Generic drugmakers file lawsuit challenging law barring brand-drug manufacturers from paying to delay releasing generic drugs.

This Weekly’s Hot Topics

  • Generic drugmakers file lawsuit challenging law barring brand-drug manufacturers from paying to delay releasing generic drugs. California News
  • Proposed anti-kickback statute and Stark law regulations. National News
  • Rules increase price transparency for both hospitals and insurers. CMS News

 

The California Medical Association (CMA) has prepared an updated guide for patients impacted by wildfires. As part of a new law enacted in 2018, health plans and insurers are required to act quickly to ensure patients in areas affected by wildfires and other disasters have continued access to care. To read more click here and go to California News.

Thank you for joining us at the MOASC Educational Series Program. Presentations included: USP 800 and Revisions to USP 797; Getting Ready for Medicare in 2020 and 2021; Billing & Coding Updates 2020; MACRA, MIPS, G-Codes; CMS Regulatory, Coding & Billing Updates and Southern California Benchmarks. If you would like copies of the presentations, please email the MOASC office at [email protected]. To read more click here and go to MOASC News.

Proposed anti-kickback statute and Stark law regulations issued on October 9, 2019 signal potentially significant easing of compliance concerns throughout the healthcare community. The highly anticipated proposed regulations would create new anti-kickback safe harbors (for certain “value based” arrangements, and other activities) and ease compliance with existing ones, and would create similar new Stark law exceptions (there is also a new safe harbor under the civil monetary penalties law (“CMP”).  To read more click here and go to National News.

Physician offices, ambulatory surgery centers and other health care sites will be subject to appropriate use criteria for advanced diagnostic imaging services beginning Jan. 1. Requirements include consulting an electronic clinical decision support tool before ordering advanced diagnostic imaging for patients covered by Medicare Part B, and the CMS will begin denying claims in 2021 if the CDS tool has not been consulted. To read more click here and go to CMS News.

To read the complete Caliornia Oncology Weekley Newsletter, click on the date below.

November 19, 2019 

This Weekly’s Hot Topics

  • Hear about the newly released Medicare Fee Schedule changes on 11/14. MOASC News & CMS News
  • Unintended consequences from California’s surprise billing law. California News
  • Washington legislators trying, again, to pass drug pricing legislation. National News

The State of California is urged to rescind, or amend, the Medi-Cal Fee-for-service reimbursement methodology and clawback. The San Francisco Board of Supervisors unanimously approved a resolution stating that the action taken by California DHCS harm patients seeking specialized medication. To read more click here and go to California News.

This Thursday! Plan to attend the “MOASC Educational Series Program,” November 14, 2019. Get the most recent information to prepare your practice for 2020 changes! Bobbi Buell  will bring news on the NEWLY RELEASED MEDICARE FEE SCHEDULE CHANGES and billing changes from across the board with southern California benchmarks and specific California healthplan issues; Carynne Godfrey, from Noridian, addressing specific Medicare changes; Dawn Holcombe presenting current USP800 (eff. 12/1/19) and USP797 news and further actions; Arthur Lurvey, MD, FACP, FACE, California Medicare Contractor, Noridian, Medical Director, speaking on new E&M codes for physicians’ awareness coming in 2021; and Remedios Turner, from Medi-Cal, reviewing state initiatives of coverage. Presenters will also address new imaging rules; payment changes; classification of physician relationship to patient; off-label coverage, and more. To read more click here and go to MOASC News.

Trying again this week to obtain unanimous consent to pass drug pricing legislation that would crack down on efforts by drugmakers to delay competition from generic drugs, Sen. John Cornyn, R-Texas, plans to address the objections of last week’s vote. Sens. Chuck Grassley, R-Iowa, and Dick Durbin, D-Ill., also failed in their attempt to pass by unanimous consent a measure that would require drug companies to disclose prices in television ads. To read more click here and go to National News

CMS released its final rule for reimbursement under the Medicare Physician Fee Schedule (MPFS), including proposals related to the Quality Payment Program (QPP) and E&M codes, and Hospital Outpatient Prospective Payment System (HOPPS) on November 1. To read more click here and go to CMS News.

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

November 12, 2019