting requirements.
 
- The passage of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) establishes two paths for physicians to choose for payment starting in 2019. ASH looks at what hematologists need to know about the pay-for-performance system called the Merit-Based Incentive Payment System (MIPS) at http://www.hematology.org/Advocacy/Policy-News/2015/4702.aspx. Read ACCC's comments to CMS's request for information on MACRA at http://accc-cancer.org/advocacy/pdf/2015-ACCC-Comments-to-MIPS-RFI.PDF. Go to www.asco.org/advocacy/asco-action-brief-macra for an introduction to MACRA from ASCO.



Affiliate Association News  
  
- On the heels of Black Friday and Cyber Monday, Giving Tuesday is a day dedicated to giving back. The National Coalition for Cancer Survivorship (NCCS) represents the millions of Americans who share a common experience - the survivorship experience - living with, through, and beyond a cancer diagnosis.   This #GivingTuesday, join NCCS in their quest to make cancer care better for survivors everywhere. Give to those around you. Make a gift to NCCS in honor or memory of a friend or loved one.  NCCS will send notification to let them know that you are thinking of them and their cancer journey this holiday season. Give a little bit of yourself.
Help NCCS get the word out over social media and be sure to use the hashtags #GivingTuesday and #canceradvocacy. Let the world know that you support improvements in cancer care. Take time today to join in the true spirit of the season and support #GivingTuesday. We extend our deepest gratitude for your generosity.
 
- ACCC's Oncology Reimbursement Update 2016, a detailed summary of the OPPS and MPFS rules for 2016, is now available at http://www.accc-cancer.org/oncology_issues/articles/JF16/JF16-Oncology-Coding-Reimbursement-Update.pdf.
 
- 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 [email protected].
 
- 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 ([email protected]) 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
   
- Lilly Oncology informs ANCO and MOASC that the United States Food and Drug Administration has approved Portrazaa in combination with two forms of chemotherapy to treat patients with advanced (metastatic) squamous non-small cell lung cancer (NSCLC) who have not previously received medication specifically for treating their advanced lung cancer.

 

- Novartis Oncology informs ANCO and MOASC that the United States Food and Drug Administration has approved the combination of Tafinlar + Mekinist for the treatment of patients with BRAF V600E/K mutation-positive unresectable or metastatic melanoma as detected by an FDA-approved test.

 

- Bristol-Myers Squibb Oncology informs ANCO and MOASC that the United States Food and Drug Administration has approved Opdivo to treat patients with advanced (metastatic) renal cell carcinoma, a form of kidney cancer, who have received a certain type of prior therapy. In addition, Opdivo has been approved for the treatment of patients with BRAF V600 wild-type unresectable or metastatic melanoma.  Bristol-Myers Squibb Oncology announced, yesterday, that the U.S. Food and Drug Administration (FDA) has approved Empliciti (elotuzumab) for the treatment of multiple myeloma as combination therapy with Revlimid� (lenalidomide) and dexamethasone (ERd) in patients who have received one to three prior therapies. The approval of this first and only immunostimulatory antibody for multiple myeloma is based on data from the randomized, open label, Phase 3, ELOQUENT-2 study, which demonstrated that the ERd regimen resulted in a 30% reduction in the risk of disease progression or death compared to Rd alone (HR 0.70 [95% CI: 0.57, 0.85; p = 0.0004]).

NCCN is collaborating with Bristol-Myers Squibb to promote the advancement of scientific knowledge concerning programmed death-ligand 1 (PD-L1) protein expression and other immune markers in lung cancer. more >

 

 

 

  

In This Issue
  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