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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.
August 30, 2016
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California News
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- A battle in California could influence bills pending in states across the country, including Pennsylvania, New Jersey, Georgia, Hawaii and Missouri. A measure to protect California consumers from surprise medical bills - among the longest-debated issues to be considered by state lawmakers - moved closer than it's ever been to becoming law when the Senate approved it yesterday with a 35-1 vote. The bill would relieve patients from having to pay surprise medical bills out of pocket by requiring insurers to reimburse out-of-network doctors and other health providers a "fair amount" and doctors to accept the payments, said its author, Assemblyman Rob Bonta (D-Oakland). That rate would be 125 percent of the amount Medicare pays for the same service or the insurer's average contracted rate for the service, whichever is greater. Under the bill, AB 72, consumers would only pay the equivalent of in-network rates if, for example, during surgery covered by insurance, they are treated by an out-of-network anesthesiologist, or have X-rays read by an out-of-network radiologist. AB 72 is in the California Senate and must be approved before going to the state assembly and governor. The state legislature has until Aug. 31 to act, or the bill effectively dies in committee.
- A California judge has rejected a request by physicians to immediately suspend the new state law allowing terminally ill people to end their lives. Judge Daniel A. Ottolia of Riverside County Superior Court ruled on Friday that the law would remain in effect for now. But he agreed to allow the physicians to pursue their lawsuit claiming that the law lacks safeguards against abuse. The law, which took effect on June 9, allows terminally ill adults to obtain a prescription for life-ending medication if a doctor has determined they have no more than six months to live. California is one of five states where terminally ill people may legally receive assistance to end their lives. Oregon became the first to provide the option in 1997. The California law is being challenged by the Life Legal Defense Foundation, the American Academy of Medical Ethics and several physicians, saying that hastening death is morally wrong, that the law puts all kinds of patients at risk of loved ones' coercing them to end their lives, and that it could become a way out for people who are not insured or who fear high medical bills. Stephen G. Larson, a lawyer representing the plaintiffs, said his clients wanted the law declared unconstitutional. Determining when someone has six months or less to live is arbitrary and opens the door for abuse, he said, and doctors are not held accountable after they prescribe the life-ending drugs. Supporters of the law have argued that terminally ill people could face prolonged, painful deaths if it is suspended. `The state attorney general's office countered that medical professionals could refuse to prescribe and dispense the drugs. The law also specifies that the terminally ill people must be able to administer the drugs themselves.
- Forthcoming California Medical Association (CMA) webinars:
* CHPI Physician Quality Rating Program: Navigating the
Review and Corrections Process (October 5)
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Noridian News
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MLN Connects Provider eNews
Announcements--ICD-10: Updated Questions and Answers
Claims, Pricers, and Codes--
Events--SNF Quality Reporting Program Webcast-September 14
Publications--Medicare and Medicaid Basics Booklet-New; PQRS Call: Audio Recording and Transcript- New
* Non Covered Services LCD-R13
* MLN Connects Provider eNews-August 18, 2016
* Mammography Services Reminder
* Next Generation Accountable Care Organization-Implementation SE1613
* MPFSDB-October 2016 October Update CR9749
* Understanding National & Local Coverage Determination Workshop-August 30, September 8
- Noridian/JEMAC will soon be deactivating billing privileges for physicians who received revalidation notices from Noridian but have not submitted completed applications to CMS. Noridian/JEMAC reports that only 19% of physicians have responded to the most recent revalidation process. To prevent deactivation, CMA recommends that practices look up their revalidation dates through the CMS look-up tool. If it shows that your practice missed the deadline, you should submit and sign your application online immediately. Visit https://med.noridianmedicare.com/web/jeb/article-detail/-/view/10546/provider-enrollment-revalidation-cycle-2 for more information.
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DMHC News
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- The Department of Managed Health Care has updated its website to reflect a new posting under "Open Pending Regulations." Pursuant to Government Code section 11346.4, the DMHC is giving notice of a proposed regulation, Prescription Drug Prior Authorization or Step Therapy Exception Request Form Process, amending section 1300.67.241 of Title 28 of the California Code of Regulations. Interested parties may submit public comments to the DMHC for 45 days (through and including October 10, 2016). A joint public hearing with the Department of Insurance will also be held on October 10, 2016, from 1 p.m. to 5 p.m. at the following location: 980 Ninth Street, 2nd Floor, Sacramento, CA 95814. The following new documents have been posted in the "Open Pending Regulations" section of http://wpso.dmhc.ca.gov/regulations/. If you have questions about this e-mail, please submit your questions to [email protected]
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- Mark your calendars, and save the date, for MOASC's Fall Clinical Staff, Billing and Administrator Programs, November 9 and 10, 2016 at Embassy Suites Anaheim-Orange 400 N. State College Blvd., Orange. The Clinical Staff Track & Billing Staff Track will be held on Wednesday, November 9th from 8am - 2pm. The Administrator's Program will be on Thursday, November 10th from 8am - 2pm.
The MOASC Office is in receipt of questions regarding the Anthem/WellPoint Pathways Program. Below is a brief survey regarding participation. Please reply to [email protected] with your answers by close of business on Friday, September 2nd. Anthem/WellPoint Pathways Program Survey: 1. Do you participate in the Anthem/WellPoint Pathway Program? 2. If so, which pathway do you utilize, i.e., Breast or Colon or Lung? Two of them? All three? 3. Is the online portal user friendly? 4. Has processing the patient been more efficient? (cost decreased and/or reimbursement increased due to no "prior authorization" requirement, flat fee payment covers your costs) 5. Any other comments? Thank you for your attention to this request! - Thank you to those who have responded to the MOASC & ANCO 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. Gift cards will be placed in the mail on October 1, 2016. Please contact MOASC if you have any questions at [email protected]
- 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.
Job Board:
M.D.
A prominent Oncologist-Hematologist is seeking new employment. He has been in private practice for 15 years, currently working for an oncology group but wants to be employed in an environment where he can concentrate on patient care and treatment. He is willing to relocate anywhere in a 50 mile radius of central Orange County, and would consider a long term employment opportunity elsewhere in the state with a successful group. Please direct any information or questions to Charles Denny, Charles Denny Consulting, [email protected], 949-233-8604, regarding CV, references, and any other questions.
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- ANCO hosted ASCO Highlights 2016 on August 27 at The Claremont Resort in Oakland. The meeting summarized the major research and treatment advancements presented at this year's ASCO Annual Meeting. The program focused on breast, gastrointestinal, genitourinary, gynecologic, and lung cancers as well as hematological malignancies. Download the presentations at www.anco-online.org/education.html.
- ANCO is organizing a series of Hematological Malignancies Updates in 2016. The second Update will take place on September 17 at the Hyatt Regency Sacramento with Bruno Medeiros, MD, Stanford University, Aaron Rosenberg, MD, University of California, Davis, and Rajeev Krishnan, MD, University of California, Davis. The latest research on novel treatment modalities for acute and chronic leukemias and myeloma along with case studies for these diagnoses will be presented. The program begins at 8:30AM with breakfast. These meetings are supported by Janssen Biotech, Seattle Genetics, and Takeda Oncology. Space is limited to the first 50 physician or nurse registrants only. A meeting announcement was mailed in mid-August. To register for this meeting, please send your name, affiliation, and e-mail address to [email protected] (Subject: 3Q2016 Clinical Meeting) or download and FAX the registration form at www.anco-online.org/3Q2016HemeMalig.pdf.
- ANCO is pleased to announce the 17th Multidisciplinary Management of Cancers: A Case-based Approach on March 17-19, 2017 at The Silverado Resort and Spa in Napa. Sign up for more information at www.multicancers.org. - 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.
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- The Food and Drug Administration (FDA) has announced efforts to help mitigate the shortage of Bleomycin. The agency will be coordinating with Anneal Bioscience to import its Bleomycin which contains the same active ingredients as the FDA-approved Bleomycin. Read the full letter to healthcare professionals at http://www.fda.gov/downloads/Drugs/DrugSafety/DrugShortages/UCM511198.pdf.
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- Join Bobbi Buell for a webcast on the Medicare Proposed Rule for 2017 and Other Issues on September 2 (https://cc.readytalk.com/registration/#/?meeting=n0h4jpuqikvp&campaign=bztndtjw6kox).
- CMS is currently working to correct technical errors that occurred when they recently updated national coverage policies regarding certain genetic tests. CMS also confirms that steps are being taken to reprocess claims that have been denied. A list of the affected codes is at http://www.asco.org/sites/new-www.asco.org/files/content-files/Cytogenetic-Testing-Codes.pdf.
- The 2015 Physician Quality Reporting System (PQRS) feedback reports will be available in September 2016 for individual eligible professionals and PQRS group practices. The PQRS feedback reports will provide the final determination on whether or not participants met the PQRS criteria for avoiding the 2017 PQRS negative payment adjustment. Additional information about the 2015 PQRS feedback reports and now to request an informal review will be available on the PQRS website and through the QualityNet Help Desk at (866) 288-8912 or [email protected]. The Annual Quality and Resource Use Reports (QRURs) will also be available in September 2016 for groups with 2 or more eligible professionals and solo practitioners. Groups and solo practitioners are identified in the QRURs by their Taxpayer Identification Number. Additional information about the 2015 Annual QRURs and how to request an informal review is available on the 2015 QRUR website at https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/PhysicianFeedbackProgram/2015-QRUR.html and through the QRUR Help Desk at [email protected] or (888) 734-6433 (option 3).
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Affiliate Association News
- A special exclusive webinar preview of what will be presented next month at the ASH Meeting on Hematologic Malignancies (MHM) will be tomorrow, Wednesday, August 31, 2016, 1:00pm (Pacific Time). Listen to three distinguished speakers from the upcoming meeting as they provide an exclusive sneak peek at their respective "How I Treat" presentations:
David Steensma, MD: How I Treat Low-Grade Myelodysplastic Syndromes
Ruben Mesa, MD: How I Treat Myelofibrosis Patients Who Have "Failed" Ruxolitinib
John P. Leonard, MD: How I Treat Diffuse Large B-Cell and Mediastinal Large Cell Lymphomas. Submit your questions throughout the webinar and participate in a special Q&A session to find out why you should attend the meeting in Chicago.
- ANCO and MOASC encourage all members to participate in ASCO's Practice Census, the only annual survey of the entire oncology community that aims to capture and describe changes in cancer care and oncology practice over time. Be counted by going to https://apps.asco.org/oncology-practice-central/survey/#/ . - 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. - The Community Oncology Alliance (COA) has launched the Advance Practice Provider Network (CAPP Network) to support advanced practice providers (NPs, PAs, etc.). To join the CAPP Network, visit www.communityoncology.org/capp. - 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 [email protected] - Join expert faculty for, "When First-Line Treatment Fails: Navigating New Treatment Paradigms in Relapsed/Refractory Multiple Myeloma,"Tuesday, September 20 at The Huntley Hotel, Santa Monica. Lead by Jonathan L. Kaufman, MD, Emory University School of Medicine, Atlanta, Georgia, and Jatin J. Shah, MD, The University of Texas MD Anderson Cancer Center, Houston, Texas, this CE accredited for physicians, nurses and pharmacists, complimentary program, will discuss recent advances in the treatment of relapsed/refractory multiple myeloma and how to navigate current agents to find the right option for your patients. The full details of the program can be found here. This program is supported by educational grants from Amgen Inc., Bristol-Myers Squibb Company, and Takeda Oncology. - Oncology Education, alongside EOCI, will be hosting Immuno-Oncology Update that will be held September 23-24, 2016 in Toronto, Ontario. This year's program will cover a variety of important topics examining advances in immuno-oncology and also explore topics that pertain to clinical practice, adverse event management and the pharmacoeconomics of novel therapies. Immuno-Oncology Update+ will draw from among experts in immuno-oncology from across North America. For more information please click here. - 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. - Join Dr Neil Love and his education group, Research To Practice, at the Loews Santa Monica Beach Hotel (1700 Ocean Avenue) on Saturday, November 12, 2016, for another installment of the Year in Review multi-tumor oncology CME program. The daylong event (from 8:00am - 4:00pm) we will be joined by an exceptional faculty panel that will review many of the year's most important new data sets and conference presentations in several distinct areas of oncology: breast cancer, lung cancer, genitourinary cancers, select gastrointestinal cancers, melanoma, multiple myeloma and Hodgkin and non-Hodgkin lymphoma. For more information or to register and secure hotel accommodation, visit: http://www.researchtopractice.com/Meetings/YIR2016/CA - NCCN has published updates to the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines�) and the NCCN Drugs & Biologics Compendium (NCCN Compendium�) for: myelodysplastic syndromes (V1.2017) and small cell lung cancer (V.2017). Please visit NCCN.org.
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MOASC CALENDAR
LunchTime Series Teleconference/Webinar
October 26th
Oncology Roundtable Teleconference September 28th November 30th
ASCO State Affiliate
Meeting in Virginia, VA
October 26th - 28th
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Hematological Malignancies Updates (November 12; Palo Alto)
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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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