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.
July 5, 2016
California News

- Several California congressional Republicans want the Obama administration to block the state's request to sell health insurance to undocumented immigrants on the state's exchange. The move comes after Gov. Jerry Brown signed a bill earlier this month authorizing California to formally request a waiver from the Affordable Care Act provision that bars undocumented immigrants from any of the law's benefits. ... Nine of California's 14 Republican representatives have signed a letter to cabinet officials appealing to them to deny this waiver. The representatives called California's request "a brazen attempt to circumvent the will of Congress."
- Save Lives California submitted about a million signatures to the Secretary of State, whose office confirmed the signatures, thereby qualifying the tobacco tax initiative for the November 8 ballot, becoming Proposition 56. The measure seeks to pass a $2-per-pack tobacco tax increase in California.

- CMA has published a new resource to help physicians comply with the new directory accuracy law that took effect on July 1. Provider Directories is now available online at; it is On-Call document #7163.
- Effective July 1, 2016, the most current San Francisco employment notices, by San Francisco ordinances, are to be posted wherever they can be easily seen and read by employees working in San Francisco. The new labor law postings should include: San Francisco Minimum Wage notice with $13.00 per hour minimum wage; San Francisco Paid Sick Leave notice; San Francisco Health Care Security Ordinance (HCSO) notice, and San Francisco Family Friendly Workplace Notice.

Noridian News

- Noridian/JEMAC has posted the following updates to its website
* MLN Connects Provider eNews
Announcements--CMS to Release CBR on Physician Assistant use of Modifier 25 in July
Claims, Prices & Codes--2017 ICD-10-CM and ICD-10-PCS Files Available
Events--Quality Measures and the IMPACT Act Call-July 7; SNF Quality Reporting Program Call-July 12
* SNF Consolidated Enforcement-October 2016 Update CR9688
* Initial Nursing Facility Care, 99306-Service Specific Targeted Review Notification
- Forthcoming Noridian/JEMAC workshops include:
* 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 for more information and to register.

DHCS/Medi-Cal News

 - DHCS/Medi-Cal is following Medicare's lead by allowing providers to bill for advance care planning discussions with beneficiaries. DHCS/Medi-Cal will accept CPT codes 99497 and 99498. These are time-based codes: 99497 is for the first 30 minutes and DHCS/Medi-Cal will reimburse it at $69.59; 99498 is an add-on code for each additional 30 minutes and DCHS/Medi-Cal will reimburse it at $62.64.


- You are cordially invited to the MOASC 2nd Annual Spotlight on ASCO, Saturday, July 16, 2016, 7:30am to 1:00pm, at the Hyatt Regency Huntington Beach. MOASC & University of California Irvine Division of Hematology Oncology bring you speakers and topics as: 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: 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!
- Renew 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 and pay online via PayPal.
If you have any questions, please do not hesitate to contact the MOASC Office at 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
- 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 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

- 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
- 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 highly experienced and nationally respected hematologist-oncologist, please contact the MOASC office for more information.

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- ANCO is pleased to announce that it will host ASCO Highlights 2016 on August 27 at The Claremont Resort in Oakland. The meeting will summarize the major research and treatment advancements presented at this year's
ASCO Annual Meeting. The program will focus on breast, gastrointestinal, genitourinary, gynecologic, and lung cancers as well as hematological malignancies. The meeting was announced in late June; download the meeting announcement and registration form at

- 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

- 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

- 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 The 2016 Staff Salary Survey was distributed to members the week of May 16 and is available online at
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  
- As part of the $1 billion National Cancer Moonshot effort being run by Vice President Joseph Biden, the FDA appointed Richard Pazdur, M.D. to run the new Oncology Center of Excellence that will coordinate all of the FDA's clinical efforts in cancer. For 20 years, Pazdur has run the office of the Food and Drug Administration charged with evaluating new cancer drugs, guiding the pharmaceutical industry as the business of oncology went from a relative backwater to the main event. Cancer medicines now account for 40% of the drugs under development, but the current revolution-that's the word most doctors use-going on in cancer care doesn't just involve drugs.

CMS News

- CMS has testified before the Senate Finance Committee that the Administration would adjust its plan to reduce Medicare payments for many prescription drugs--but those assurances did not fully allay deep concerns from the Senators. CMS indicated that the Administration would probably go ahead with its proposal in some form and pledged that it would try to prevent any harm to patients. At the same hearing, ASCO voiced its strong opposition to CMS's plans. Read ASCO's testimony at
- CMS finalized new rules for the Qualified Entity Program.
The Centers for Medicare & Medicaid Services (CMS) today finalized new rules that will enrich the Qualified Entity Program by expanding access to analyses and data that will help providers, employers, and others make more informed decisions about care delivery and quality improvement. The new rules, as required by the Medicare Access and CHIP Reauthorization Act (MACRA), allow organizations approved as qualified entities to confidentially share or sell analyses of Medicare and private sector claims data to providers, employers, and other groups who can use the data to support improved care. In addition, qualified entities may provide or sell claims data to providers and suppliers, such as doctors, nurses, and skilled nursing facilities among others. The rule also includes strict privacy and security requirements for all entities receiving patient identifiable and beneficiary de-identified analyses or data, as well as expanded annual reporting requirements. For example, if entities receive patient identifiable data or analyses, they must use protections that are at least as stringent as what is required of covered entities and their business associates for protected health information (PHI) under the HIPAA Privacy and Security Rules.
This initiative is part of a broader effort by the Obama Administration to use data to help create a health care system that delivers better care for patients, spends dollars more wisely, and results in healthier people.
"Increasing access to analyses and data that include Medicare data will make it easier for stakeholders throughout the healthcare system to make smarter and more informed healthcare decisions," said CMS Chief Data Officer Niall Brennan.
The Qualified Entity Program was authorized by Section 10332 of the Affordable Care Act and allows organizations that meet certain qualifications to access patient-protected Medicare data to produce public reports. Qualified entities must combine the Medicare data with other claims data (e.g., private payer data) to produce quality reports that are representative of how providers and suppliers are performing across multiple payers, for example Medicare, Medicaid, or various commercial payers. Currently, 15 organizations have applied and received approval to be a qualified entity.  Of these organizations, two have completed public reporting while the other 13 are preparing for public reporting. Additional information on the qualified entity program can be found at the Qualified Entity Certification Program website at
Today's rules seek to enhance the current qualified entity program to allow innovative use of Medicare data for non-public quality improvement and care delivery efforts while ensuring the privacy and security of beneficiary information. For example, qualified entities can conduct analyses on chronically ill or other resource-intensive populations to increase quality and drive-down costs in the healthcare system. The final rule contains few changes from the proposed rule.  Future rule-making is anticipated to expand the data available to qualified entities to include standardized extracts of Medicaid data. The final rule is on display at the Office of the Federal Register at
- California Medical Association will host a webinar entitled MACRA: What is CMA Doing to Improve It? What Steps Can You Take to Prepare Now? July 13 at 12:15pm Pacific time. The webinar will provide an overview of the new MACRA payment changes, with an emphasis on what CMA is doing to improve MACRA regulations for physicians. The webinar will also discuss what physicians can do now to be ready for the major changes ahead. Go to to register.
- CMS announced the start of the Oncology Care Model (OCM) on June 29 along with the long awaited list of practices that will be participating (including several ANCO and MOASC practices). The OCM is an alternative payment model that aims to provider higher quality, more highly coordinated oncology care, while lowering overall costs to Medicare. The practices participating in the OCM have committed to providing enhanced services to Medicare beneficiaries, such as care coordination and navigation, and to using national treatment guidelines for care. For more information, please visit
- 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 CMS released the second full year of Open Payments data last week. The database is made publicly available and was established under a sunshine provision in the Affordable Care Act. Novartis Pharmaceuticals Corp. paid the most by far. Analysis by ProPublica shows that the hospital's owner is an important factor in whether a doctor has received gifts or payments from the drug or medical device industry. Of doctors affiliated with Kaiser Permanente, which has strict policies to restrict such activities, 27 percent took payments, whereas at Scripps Green Hospital 83.8 percent did. Payments reported to the federal government found that roughly 75 percent of doctors primarily affiliated with Desert Regional and Eisenhower hospitals and who accept Medicare took payments from outside companies in 2014.
- Data mining of patient medical records kept by the federal government will get a boost by the CMS, following the release of finalized changes to the so-called Qualified Entity Program. The final rule released last Friday authorizes certain CMS-approved organizations - including for-profit companies - to buy Medicare claims and other federal data at a price that matches the governments' cost in processing the data. These "qualified entities" can then combine it with patient data from insurance companies, providers and other sources, and then resell that data to those organizations and others, including employers and device makers. Information on the Qualified Entity Certification Program can be found at

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

- 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 for more information; read Bobbie Buell's analysis of the MACRA proposal at; listed to ACCC's webinar at Read ASCO's comments on the proposed MACRA regulations at; COA has submitted comments on the proposed MACRA regulations; read them at
- ASCO has issued new clinical practice guidelines for invasive cervical cancer and these guidelines are the first to be "resource-stratified" meaning that they provide specific recommendations based on the availability of health care in different regions. Learn more at
- Applications for ASCO's Leadership Development Program are now open and must be received by September 23. To learn more about the Program, please visit
- ASH has launched a new website focusing on hematology Risk Evaluation and Mitigation Strategies (REMS), safety programs to manage the serious risks that can arise from certain drugs and biologicals and established by the United States Food and Drug Administration to ensure that the benefits of the drug outweigh the risks. The new ASH website tracks hematologic therapies that require REMS and provide links to programs and additional information. To learn more, please visit
- The ASH-SAP, Sixth Edition, is the premier self-assessment program for hematologists covering the full spectrum of adult and pediatric hematology with over 23 pertinent chapters in the textbook and 285 new questions in the Question and Answer Book. The online version features 7 chapters with multimedia including 3D animation and audio. Earn up to 70 CME/MOC points with 6 different tests, which you may take individually, or all of them at the same time. The Sixth Edition officially launched on June 1; visit to purchase your copy now.
- NCCN has published updates to the NCCN Clinical Practice Guidelines in Oncology (NCCN GuidelinesŪ) and the NCCN Drugs & Biologics Compendium (NCCN CompendiumŪ) for: Acute Myeloid Leukemia (V2.2016), Colorectal Cancer Screening (V1.2016), Hepatobiliary Cancers (V2.2016), Penile Cancer (V2.2016), and Thyomas and Thymic Carcinomas (V2.2016). Please visit
- At the MGMA 2016 Annual Conference, Oct. 30 - Nov. 2 in San Francisco, you'll find the best practices, proven strategies and lasting support you need to grow professionally; see and capitalize on opportunities; and, ultimately, lead your practice to even greater success.Click herefor the full schedule and session details.
In This Issue
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's ASCO Highlights 2016
 (August 27, Oakland)
Hematological Malignancies Updates
(September 17; Sacramento)

 MGMA 2016 National Conference
 (October 30-November 2; San Francisco)

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|

ANCO: P.O. Box 151109, San Rafael, CA 94915 |  P (415) 472-3960 | F (415) 472-3961 |