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.
 
 
June 28, 2016
California News
 
- California is among about a dozen states considering proposals this year to impose greater price transparency on drug companies. The measures in many states have gone farther than California's bill, SB 1010 (Hernandez), requiring manufacturers to report their research and development costs, not just the prices and the reasons for them. Vermont, for example, just passed a law requiring justification of price increases for drugs that have a significant impact on the state budget. SB1010, in its current version, can potentially impact patients and providers -the required notification of price increases could potentially cause medication shortages as wholesalers buy up prior to the price increase. Here is a link to a site with more information on SB1010.  https://protectaccessandinnovation.org/. The bill was pulled from Assembly Health committee last week and is expected to be heard today, Tuesday, June 28. 

 
 
Noridian News

- Noridian/JEMAC has posted the following updates to its website (http://med.noridianmedicare.com/web/jeb):
* MLN Connects Provider eNews
Announcements--EHR Incentive Program: Hardship Exception Applications Due July 1; CMS to Release CBR on Immunohistochemistry and Special Stains in July; Track and ImproveYour ICD-10 Progress; Medicare Will Use Private Payor Prices to Set Payment Rates for Clinical Diagnostic Laboratory Tests Staring in 2018; HHS Announces Major Initiative to Help Small Practices Prepare for the Quality Payment Program2016 PQRS GPRO Registration Open through June 30; Quality Payment Program: What's Available Online
Claims, Prices & Codes--Chronic Care Management Payment Correction for RHCs and FQHCs
Events--Quality Measures and the IMPACT Act Call-July 7; SNF Quality Reporting Program Call-July 12; Clinical Diagnostic Laboratory Test Payment System Final Rule Call-July 6
Publications--Reading a Professional Remittance Advice Booklet-Reminder
* Coding Revisions to NCDs-Revised CR9631
* New Enrollment on Demand Application Tutorials (http://med.noridianmedicare.com/web/jeb/enrollment/revalidation)
* MLN Connects eNews-June 9, 2016
* JW Modifier: Drug Amount Discarded/Not Administered to any Patient-Second Revision CR9603
* Avoiding Denials on Priced Per Invoice Claims: Additional Codes-Effective August 15, 2016
* Clinical Diagnostic Laboratory Test Payment System Final Rule Call-Registration Now Open
 
- Forthcoming Noridian/JEMAC workshops include:
* Reopenings Workshop (June 29)
* Recoupment Workshop (June 30)
* Medicare Secondary Payer Workshop (July 6)
* Medicare Secondary Payer Calculation Workshop (July 7)
* NCCI and MUEs Workshop (July 12)
* Telehealth Services Workshop (July 14)
* Part B Ask the Contractor Teleconference (July 20)
Go to https://med.noridianmedicare.com/web/jeb/education for more information and to register.



DHCS/Medi-Cal News


- The California Health Care Foundation (CHCF) recently released a report, "Moving Medi-Cal Forward on the Path to Delivery System Transformation."  With the 50th anniversary of the Medicaid program happening this year, CHCF contracted with the folks at Manatt Health to explore California's Medi-Cal program and the best path forward.  You can access the full report here. Their focus was primarily on the state's Medi-Cal managed care system.   It includes an overview of how Medi-Cal operates, is financed, and performs, as well as some insight into individuals who use the program.  You can download the landscape detail here.
 
- Last week, the Centers for Medicare & Medicaid Services (CMS) issued a notice of proposed rulemaking outlining proposed changes to the Payment Error Rate Measurement (PERM) and Medicaid Eligibility Quality Control (MEQC) programs to implement provisions in the Affordable Care Act's changes to the way states adjudicate eligibility for Medicaid and the Children's Health Insurance Program (CHIP). The proposed rule addresses the new eligibility provisions of the Affordable Care Act and makes other general improvements to the PERM and MEQC programs. The proposed rule also includes policies that, if implemented, would reduce state burden and increase the focus on the continuous reduction of improper payment rates. Comments on this proposed rule are due by August 22, 2016.



 MOASC News

- MOASC & University of California Irvine Division of Hematology Oncology cordially invite you to the 2nd Annual Spotlight on ASCO, Saturday, July 16th, 2016, 7:30am to 1:00pm, at the Hyatt Regency Huntington Beach. Speakers include: John Fruehauf, MD, PhD, on Melanoma; Sai Hong Ignatius Ou, MD, PhD, on Lung; Jason Zell, DO, MPH on GI; Samuel Klempner, MD on GI (non-colorectal abstracts), and  Chaitali S. Nangia , MD on Breast (ASCO abstracts). To register, e-mail: [email protected] or contact the MOASC Office at 800-310-3553 x1. Reduced room rates are available for this event. RSVP before no rooms are available, as it is summer!

 

- MOASC Member, Cedars-Sinai, Samuel Oschin Comprehensive Cancer Institute, is currently recruiting for Pancreatic Cancer Clinical Trials for locally advanced/borderline resectable and metastatic. Please contact the MOASC Office for more information [email protected].

 

- Support the association that works for you by renewing your MOASC membership today.
There are two ways you can join:

To pay by check:

Make check payable to:

Medical Oncology Association of Southern California

Mail to:

P.O. Box 161, Upland, CA 91785

To pay by credit card:

Fill out the enclosed Membership Application.

You can go to www.moasc.org and pay online via PayPal.

If you have any questions, please do not hesitate to contact the MOASC Office at [email protected] or 909-985-9061 ext. 1.

 

- MOASC and ANCO have partnered with SullivanLuallin Group to offer your practice the opportunity to participate in an Oncology-based Patient Satisfaction Survey. The Survey is designed to assess your organization's performance in key areas associated with the ACO, PQRS and CAPHS Surveys. SullivanLuallin Group's eSurv: Online Patient Satisfaction Survey platform allows you to efficiently and cost-effectively capture how your patients feel about your systems, services, and performance. Download more information and an enrollment form at www.anco-online.org/PtSurvey2016.pdf.

 

- In 2016, MOASC has joined ANCO in conducting a 2016 Staff Salary Survey. The purpose of the staff salary survey is to update data relevant to practice expenses in California. This year's survey questionnaire and past survey results can be found at www.anco-online.org/salsrvy.html. The survey was adopted from The Health Care Group and updated by studying other salary surveys. Please complete the survey and return it to the MOASC office at your earliest convenience but no later than September 30, 2016. Respondents will be provided with a $50 Visa gift card. Please contact MOASC if you have any questions at [email protected]

 

JOB BOARD:

- Busy Oncology office in Orange, CA has immediate opening for F/T Oncology Chemo certified RN. Must have excellent IV skills; Exceptional communication and organizational skills are a must.  We offer competitive salary and great benefits. Email resume to Administrator at [email protected]

 

- Board certified medical oncologist with over 26 years of clinical experience including industry and network trial, is relocating to California. I f your practice has an opportunity for a high experienced and nationally respected hematologist-oncologist, please contact the MOASC office [email protected] for more information.

 
 
Like us on Facebook  Follow us on Twitter   View our profile on LinkedIn



ANCO News
 
- ANCO is pleased to announce that it will host it 2016 Professional Education Meeting on August 3 at The Claremont Resort in Oakland. The meeting will feature sessions on MACRA, Managing Oncology within Medicare, California's End of Life Option Act, and An ANCO Atlas. The meeting was announced in early June; download the meeting announcement and registration form at www.anco-online.org/ProfEduc2016.pdf.

- ANCO and MOASC have partnered with SullivanLuallin Group to offer your practice the opportunity to participate in an Oncology-based Patient Satisfaction Survey. The Survey is designed to assess your organization's performance in key areas associated with the ACO and PQRS CAPHS Surveys. SullivanLuallin Group's eSurv: Online Patient Satisfaction Survey platform allows you to efficiently and cost-effectively capture how your patients feel about your systems, services, and performance. Download more information and an enrollment form at www.anco-online.org/PtSurvey2016.pdf.

- ANCO and MOASC have partnered to conduct a 2016 Staff Salary Survey. The purpose of the Staff Salary Survey is to update data relevant to practice expenses in California. Past ANCO Staff Salary Survey results are reported at www.anco-online.org/salsrvy.html. The 2016 Staff Salary Survey was distributed to members the week of May 16 and is available online at www.anco-online.org/SalarySurvey2016.pdf. Completed Surveys are due no later than September 30 and respondents will be provided with a $50 Visa gift card. Results will be analyzed and reported during 4Q2016.



National News  
 
- A report released Thursday by the Bipartisan Policy Center says that the U.S. should modernize how new drugs are brought to market. "Modernizing the drug discovery, development, and approval of new cures and treatments plays a critical role in addressing this issue and should be a key priority for the United States. It takes too long and costs too much to bring treatments and cures to patients in need...The most reliable studies suggest that on the average it costs approximately $2 billion and takes more than a decade for a new drug to reach the market." Much of this relies on the ability of top Senators on the Health, Education, Labor and Pensions Committee to reach an agreement on funding to accompany several bills related to medical innovation. Negotiations are also ongoing around drug and device user fee legislation that is scheduled to come up next year. The BPC report recommends that, among other things, the Food and Drug Administration develop a formal guidance regarding how to use real-world evidence in decision making about drug approvals. Additionally, the agency should establish a program to promote sharing and evaluating methods used in the evaluation of real-world evidence for regulatory decision-making and require researchers who use federal funding to draw real-world conclusions to publish their methods for peer review. (The Morning Consult Mary Ellen McIntire | June 23, 2016)
 
- A bill, that would reduce the amount of time that a pharmaceutical company has exclusivity rights over a biologic from 12 years to seven, was introduced last week by Rep. Jan Schakowsky (D-Ill.) and Sens. Sherrod Brown (D-Ohio) and John McCain (R-Ariz.). Known as the PRICED Act, they say the change would allow for more versions of the drugs to enter the market faster, which would in turn drive down prices. Per Senator Schakowsky, "The PRICED Act will allow for more robust competition in the biologics market and provide for more new, equally effective biosimilars which will help provide more options for consumers and drive down prices."
 
- The American Telemedicine Association expects the number of U.S. patients to receive some sort of remote medical care to grow by 30 percent from 15 million next year. Though telemedicine is growing rapidly, providers still face multiple challenges, such as how to charge insurers for the care.



CMS News

- UPDATE: Starting January 1, 2017 (postponed from July 1, 2016), CMS will require MACs to enforce the following rules for modifier -JW:
* Modifier JW is required to identify unused drugs or biological from single use vials or single use packages that are appropriately discarded.
* The only exception to this requirement is when the J-code unit is larger than the drug plus the waste.
* Documentation in the record must reflect the drug given PLUS the amount of drug wasted.
* Every effort must be made to use drugs "in such a way that they can use drugs or biological most efficiently, in a clinically appropriate manner."
* This guidance does not apply to multi-dose vials
Starting July 1 (implementation on July 5), -JW will be mandatory for all Medicare intermediaries and will be used as follows from the transmittal:
 
- The Physician Value - PQRS (PV-PQRS) Registration System is now open through June 30! Groups of two or more eligible professionals (EPs) can avoid the -2.0% CY 2018 Physician Quality Reporting System (PQRS) payment adjustment by meeting the satisfactory reporting criteria through the 2016 PQRS Group Reporting Option (GPRO).
For groups to select a GPRO reporting mechanism:
* Qualified PQRS Registry
* Electronic Reporting using Certified Electronic Health Record Technology (CEHRT)
* Web Interface (for groups with 25 or more EPs only)
* Qualified Clinical Data Registry (QCDR)
* Consumer Assessment of Health Providers and Systems (CAHPS) for PQRS Survey via a CMS-certified Survey Vendor (in addition to another GPRO reporting mechanism).
Avoiding the CY 2018 PQRS payment adjustment by satisfactorily reporting via PQRS GPRO is one of the ways groups can avoid the automatic downward payment adjustment under the Value Modifier (-2.0% or -4.0% depending on the size and composition of the group) and qualify for adjustments based on performance in CY 2018. Alternatively, groups that choose not to report via the PQRS GPRO in 2016 must ensure that the EPs in the group participate in the PQRS as individuals in 2016 and at least 50 percent of the EPs meet the criteria to avoid the CY 2018 PQRS payment adjustment.
For more information:



Affiliate Association News  

- The American Medical Association (AMA) House of Delegates (HOD) adopted an ASCO-submitted resolution asking CMS to withdraw the Medicare Part B drug reimbursement experiment or alternatively asking Congress to block the experiment from moving forward. ASCO also supports HR5122, legislation that would halt CMS from implementing the experiment, and urges members to ask their Representatives to co-sponsor the legislation at http://cqrcengage.com/asco/.

- Services provided in 2017 will form the basis of MACRA determined payments in 2019. The actions you take starting in January 2017 will result in a reduction of up to 4% or increase of up to 22% in your Medicare revenue in 2019. Go to www.asco.org/practice-guidelines/practice-management-issues/medicare-program/macra for more information; read Bobbie Buell's analysis of the MACRA proposal at www.anco-online.org/BBMacraAnalysis.pdf; listed to ACCC's webinar at http://attendee.gotowebinar.com/recording/viewRecording/2308644939852908546/4288900566134237187/[email protected].
 
- NCCN has published updates to the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines�) and the NCCN Drugs & Biologics Compendium (NCCN Compendium�) for: Bladder Cancer, Malignant Pleural Mesothelioma, Prostate Cancer, V2.2016, Cervical Cancer, V1.2016, Hodgkin Lymphoma Please visit NCCN.org



Industry News  
  
- Lilly Oncology informs ANCO and MOASC that CMS has assigned C9475 (16mg/ml) to Portrazza with an effective date of April 1, 2016.
 
- Pfizer wishes to share their website, www.gethealthystayhealthy.com video with you. This video is from the TV show, The Doctors, that highlights Pfizer's Chief Medical Officer, Dr. Freda Lewis-Halls discussion on the work that is being done in immunotherapy and the advances in cancer research. http://www.gethealthystayhealthy.com/videos/latest-cancer-breakthroughs#
In addition, there is an entire page on this site dedicated to Cancer. We hope you find this information beneficial. http://www.gethealthystayhealthy.com/cancer
 





In This Issue
  1.  
 
 MOASC CALENDAR
 
LunchTime Series Teleconference/Webinar 
August 31st
October 26th

Oncology Roundtable Teleconference 
July 27th 
September 28th  
November 30th 

 
ASCO National Meeting
in Chicago, II
June 3rd - June 6th

ASCO State Affiliate
Meeting in Virginia, VA

October 26th - 28th
  



 
 
ANCO  
CALENDAR
   
 
ANCO's ASCO Highlights 2016
 (August 27, Oakland)
 
Hematological Malignancies Updates
(September 17; Sacramento)
 
 
Hematological Malignancies Updates (November 12; Palo Alto)
 


 
 
 
 
 
 
 
 
 
 
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