California Oncology Weekly Newsletter 11.24.15

The Medical Board of California is asking physicians who need to renew their medical licenses in the next few months to do so early to avoid delays associated with scheduled upgrades to the BreEZe online licensing system. Licenses expire on the last day of the licensee’s birth month during the second year of a two-year term. Renewal notices are sent out 90 days in advance of the expiration date.For more information click here.

Noridian/JEMAC has posted the following updates on its website
* MLN Connects Provider eNews
Announcements–EHR Incentive Programs Stage 3 Final Rule: Submit Comments by December 15                                                                                        * Claims, Prices, and Codes–ICD-10 Transition: Clarifications about NCDs and LCDs                                                                                                                       * Immune Globulin Intravenous (IVIg) LCD-R4. For more information click here.

Cancer patients who are enrolled in California’s Medicaid program have lower survival rates and are less likely to receive recommended treatments, compared with those who have other types of insurance, per a new study by researchers from UC-Davis’ Institute for Population Health Improvement. For more information click here.

The House Energy & Commerce Committee’s Health Subcommittee held a hearing on November 17, 2015, to discuss a proposal by the Food and Drug Administration (FDA) that would broaden FDA authority on the regulation of laboratory developed tests (LDTs). As part of the 21st Century Cures initiative, the Committee has heard from a wide range of interested parties about the important role diagnostic tests play in the advancement of precision medicine. For more information click here.

CMS is extending the 2014 Informal Review period. Individual eligible professionals (EPs), Comprehensive Primary Care (CPC) practice sites, PQRS group practices, and Accountable Care Organizations (ACOs) that believe they have been incorrectly assessed the 2016 PQRS negative payment adjustment now have until 8:59 p.m. Pacific Time on December 16, 2015 to submit an informal review requesting CMS investigate incentive eligibility and/or payment adjustment determination. For more information click here.

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November 24, 2015

 

ANCO and MOASC respectfully request feedback from their membership, regarding experiences with Anthem Pathways. Please click on the link and respond as soon as practical, at https://www.surveymonkey.com/r/V92MLKK. Thank you. For more information click here.

Noridian/JEMAC has posted the following updates to its website *MLN Connects Provider eNews
Calls and Events–Clinical Diagnostic Laboratory Test Payment System Proposed Rule Call-Last Chance to Register; Medicare Quality Reporting Programs: 2016 Physician Fee Schedule Call-Register Now. For more information click here.

According to a study by UC Davis researchers, DHCS/Medi-Cal beneficiaries diagnosed with cancer are less likely to receive recommended treatment and have lower survival rates, compared with those with other types of insurance. Read the Institute for Population Health Improvement report at https://www.ucdmc.ucdavis.edu/iphi/. For more information click here.

November is Lung Cancer Awareness Month. Please see the announcements  to find resources and tools to raise awareness about lung cancer in your community. For more information click here.

CMS has released a new proposed coverage policy for hematopoietic stem cell transplant that could allow some Medicare patients with multiple myeloma to receive the service. Read the proposed policy at https://www.cms.gov/medicare-coverage-database/details/nca-proposed-decision-memo.aspx?NCAId=280. For more information click here.

To view the complete California Oncology Weekly Newsletter, click on the date below.

November 17, 2015.

The Medical Board of California is asking physicians who need to renew their medical licenses in the next few months to do so early to avoid delays associated with scheduled upgrades to the BreEZe online licensing system. Licenses expire on the last day of the licensee’s birth month during the second year of a two-year term. Renewal notices are sent out 90 days in advance of the expiration date.Click here for more information.

Not all new anti-cancer drugs should be billed using chemotherapy administration codes, so says Noridian Medical Director. MOASC & ANCO are currently in discussion with Richard W. Whitten, MD, MBA, FACP, Contractor Medical Director; VP Health Policy, Noridian Healthcare Solutions, regarding Noridian’s recommended position that not all new anti-cancer drugs should be billed using chemotherapy administration codes. Click here for more information.

DHCS is continuing to develop policy to implement Senate Bill 1004 (Hernandez, 2014).  SB 1004 requires DHCS to establish standards and provide technical assistance for Medi-Cal managed care plans for the delivery of palliative care services. Click here for more information.

ASCO has submitted comments to the Food and Drug Administration (FDA) on its proposed rule for the nonproprietary naming of biologic products, specifically biosimilars. ASCO encourages the FDA to use a biosimilars naming convention that ensures safety and does not add any administrative burden for physicians and pharmacists. Click here for more information.

CMS has released the final 2016 Medicare Physician Fee Schedule. One of the biggest changes in the CMS final rule is the assignment of codes to pay physicians for end-of-life consultations. In addition, the final rule includes a .5% overall increase in Medicare reimbursement in 2016 for all providers. Click here for more information.

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November 10, 2015.

The open enrollment period for the third year of Covered California, California’s health benefit exchange, began November 1, 2015, and continues through January 31, 2016. All 10 health insurance companies that offered coverage in 2015 will continue to offer coverage in 2016, with two new health insurance companies, United Healthcare (UHC) and Oscar, entering into the marketplace for 2016 in select regions. For more information click here.

Noridian/JEMAC has posted the following updates to its website                      * MLN Connects Provider eNews                                                           ICD-10–Learn How to Assign an ICD-10-CM Diagnosis Code with MLN Connects Videos; 5 Ways to Check Your Claim Status; Contact List for ICD-10 Questions. For more information click here.

DHCS is conducting biweekly external stakeholder meetings, with no reported high severity ICD-10 billing issues from the provider community.  DHCS will rapidly investigate and mitigate any issues that are identified, demonstrating the department’s commitment to the transition to ICD-10 and delivering quality health care to Medi-Cal beneficiaries.  DHCS reports to CMS daily, weekly, and monthly post implementation claims processing metrics.  For more information click here.

Congress included a fix to the disparity in Medicare payments to hospital outpatient departments and physician offices in their bipartisan budget deal. The site-neutral payment fix will result in lower costs for seniors, especially with cancer, the Medicare program, and taxpayers. Starting in 2017, Medicare will pay identical rates for critical cancer care services, such as the administration of chemotherapy, whether provided in physician-directed community cancer clinics or hospital outpatient departments. For more information click here.

The Obama administration has issued a final rule that will allow physicians to bill Medicare for discussions they have with patients about end-of-life care. CMS said the rule, which takes effect next year, is “consistent with recommendations from a wide range of stakeholders and bipartisan members of Congress.” For more information click here.

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November 3, 2015