California Oncology Weekly Newsletter 3.29.16

On March 21, 2016, The Sacramento Bee ran a story “Got a health care grievance? There’s a place to complain,” about the California Chronic Care Coalition Mypatientrights.org website, which services as a health consumer tool to collect grievances and denials that consumers face when accessing healthcare and prescription drug coverage. For more information click here.

California’s End of Life Options Act becomes law on June 9. State lawmakers adjourned the special session that passed the Act on March 9 starting the 90-day countdown to making physician-assisted suicide legal. The California Medical Association has released guidelines for physicians regarding the Act. For more information click here.

Noridian /JEMAC has posted the following updates to their website: Announcements–Major Commitments from Healthcare Industry to Make Electronic Health Records Work Better; Program Integrity Enhancements to the Provider Enrollment Process; EHR Incentive Program Hardship Application Deadline Extended to July 1; EHR Incentive Programs: FAQs on Public Health Reporting Requirements; ICD-10 Next Steps Toolkit; CMS Proposes to Test New Medicare Part B Prescription Drug Models; 2016 Value Modifier Results and Upward Payment Adjustment Factor; 2015 PQRS Data Submission Deadlines; ICD-10: Track and Improve Your Progress; 2016 PQRS Educational Materials. For more information click here.

Last week, DHCS hosted a webinar regarding the implementation of SB 75, which makes children under 19 years of age eligible for full-scope Medi-Cal benefits regardless of immigration status, as long as they meet the income standards and all other eligibility requirements.  You can follow along on the state’s implementation strategies and progress.  For more information click here.

California Department of Managed Health Care (DMHC) Director Shelley Rouillard approved Centene’s acquisition of Health Net. In a press release issued March 22, Director Shelley Rouillard commented, “As the largest health plan regulator in California our focus is to ensure the strong consumer protections and financial solvency requirements under the Knox-Keene Act are upheld.”  For more information click here.

USP recently released a final version of Chapter 800, Hazardous Drugs–Handling in Healthcare Settings–with an official implementation date of July 1, 2018. ASCO disagrees with many of the USP800 requirements and has developed an FAQ on USP800 and the safe handling of hazardous drugs for its member.  For more information click here.

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

March 29, 2016

Under California law, all individuals practicing in California who possess both a state regulatory board license authorized to prescribe, dispense, furnish or order controlled substances and a Drug Enforcement Administration Controlled Substance Registration Certificate (DEA Certificate) must register for the Controlled Substance Utilization Review and Evaluation System (CURES) by July 1, 2016. For more information click here.

Since the passage of the Affordable Care Act (ACA), all Medicare providers and suppliers have been required to re-validate their Medicare enrollment information under new enrollment screening criteria in an effort to prevent fraud within the Medicare system. According to CMS, Medicare Administrative Contractors (MAC) – Noridian in California – will continue to send re-validation notices two or three months prior to each provider’s re-validation due date. For more information click here.

The HHS Office for Civil Rights (OCR) has begun its next phase of audits of covered entities and their business associates. This is part of the government’s continued efforts to assess compliance with the HIPAA Privacy, Security and Breach Notification Rules. If an entity does not respond to OCR’s request to verify its contact information or pre-audit questionnaire, OCR will use publicly available information about the entity to create its audit subject pool. For more information click here.

Despite the federal government’s repeated efforts to make it easier for providers to participate, participation in the Medicare EHR incentive program dropped by 1% in 2015, while hospital participation also dropped 3%, a CMS spokesman said. Industry group representatives said the drop in participation comes as a surprise because the CMS published several rules in 2015 to ease the program’s requirements. For more information click here.

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

March 22, 2016.

California’s End of Life Options Act will become law on June 9. State lawmakers adjourned a special session on March 9 starting the 90-day countdown to physician-assisted suicide. For more information click here.

Noridian/JEMAC has posted the following updates to its website:  Announcements–Major Commitments from Healthcare Industry to Make Electronic Health Records Work Better; Program Integrity Enhancements to the Provider Enrollment Process; EHR Incentive Program Hardship Application Deadline Extended to July 1; EHR Incentive Programs: FAQs on Public Health Reporting Requirements; ICD-10 Next Steps Toolkit; CMS Proposes to Test New Medicare Part B Prescription Drug Models; HHS Reaches Goal of Tying 30 Percent of Medicare Payments to Quality Ahead of Schedule; 2016 Value Modifier Results and Upward Payment Adjustment Factor; 2015 PQRS Data Submission Deadlines; EHR Incentive Programs: Attest to 2015 Program Requirements by March 1. For more information click here.

CMS has proposed a new experiment in payment rates for physician-administered drugs such as chemotherapy. The proposed plan would change the current formula for drug payment in two phases. The first phase reduces drug reimbursement from the current ASP + 6% to ASP + 2.5% + $16.80 for Part B drugs administered in certain zip codes. The second phase of the plan will include value based purchasing mechanisms in addition to the first phase adjustments. For more information click here

CMS has released the Next Steps Toolkit to help providers track and improve ICD-10 progress. The Toolkit includes information and resources on how to assess ICD-10 progress using key performance indicators to identify potential productivity or cash flow issues, address opportunities for improvement, and maintain progress and keep up-to-date on ICD-10. For more information click here

 

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

March 15, 2016

Forthcoming CMA webinars: Closing a Medical Practice (March 9). Register at www.cmanet.org/events. For more information click here.

Noridian/JEMAC has posted the following updates to its website: MLN Connects Provider eNews Announcements–EHR Hardship Exception Application-New FAQ; Major Commitments from Healthcare Industry to Make Electronic Health Records Work Better; Program Integrity Enhancements to the Provider Enrollment Process; EHR Incentive Program Hardship Application Deadline Extended to July 1; ICD-10 Next Steps Toolkit. For more information click here.

Medicaid EHR Incentive Program participants should refer to their respective states for attestation information and deadlines. Certain Medicaid eligible professionals may use the Registration and Attestation System as an alternate attestation method to avoid the Medicare payment adjustment (80 FR 62900 through 62901). For more information click here.

The Obama Administration denied a group of more than 50 House Democrats request to HHS that the department issue guidance on the situations in which “march-in rights” would apply, in an attempt to lower drug prices. For more information click here.

The attestation deadline for the Medicare Electronic Health Record (EHR) Incentive Program is only 3 days away! Eligible professionals, eligible hospitals, and critical access hospitals (CAHs) participating in the Medicare EHR Incentive Program must attest using the Medicare & Medicaid EHR Incentive Program Registration and Attestation System no later than Friday, March 11, 2016 at 8:59 p.m. PT. For more information click here.

ANCO and MOASC have signed onto ASCO and COA letters to CMS urging not to release a proposed rule that will announce a demo. Project focused on altering the average sales price (ASP) for drugs in certain regions of the country. For more information click here.

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March 8, 2016

ANCO and MOASC have been working diligently with the office of Assemblywoman Susan A. Bonilla, and have successfully introduced AB2209 to the California legislature. AB2209 (Bonilla): Prohibits health insurance plans from developing and implementing clinical care pathways, which are treatment plans that dictate how medical professionals practice medicine. For more information click here.

MOASC President, Warren Fong, M.D. attended the Noridian Carrier Advisory Committee on February 17, 2016. For more information click here. 

California lawmakers are expected to take action on a tax package aimed at appeasing federal regulators and preventing a $1.1 billion funding hole in the Medi-Cal budget. The state Senate and Assembly were expected to consider three bills, yesterday, that are the culmination of a special legislative session Gov. Jerry Brown called last year to adjust taxes on health insurance plans. For more information click here.

The United States Food and Drug Administration (FDA) has released an online CDERLearn continuing education (CE), credit course for health care professionals about biosimilars entitled FDA Overview of Biosimilar Products. The 90-minute course shares important information about the new type of biological product to help health care professionals make informed decisions when considering, prescribing, or dispensing biosimilar products. For more information click here.

The CMS released a sweeping final rule (PDF) yesterday that solidifies the Affordable Care Act’s coverage policies for 2017. Monday’s rule relaxes CMS’ originally proposed tight network adequacy provisions and standardized health plan options. Relaxing the aggressive proposals will likely raise concerns of consumer groups that have pushed for stronger insurance protections for patients.  For more information click here.

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

March 1, 2016.