DHCS releases its finalized telehealth policy for Medi-Cal FFS

This Weekly’s Hot Topics

  • DHCS releases its finalized telehealth policy for Medi-Cal FFS. California News
  • Control of workload, work-life balance and office atmosphere are factors that contribute to physician burnout and should be addressed along with EHR concern. National News
  • Significant changes to MOC standards. Affiliate Association News

DHCS released its finalized telehealth policy update for the following: Medi-Cal (California’s Medicaid Program) fee-for-service program; An All Plan Letter (APL) for Managed Care; Indian Health Services, Memorandum of Agreement (IHS-MOAs); Family Plan, Access, Care and Treatment (Family PACT); Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs). The policies were effective as of July 1, 2019 though only just released in their final form this month. For more infromation click here and go to California News.

Control of workload, work-life balance and office atmosphere are factors that contribute to physician burnout and should be addressed along with EHR concerns, according to a study published in JAMA Network Open. Forty-five percent of the 282 providers surveyed reported burnout symptoms. For more infromation click here and go to National News.

CMS has issued the FY2020 Hospice Payment Rate Update final rule and ASH has commented on the final rule’s provisions related to coverage for palliative blood transfusions, the topic of ASH’s recently released statement in support of palliative blood transfusions in hospice setting. For more infromation click here and go to CMS News.

Community Oncology Alliance (COA) continues to contract with the law firm Frier Levitt to assist oncology practices with the cumbersome interaction with PBM’s. Frier Levitt has provided the following action plan for anyone that is experiencing slow rolling on their CVS application on getting into network below. It can also be found on the COPA website under “Member Tools” and then select “PBM – Take Action” Jon and Jesse’s contact info is located on that page as well for directly speaking to them on any matter.  For more infromation click here and go to Affiliate Association News.

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

August 27, 2019

This Weekly’s Hot Topics

  • MOASC mourns the passing of Fredrick Rundall II, M.D. MOASC News
  • DMHC now required to review unfair billing patterns complaints. California News
  • The Virtual Research and Development Center to accelerate research into new cancer treatments. National  News

Anthem Blue Cross has notified physicians that it will begin conducting pre-payment reviews for claims with certain modifiers for dates of service on or after October 1, 2019. The pre-payment modifier review will focus on claims with modifiers 25, 59, 57, LT/RG, and other anatomical modifiers to determine whether it is appropriate for the modifier to bypass the edit. To read more click here and go to California News.

ATTENTION PHYSICIANS, NURSES, PHARMACISTS AND ALL CLINICAL STAFF! Save the date for the MOASC LunchTime Series webinar, “The Venetoclax CLL Scientific Story, Wednesday, August 28th at 12:00pm Pacific time. To read more click here and go to MOASC News.

Telehealth utilization between patients and health care providers not based at hospitals grew from 0.007% of all medical claim lines in 2014 to 0.104% in 2018, according to a FAIR Health analysis of data from more than 29 billion private health care claims. The usage increase was more pronounced in urban than in rural areas, and 31- to 40-year-olds accounted for 21% of all telehealth claim lines. To read more click here and go to National News.

The provisions of the SUPPORT Act that impact the Open Payments program and the additional proposed CMS changes appear as a rider to the 2020 Physician Fee Schedule. The CY 2020 Medicare Physician Fee Schedule Proposed Rule with comment period was placed on display at the Federal Register on July 29, 2019. CMS will accept comments on the proposed rule until September 27, 2019 and will respond to comments in the final rule. To read more click here and go to CMS News.

 

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

August 20, 2019

This Weekly’s Hot Topics

  • PBMs have the authority to trump a doctor’s medical judgment. Protect your patients’ access to YOUR cancer care. California News
  • This Sunday, August 12th, send YOUR ideas to reduce unnecessary administrative burdens! National News
  • NOW is the time to get your representative and senator to Sit in My Chair! Affiliate Association News

The California Medical Association asks all California practices to schedule appointments with their Members of Congress during the month-long August Congressional Recess, August 1 – September 9, to discuss CMA’s Congressional priorities which include the surprise medical billing legislation moving swiftly through Congress. To read more click here and go to California News.

THIS SUNDAY, August 11 comments are due for YOUR ideas to reduce unnecessary administrative burdens for regulatory, sub-regulatory, policy, practice and procedural changes for clinicians, providers, patients and their families! COA has been asked to participate in an RFI project as part of the “Reducing Administrative Burden to put Patients over Paperwork” that was initiated by the Administration through an Executive Order in 2017. Please provide specific areas of concern that might be included in the COA comments including any specific solutions that you may like to offer. To read more click here and go to National News.

CMS has released proposed rules for the 2020 Medicare Physician Fee Schedule (MPFS) and other changes to Medicare Part B payment policies, including proposals related to the Quality Payment Program (QPP).  Cursorily, the conversion factor increased a bit, so depending on E&M billing practices physicians may see a slight bump. CMS estimates a 0% overall impact for both the hematology/oncology and radiation oncology specialties in 2020. Depending on how CMS implements the collapsing of 1-4 level codes, while retaining level 5. To read more click here and go to CMS News.

The time is NOW, during the August congressional recess (August 1 – September 9) to get your representative and senator to Sit in My Chair! COA continues to make organizing a policymaker visit easy with the new and improved Sit in My Chair toolkit. It offers everything your practice needs to curate a moving and memorable experience, from checking policymakers into your waiting room, walking them through diagnosis, having them sit in a chemotherapy chair for treatment, and more. To read more click here and go to Affiliate Association News.

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

August 6, 2019