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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.
January 19, 2016
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- SB282 took effect on January 1, 2016 and requires health plans and health insurers to respond to prescription drug prior authorization requests within 72 hours for non-urgent requests and 24 hours for urgent requests. The law deems such requests to be granted if the payor fails to respond within these timeframes.
- Upcoming California Medical Association (CMA) webinars:
* CMA Federal Update: Federal Changes Impacting Physicians (January 20)
* CMS Priorities: Health System Transformation and the Medicare Access and CHIP Reauthorization Act (January 27)
Contact CMA's member help center at (800) 786-4262 or memberservice@cmanet.org.
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- The Noridian Provider Outreach and Education (POE) staff is hosting a Reopening Workshop on January 20 at 12 p.m. Pacific Time. Read the complete update.
* MLN Connects Provider eNews
Announcements--PQRS Web-Based Measure Search Tool
Publications--Hospice Payment System Fact Sheet-Revised; ICD-10 Post-Implementation: Coding Basics Revisited Video-Reminder
* Prompt Payment Interest Rate-January 2016 Update
* Clinical Laboratory Fee Schedule-Medicare Travel Allowance Fees for Collection of Specimens CR9485
* MolDx: Molecular Diagnostic Tests (MDT)-2016 CPT/HCPCS Coverage Article Revisions
* MolDx: CYP Gene Evidence Analysis
* MPFSDB-2016 Emergency Update CR9495
* Ask the Contractor Teleconference (January 20)
* Advance Beneficiary Notice of Noncoverage Workshop (ABN; January 21, 22)
* Remittance Advice (RA) Workshop (January 21, 22)
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- President Obama's fiscal year 2017 budget proposal, which is scheduled to be released Feb. 9, will call on Congress to extend the federal government's 100% funding share of Medicaid (Medi-Cal) expansion costs for the first three years of a state's expansion. The proposal aims to encourage more states to expand Medicaid under the Affordable Care Act.Obama's Budget Will Seek To Encourage More Medicaid Expansions
- A new research letter discusses a study that found states that expanded Medicaid (Medi-Cal) under the Affordable Care Act saw greater reductions in rates of uncompensated care than those that did not expand their programs. Meanwhile, a separate research letter details a study that found the ACA increased access to coverage for young adults.ACA Improved Access to Coverage, Reduced Uncompensated Care.
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- MOASC's first 2016 LunchTime Series presentation is scheduled for Wednesday, January 27th, 12:00pm Pacific Time. Elaine L. Towle, CMPE, Director, Analysis & Consulting Services, Clinical Affairs Department, American Society of Clinical Oncology, will present the changes in Medicare for 2016 and how to survive them. Please RSVP via phone 909-985-9061 ext. 1 or via email moasc@moasc.org.
- SAVE THE DATE! MOASC and University of California Irvine are proud to present the first "Spotlight on ASH." Speakers, who attended ASH in Orlando this week, will bring the premier topics and discussions to clinicians, Thursday, January 28, 2016, 5:30pm - 9pm, at the Fairmont Newport Beach. Please RSVP via phone 909-985-9061 ext. 1 or via email moasc@moasc.org.
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- ANCO's SABCS Highlights 2015 took 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) presented and reviewed the clinically most relevant results presented at December 2015's San Antonio Breast Cancer Symposium.
- 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. Early registration rates end January 31. For more information, visit http://cme.stanford.edu/multicancers.
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- USP Compounding Committee has announced its intention to publish the Proposed Handling Hazardous Drugs on February 1, 2016. The official implementation will not be until July 1, 2018. You can read about it on USP.org at:
- In his final State of the Union address Tuesday, President Obama tasked Vice President Joe Biden with leading a national effort to cure cancer. Biden outlined the project in a blog post, and said it would focus on increasing public and private funding and breaking down barriers between researchers to bring them together. Biden worked with Congress to increase funding to the National Institutes of Health by $2 billion, the largest funding increase since 2003. Two primary goals of this effort are to increase private and public resources to fight cancer and "break down silos and bring all the cancer fighters together."
- Obama's announcement comes as the HELP Committee is working to advance a medical innovations bill to match the 21st Century Cures Act, which passed the House over the summer.
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- CMS has announced the 2015 PQRS data submission timeframes:
EHR Direct or Data Submission Vendor (QRDA I or III) - 1/1/16 - 2/29/16
Qualified Clinical Data Registries (QCDRs) (QRDA III) - 1/1/16 - 2/29/16
Group Practice Reporting Option (GPRO) Web Interface - 1/18/16 - 3/11/16
Qualified Registries (Registry XML) - 1/1/16 - 3/31/16
QCDRs (QCDR XML) - 1/1/16 - 3/31/16
Submission ends at 5:00 p.m. Pacific Time (PT) on the end date listed. An Enterprise Identity Management (EIDM) account with the "Submitter Role" is required for these PQRS data submission methods. Please see the EIDM System Toolkit for additional information.
Please know that maintenance is currently scheduled for the following timeframes:
1/22/2016 at 5:00 p.m. PT - 1/25/2016 at 3:00 a.m. PT
2/26/2016 at 5:00 p.m. PT - 2/29/2016 at 3:00 a.m. PT
3/11/2016 at 5:00 p.m. PT - 3/14/2016 at 3:00 a.m. PT
3/16/2016 at 5:00 p.m. PT - 3/21/2016 at 3:00 a.m. PT
The Physician and Other Health Care Professionals Quality Reporting Portal (Portal) may be unavailable during these times.
- The U.S. Department of Health and Human Services announces the first meeting of the new Physician-Focused Payment Model Technical Advisory Committee on February 1, 2016. The Committee is required by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), and its members were appointed by the Comptroller General. On January 5, 2016, Secretary Burwell signed the Charter of the Committee. The Committee will review proposals for physician-focused payment models submitted by stakeholders based on criteria that the law requires the Secretary to establish through notice and comment rulemaking by November 1, 2016. Meeting information can be found by visiting the Federal Register Notice of Public Meeting.More information on the Committee can be found at https://aspe.hhs.gov/medicare-access-and-chip-reauthorization-act-2015.
- CMS has announced that it will cover screening for colorectal cancer using Cologuard at https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/MM9115.pdf.
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Affiliate Association News
- Capitol Hill Day 2016 will serve as the kick-off for the Association of Community Cancer Centers (ACCC) 42nd Annual Meeting, CANCERSCAPE, March 2-4, 2016, in Washington D.C., where the policy conversation will continue. Capitol Hill Day 2015 mobilized ACCC members from 23 states to advocate for a permanent fix to the sustainable growth rate (SGR), oral chemotherapy parity legislation, and elimination of the prompt pay discount. More than 80 congressional meetings helped to pass legislation and positively influence the future of community oncology. Capitol Hill Day 2016 is Wednesday, March 2. - Registration is open for the Community Oncology Alliance's (COA) 2016 Community Oncology Conference. The most comprehensive community oncology conference is back, bringing together clinicians, practice administrators, payers, and industry leaders for two days of learning and networking. April 14-15, 2016 at The Lowes Royal Pacific Resort, Orlando. - ASCO has released a new policy statement with recommendations to ensure that clinical pathways in oncology promote--and not hinder--the care of patients with cancer. Published in the Journal of Oncology Practice, the statement asserts that the way in which these treatment management tools in cancer care have proliferated raises significant concerns about patient access, care quality, and transparency in pathway development and implementation. For the complete statement, please visit http://jop.ascopubs.org > Featured Content or http://www.asco.org/advocacy/asco-calls-improvements-clinical-pathway-programs-oncology. - ASCO Journal of Oncology Practice (JOP) goes to monthly distribution with new and enhanced resources staring with its January 2016 edition.
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Industry News
- Bristol-Myers Squibb Oncology informs ANCO and MOASC that the United States Food and Drug Administration has approved Empliciti in combination with two other therapies for the treatment of multiple myeloma in treatment-experienced patients.
- Janssen Biotech informs ANCO and MOASC that the US FDA has approved Darzalex for the treatment of patients with multiple myeloma who have received at least three prior lines of therapy, including a proteasome inhibitor (PI) and an immunomodulatory agent, or who are double-refractory to a PI and an immunomodulatory agent.
- Sandoz Biopharmaceuticals informs ANCO and MOASC that several member offices have reported that claims for Zarxio have been denied due to an improper modifier. Claims for Zarxio (Q5101) should be submitted with modifier ZA-Novartis/Sandoz per CMS Transmittal 1542, Pub. 100-20, Change Request 9284 dated September 4, 2015.
- Eisai Inc. announced yesterday that the U.S. FDA has accepted for Priority Review the supplemental New Drug Application (sNDA) for lenvatinib for the potential treatment of patients with unresectable advanced or metastatic renal cell carcinoma (RCC) in combination with everolimus following one prior vascular endothelial growth factor (VEGF)-targeted therapy. The FDA had previously granted lenvatinib Breakthrough Therapy designation for this investigational indication. Breakthrough Therapy designation is reserved for drugs with preliminary clinical evidence that indicates the drug, alone or in combination, may demonstrate a substantial improvement over existing therapies for the treatment of a serious condition.For more information about LENVIMA, click here for the full Prescribing Information.
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MOASC CALENDAR
Spotlight on ASH
January 28th
LunchTime Series Teleconference/Webinar
April 27th June 29th August 31st October 26th Oncology Roundtable Teleconference March 2nd May 25th July 27th September 28th November 30th
ASH Highlights in
San Diego, CA
January 29th - 30th
NCCN in Florida
April 1st - 2nd General Membership Meeting April 29-30
ASCO National Meeting
in Chicago, II
June 3rd - June 6th ASCO State Affiliate
Meeting in Virginia, VAOctober 26th - 28th MOASC Billers Program November 30th
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(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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