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 19, 2016

California News

- CMA's Practice Resources (July 2016) is now available online at http://www.cmanet.org/cpr/cpr-archives/2016/july-2016 and features articles entitled: CMA publishes guide on new provider directory accuracy law; Updated payor profiles now available; United Healthcare extended clinical data submission deadline to Sept 2; DMHC IMR/complaint webinar now available; CMA medical legal library updated for 2016; California Insurance Commissioner urges DOJ to block Anthem/Cigna merger; Have you registered for CURES?; Medi-Cal to reimburse providers for advanced care planning; The Coding Corner: How coding guidelines define new vs. established patients.

- Bobbi Buell is hosting three forthcoming webinars, as follows:

* Beginner's Guide to Oncology Billing and Coding (July 28; 12PM PT)--register at https://cc.readytalk.com/registration/#/?meeting=9u9xd6655i17&campaign=l688klusals3
* Medicare Proposed Rule for 2017 and Other Issues (August 10; 9AM PT)--register at https://cc.readytalk.com/registration/#/?meeting=wqpr4n887l5d&campaign=mz6m9ppz83ro

* Medicare Proposed Rule for 2017 and Other Issues (September 2; 9AM PT)--register at https://cc.readytalk.com/registration/#/?meeting=n0h4jpuqikvp&campaign=bztndtjw6kox

Noridian News

- Noridian/JEMAC has posted the following updates to its website (http://med.noridianmedicare.com/web/jeb):

MLN Connects Provider eNews
Announcements--New Hospice Report Available July 17; Clinical Laboratory Fee Schedule Resources; HIPAA Administrative Simplification Enforcement and Testing Tool
Claims, Pricers, and Codes--

Events--PQRS Feedback Reports and Informal Review Process for Program year 2015 Results Call-August 10

Publications--Medicare Billing Certificate Program for Part A and Part B Providers WBT-Revised; Complying with Medicare Signature Requirements Fact Sheet-Revised; Medicare Enrollment Guidelines for Ordering/Referring Providers Fact Sheet-Reminder

* Prompt Payment Interest Rate- July 2016

* Stem Cell Transplantation for Multiple Myeloma, Myelofibrosis, and Sickle Cell Disease, and Myelodysplastic Syndromes-Revised CR9620

* Chemotherapy Administration-R2-Revised

* Flow Cytometry LCD-R4

- Forthcoming Noridian/JEMAC workshops include:

* Part B Ask the Contractor Teleconference (July 20)

Go to https://med.noridianmedicare.com/web/jeb/education for more information and to register.

- Noridian/JEMAC reports that only 19% of physicians have responded to the most recent revalidation notices. If you do not know when you are up for revalidation, you can look up your revalidation date through the CMS look-up tool at https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/MedicareProviderSupEnroll/Revalidations.html. Those due for revalidation in the near future will display a revalidation due date. All other providers will see TBD in the due date field. If you do not revalidate your Medicare enrollment by your due date, then Medicare payments will be suspended.

DHCS/Medi-Cal News

- Ballot measure to provide new funding for Medi-Cal has officially qualified for the November 2016 ballot.The ballot initiative will maintain the taxes on the wealthiest Californians to prevent billions in cuts to education and other vital services The California Secretary of State announced that the initiative could move forward as enough valid signatures were submitted and verified. This measure will generate an average of $8 billion per year, and provide up to $2 billion annually to improve access to health care for low-income children and their families.

"Doctors and other health care providers across the state are supporting this initiative because it will provide critical funds to improve access to health care for low-income children and their families," said California Medical Association (CMA) President-Elect Ruth Haskins, M.D.

The California Children's Education and Health Care Protection Act of 2016 - now known as Proposition 55 - will temporarily extend for 12 years current tax rates on the wealthiest Californians - singles earning more than $250,000 and couples earning more than $500,000 a year. The measure will direct funds specifically to K-12 public education and community colleges, while also allocating funds to health care for low-income children and their families. The measure contains strict accountability requirements.

MOASC News

- 340B: An Overview, What's at stake? MOASC's LunchTime Series Teleconference, is scheduled for Wednesday, July 27, 2016, 12:00pm-PST. Presented by: Mike Ybarra, M.D., Senior Director of Alliance Development, PhRMA. Please RSVP to moasc@moasc.org or by calling 909-985-9061 ext. 1

- You are cordially invited to the MOASC Cocktail Networking Reception. Stop by and network with colleagues and discuss the new and exciting clinical developments discussed
during the 2016 Best of ASCO� San Diego Meeting, Friday, August 12, 2016, 4:30PM - 6:30PM, Hilton San Diego Bayfront (Sapphire 411 Room), 1 Park Blvd, San Diego, CA.

Please RSVP to the MOASC Office moasc@moasc.org or call 909-985-9061, ext. 1 no later than Monday, August 8th. MOASC's Networking Reception is not an official event of the 2016 Best of ASCO San Diego Meeting. It is not sponsored or endorsed by ASCO or the Conquer Cancer Foundation, nor is it CME-accredited.

- Thank you to those physicians who joined us at the MOASC 2nd Annual Spotlight on ASCO, held last Saturday, July 16, 2016,at the Hyatt Regency in Huntington Beach. University of California Irvine, Division of Hematology Oncology presented the following speakers and topics:

Jason Zell, DO, MPH, Associate Professor, Depts. Of Medicine & Epidemiology School of Medicine University of California, Irvine and chair of this program, introduced the two UCI Fellows who received the MOASC Fellows Grant to attend ASCO.

John Fruehauf, MD, PhD, Director Clinical Pharmacology and Developmental Therapeutics, UC Irvine Comprehensive Cancer Center, spoke on Genitourinary Cancer and Melanoma;

Sai Hong Ignatius Ou, MD PhD, UC Irvine School of Medicine discussed Lung Cancer;

Samuel Klempner, MD, Director of Precision Medicine, The Angeles Clinic and Research Institute presented an Update in Non-Colorectal GI Malignancies;

Jason Zell, DO, MPH, Associate Professor, Depts. Of Medicine & Epidemiology School of Medicine University of California, Irvine, presented GI-Colorectal Cancer Abstracts;

Chaitali Nangia, MD, UC Irvine School of Medicine, spoke on Breast Cancer Updates, and

Kanwar Kahlon, M.D. Assistant Clinical Professor, Department of Medicine UC Irvine School of Medicine, discussed Multiple Myeloma.

Congratulations to Dr. Bharadwaj; Dr. Moss; Dr. Ou, and Dr. Sapra, the winners of the day's door prizes.

You can view the entire program here: Spotlight on ASCO

If you would like copies of the presentation slides, please email moasc@moasc.org.

MOASC would like to thank:

Alexion, Amgen, American Regent, Astrazeneca, Eli Lilly, Gilead Science, Ipsen Biopharmaceuticals, Johnson and Johnson, McKesson, Medivation, Merck, Phamacyclics, Takeda, Teva for their sponsorship of this meeting.

- Read MOASC Chair, Cary A. Presant, M.D. Medscape article, " Reimbursement Tips From ASCO 2016." http://www.medscape.com/viewarticle/865872

- 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 www.moasc.org and pay online via PayPal.

If you have any questions, please do not hesitate to contact the MOASC Office at moasc@moasc.org 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 moasc@moasc.org

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 Julie@medicaloncologycare.com

- 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 moasc@moasc.org for more information.

ANCO News

- 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 www.anco-online.org/ASCOHL2016.pdf.

- 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

- MOASC and ANCO are interested to know of their member practices' receipt of the CVS/Caremark communiqu� regarding "In-office Dispensing." Physicians in several states, including California, are currently experiencing issues with this. Apparently, CMS tacitly supports the CVS/Caremark interpretation that Medicare Advantage Part D drug dispensing should be only allowed for pharmacy networks, and that physician practices and cancer centers do not qualify. At this point, apparently only CVS/Caremark has chosen to present this interpretation of the MMA language 13 years after the signing of the MMA. CVS/Caremark Communication.
Please let the MOASC Office know moasc@moasc.org if you are in receipt of this communiqu�, if, and how, it has impacted your practice. Thank you

CMS News

- CMS has released the proposed CY2017 Medicare Physician Fee Schedule (MPFS) at https://www.federalregister.gov/articles/2016/07/15/2016-16097/medicare-program-payment-policies-under-the-physician-fee-schedule-medicare-advantage-pricing-data and the proposed CY2017 Hospital Outpatient Prospective Payment System (HOPPS) at https://www.federalregister.gov/articles/2016/07/14/2016-16098/medicare-program-hospital-outpatient-prospective-payment-and-ambulatory-surgical-center-payment.

LEARN WHAT'S IN STORE FOR RADIATION AND MEDICALONCOLOGY IN 2017.

Join industry experts for two free pre-recorded webinars that will summarize the Proposed Rules changes. One of these webinars will focus on radiation oncology and the other will focus on medical oncology. These presentations will educate physicians, nurses, department managers, therapists, dosimetrists, coders and compliance officers - so your business can be prepared for the upcoming year. Some of the top takeaways for the 2017 proposed changes include:

Changes to off-campus provider-based departments; G codes to replace special treatment procedure code; New Quality Reporting measure for ER visits from recent chemotherapy patients; Whether you're a private practice, freestanding cancer center or a hospital-based healthcare provider, you will come away with practical knowledge and guidance so that you can plan for the quickly approaching year. Stay informed and be prepared for 2017!

Watch the Free Webinar now.

- The Centers for Medicare & Medicaid Services (CMS) recently provided additional clarification to Medicare administrative contractors (MAC) and providers regarding reimbursement for prolonged drug and biological infusions that are started in the office or outpatient hospital and are associated with care that is billed incident to a physician service using an external pump. In order for Medicare to pay for a drug or biological under section 1861(s)(2)(A) or (B) of the Act, the physician or hospital (respectively) must incur a cost for the drug or biological. Generally, the administration of drugs or biologicals covered by Medicare under the "incident to" benefit (1861(s)(2)(A) and (B)) will start and end while the patient is in the physician's office or the hospital outpatient department under the supervision of a physician. However, in some situations a hospital or office may purchase a drug for a medically reasonable and necessary prolonged drug infusion, then begin the drug infusion in the care setting using an external pump, send the patient home for a portion of the infusion duration, and have the patient return at the end of the infusion period. In this case, the drug or biological continues to be covered under Section 1861(s)(2)(A) and (B) of the Act and is billable to the A/B MAC even though the entire administration of the drug or biological did not occur in the physician's office or the hospital outpatient department.

In order for physicians and hospital outpatient departments to receive reimbursement for cost incurred for the services above the instructions listed below should be followed.

Part B physician services

* Please continue to bill any applicable Current Procedural Terminology (CPT�) or HCPCS codes for the drug or biological, and its administration.

* To bill for the use of the external pump, please submit using unlisted CPT� code 96379 for a daily reimbursement of the service.

* CPT� code 96379 should be billed on a single line with a FROM and TO date and the corresponding number of units (days) indicated in the appropriate field.

* The word "pump" must be notated in block 19 on the CMS-1500 claim form or the equivalent segment for electronic claims submissions.

* If you have previously billed the drug and administration and are now needing to bill for the pump, bill only the pump as a new claim. You do not need to rebill the administration and drug codes. The complete information can be found in MLN Matters� SE1609

Affiliate Association News

- The FDA is accepting comments through August 2 on "Labeling for Biosimilar Products" draft guidance released by the FDA in March 2016. The labeling will be used by providers and patients. Here is an opportunity to provide the FDA with your input. Additional organizations comments are listed on the FDA Registrar where comments are submitted: https://www.regulations.gov/docket?D=FDA-2016-D-0643. Here are the comments that have been submitted from Oncology Nursing Association.ONS Comments

- The first 25 ANCO and MOASC members to register will have their registration fees waved using the code L16ANCO or L16MOASC, respectively. Join PER^� at this year's 17^th Annual International Lung Cancer Congress� at the Hyatt Regency in Huntington Beach on Thursday, August 4^th through Saturday, August 6^th 2016. Leading international and national faculty, such as David Gandara, MD, will address critical topics in lung cancer staging, personalized therapy, and the latest clinical data impacting the treatment of lung cancer. The International Lung Cancer Congress� provides current, practical information on the management of lung cancer, as well as a look at the novel agents and strategies that will shape the future of lung cancer therapy.

Don't miss this unique learning opportunity. Visit our site here to register!

For more information and for assistance in registering, please call (609) 378-3701 or email info@gotoper.com

- To help you prepare for MACRA implementation, ASCO will be offering a series of webinars and an in-person workshop. Click the Registration link for the July 19 webinar. As an alternative, you may also visit the ASCO in Action page on www.ASCO.org to find the registration link. Please scroll down to the last paragraph and click on the "Registration" hyperlink. As registration opens for future webinars and the workshop, notifications will be included in our weekly newsletter. Additionally, you can find video and PowerPoint slides from previous webinars, as well as, additional information on the MACRA Resource page.

- 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; listen to ACCC's webinar at http://attendee.gotowebinar.com/recording/viewRecording/2308644939852908546/4288900566134237187/execdir@anco-online.org.

- Read ASCO's comments on the proposed MACRA regulations at http://www.asco.org/advocacy-policy/asco-in-action/asco-submits-comments-proposed-macra-implementation-rule; read ACCC's comments on the proposed MACRA regulations at www.accc-cancer.org/advocacy/pdf/2016-ACCC-Comment-Letter-to-CMS-on-Proposed-MACRA-Rule.pdf; COA has submitted comments on the proposed MACRA regulations; read them at http://www.communityoncology.org/wp-content/uploads/2016/06/COA_CMS_MACRA_5517PR_Comment_Letter_FINAL.pdf. ASCO's MACRA resources, including its educational series, are available at http://www.asco.org/practice-guidelines/practice-management-issues/medicare-program/macra.

- 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 www.asco.org/leadership.

- ASCO invites interested stakeholders to submit comments on its draft Integration of Palliative Care into Standard Oncology Care Guideline Update. This open comment process provides greater transparency in the guideline development process and the opportunity for key stakeholders to provide feedback before the guideline's finalization and publication. Go to www.asco.org/practice-guidelines/quality-guidelines/guidelines-tools-resources/open-comment-guidelines to submit your comments.

- Read ASH's initial summary of CMS's proposed CY2017 Medicare Physician Fee Schedule and Hospital Outpatient Prospective Payment System at http://www.hematology.org/Advocacy/Policy-News/2016/5846.aspx. Similar, read ASCO's initial summary at http://www.asco.org/advocacy-policy/asco-in-action/proposed-2017-medicare-physician-fee-schedule-rule-released?et_cid=38082539&et_rid=933038345&linkid=http%3a%2f%2fwww.asco.org%2fadvocacy-policy%2fasco-in-action%2fproposed-2017-medicare-physician-fee-schedule-rule-released. Read Bobbi Buell's analyses of these proposals at www.anco-onlne.org/BBMPFS2016Analysis.pdf and www.anco-online.org/BBHOPPS2016Analysis.pdf.

- COA has launched a peer-to-peer support network for practices participating in the CMS Oncology Care Model (OCM). The COA OCM support network was created at the request of OCM practices, and nearly 200 individuals from more than 112 cancer care teams have already joined. It is free of charge for all OCM practices to join, completely noncommercial, and practices to no have to be members of COA to participate. The COA OCM support network is focused on helping practices succeed. It is enabling ongoing, private, peer-to-peer knowledge sharing to ease the challenges practices face; hosting monthly calls for participants; developing free tools and resources to help practices deal with IT and other implementation issues; and, working as a unified voice for practices engaged in this effort. If you are interested in joining the support network, e-mail OCMSupport@coacancer.org.

- 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 here for the full schedule and session details.

- NCCN has published updates to the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines�) and the NCCN Drugs & Biologics Compendium (NCCN Compendium�) for: esophageal and esophagogastric cancer (V2.2016), gastric cancer (V2.2016), melanoma (V3.2016), thyroid carcinoma (V1.2016). Please visit NCCN.org

- The College of American Pathologists (CAP), the International Association for the Study of Lung Cancer (IASLC), and the Association for Molecular Pathology (AMP) have announced an open comment period for the revised evidence-based Molecular Guideline for Selection of Lung Cancer Patients for EGFR and ALK Tyrosine Kinase Inhibitors. Learn more at http://amp.org/committees/clinical_practice/AMPclinicalpracticeguidelines/LBGOCP.cfm. The guideline is designed to provide state-of-the-art molecular testing of lung cancer recommendations. The comment period ends August 2.

Industry News

- Novartis Oncology is hosting virtual ASCO Annual Meeting sessions. To access the virtual platform, please register at www.ASCO2016.com.

In This Issue

California News

Noridian News

DHCS/Medi-Cal News

MOASC News

ANCO News

National News

CMS News

Affiliate Association News

Industry News

MOASC CALENDAR

LunchTime Series Teleconference/Webinar

July 27th

August 31st
October 26th

Oncology Roundtable Teleconference

September 28th

November 30th

ASCO State Affiliate
Meeting in Virginia, VA
October 26th - 28th

ANCO

CALENDAR

ANCO's 2016 Professional Education Meeting (August 3; Oakland)

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| www.moasc.org

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