ANCO FAX News. Vol. 17, No. 13 July 27 th, The ANCO FAX News has information for every member of your practice or organization. Pass it along!

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1 ANCO FAX News Association of Northern California Oncologists Post Office Box , San Rafael, California Voice: (415) FAX: (415) Vol. 17, No. 13 July 27 th, 2018 The ANCO FAX News focuses on ANCO s core activities advocacy, clinical and professional education, and Association and membership news. While membership mailings and /fax broadcasts continue, the ANCO FAX News summarizes this information in a regular forum of important news to members. Contact the ANCO office for additional information regarding any item published in the ANCO FAX News. Find the ANCO FAX News online at In this issue: ASCO & ACCC Respond to Administration s Blueprint CMS Proposes CY2019 MPFS ANCO s ASCO Highlights 2018 The ANCO FAX News is FAXed to Individual Member practices, and ed to Group, Institutional, and Corporate (contacts) Members. The next regular ANCO FAX News will be published on August 10 th. Send your comments or contributions to ANCO, P.O. Box , San Rafael, CA ; Voice: (415) ; FAX: (415) ; execdir@ancoonline.org. The ANCO FAX News has information for every member of your practice or organization. Pass it along! Physician Members Nurses & Office Managers Office Staff Colleagues & Representatives 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 ANCO FAX News is intended as general information for ANCO members. Because diagnostic, treatment, contracting, coding, and billing decisions should be made on a case-by-case basis, any such information contained in the ANCO FAX News 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 the ANCO FAX News should not be used as a substitute for such advice. Page 1 of 9

2 Page 2 of 9 ANCO FAX News ( July 27 th, 2018 ADVOCACY [Editor s Note: ANCO is a member of the Association of Community Cancer Centers (ACCC) and a state/regional affiliate of the American Society of Clinical Oncology (ASCO). ANCO and the Medical Oncology Association of Southern California (MOASC) are members of the California Medical Association s (CMA) Council on Legislation, House of Delegates, and specialty delegation. ANCO meets regularly with these and other organizations to discuss issues of importance to hematology/oncology practices and people living with cancer. We continually seek input from members on agenda items for these meetings. Send your issues to the ANCO office.] ACCC, ASCO, ASH, COA, and National Legislative & Regulatory Issues ASCO has submitted a response to the Request for Information that was included in the Administration s blueprint to lower drug prices and reduce out-of-pocket costs ( sites/default/files/americanpatientsfirst.pdf). ASCO recommended a value-based approach to address rising drug costs and made specific recommendations regarding the 340B Drug Pricing Program, reviving the Competitive Acquisition Program (CAP), moving drugs from Medicare Part B to Part D, and site neutrality proposals. Read ASCO s letter at content-files/asco-drug-pricing-rfi- Response.pdf; read ACCC s response Documents/Advocacy/pdf/accc-comments-tohhs-blueprint-rfi-final; and, read ASH s response at Testimony.aspx CMS has proposed changes to the CY2019 Medicare Physician Fee Schedule that would streamline clinical billing and expand access to high-quality care. Included in their proposed changes are a single payment rate for Level 2-5 office visits. Also included in the changes is a proposal to reimburse new drugs and drugs that do not have a reported ASP at WAC+3%. Read ASCO s focused summary at read ACCC s initial take at physician-fee-schedule-rule; read Bobbi Buell s analysis at BBMPFS2019.pdf; and, read the CMS fact sheet at MediaReleaseDatabase/Fact-sheets/2018-Factsheets-items/ html. CMS ended a proposed outcomes-based agreement to pay for tisagenlecleucel, a CAR-T therapy for the treatment of acute lymphocytic leukemia and diffuse large B-cell lymphoma. The plan had drawn scrutiny from CMS and members of Congress who contend that the model was too favorable to the manufacturer. Though CMS pulled out of the plan, the agency is not giving up on its quest to lower drug prices through new models of payment. The United States Food and Drug Administration has released its long-awaited Biosimilar Action Plan. The plan is meant to spur biosimilar competition in the U.S. marketplace by improving the efficiency of the biosimilar and interchangeable product development and approval process; maximizing scientific and regulatory clarity for the biosimilar product development community; developing effective communications to improve understanding of biosimilars among patients, providers and payers; and, supporting market competition by reducing gaming of FDA requirements or other attempts to unfairly delay market competition to follow-on products. CMS has announced that participants in the Merit-based Incentive Payment System (MIPS) for 2017 can review their MIPS final score and performance feedback on the Quality Payment Program website (qpp.cms.gov). The payment adjustment received in 2019 is based on this final score. A positive, negative, or neutral payment adjustment will be applied to the Medicare paid amount for covered professional services furnished under the Medicare Physician Fee Schedule in MIPS eligible clinicians or groups, including those who are subject to the APM scoring standard, may request for CMS to

3 Page 3 of 9 ANCO FAX News ( July 27 th, 2018 review their performance feedback and final score through a process called targeted review. If you believe an error has been made in your MIPS payment adjustment calculation, you can request a targeted review until September 30 th. ASCO and the American Society for Radiation Oncology (ASTRO) have a joint platform for quality reporting, making it easier for oncologists to comply with Federal government reporting requirements for The QOPI Reporting Registry, a Qualified Clinical Data Registry (QCDR), makes it possible for any practice with at least one active ASCO or ASTRO member to report their quality performance data either electronically or manually, based on their preference. Sign up for electronic reporting by October 1 st. Learn more at practice.asco.org/ quality-improvement/quality-programs/qopireporting-registry. CMA, MOASC, and State Legislative & Regulatory Issues The California Medical Association(CMA) has rebranded itself and launched the next generation of its website at CMAdocs.org a powerful engagement tool to provide CMA members with innovative resources for an ever-changing health care landscape. The California Department of Justice (DOJ) has certified that as of April 2 nd, the Controlled Substance Review Utilization and Evaluation System (CURES), California s prescription drug monitoring database, is ready for statewide use. The certification starts a six-month implementation period for the duty to consult requirements enacted by the Legislature in SB482. Physicians will need to consult CURES prior to writing specified prescriptions as of October 2 nd. Learn more and access CMA s CURES resources at CMA Practice Resources (CPR) is a monthly e- mail bulletin from CMA s Center for Economic Services that is full of tips and tools to help physicians and their office staff improve practice efficiency and viability. Subscribing to CPR is free and open to anyone but CMA membership is necessary to access the resources, toolkits, forms, and tools that are located on the members-only CMA website. Please visit to subscribe. Noridian/JEMAC, DHCS/MediCal, & Private Payers Noridian Administrative Services is the Jurisdiction E (JE) Medicare Administrative Contractor (MAC). Jurisdiction E includes California. Regularly review postings at the Noridian/JEMAC website at med.noridianmedicare.com/web/jeb. Recent updates include: MLN Connects Provider enews Announcements CMS Proposes Historic Changes to Modernize Medicare and Restore the Doctor-Physician Relationship; MIPS 2017 Performance Feedback User Guide; MIPS Payment Adjustment Targeted Review: Request by October 1; July Quarterly Provider Update; New Medicare Card Mailing Update-Wave 4 Begins, Wave 2 Ends Publications New MBI: Get It, Use It MLN Matters Article-Revised; Medical Review of E/M Documentation MLN Matters Article-New; Medicare Part A SNF PPS Pricer Update MLN Matters Article-New; Medicare Preventive Services Educational Tool-Revised; Chronic Care Management Services: Changes for 2017 Fact Sheet-Reminder; Chronic Care Management Services Fact Sheet-Reminder; Avoiding Medicare Fraud & Abuse: A Roadmap for Physicians Web-based Training- Reminder Nerve Blockade for Treatment of Chronic Pain and Neuropathy LCD-R13 MBI-Get It, Use It-Second Revision SE18006

4 Page 4 of 9 ANCO FAX News ( July 27 th, 2018 Medical Review of E/M Documentation CR10627 MolDX: Myriad BRACAnalysis CDX Billing and Coding Guidelines Article-R1 MolDX: Abbott RealTime IDH2 Testing for Acute Myeloid Leukemia (AML) Billing and Coding-R1 MolDX: Molecular Diagnostic Tests (MDT) LCD-R6 MolDX: ThermoFisher Oncomine Dx Target Test for Non-Small Cell Lung Cancer Billing and Coding Guidelines- R1 Robotic Radiosurgery Fee Revisions Phase In-Effective July 1, 2018-Revised Laboratory NCD Edit Software Changes for October 2018 CR10873 Additional Information Required for Coverage and Pricing for Category III CPT Codes-R5 New Waived Tests CR10819 Clinical Laboratory Fee Schedule and Laboratory Services Subject to Reasonable Charge Payment Update CR10875 SNC CB Enforcement of HCPCS Codes-2018 Annual Update CR10852 Forthcoming Noridian/JEMAC meetings/webinars/workshops include: Modifier 59, NCCI and MUEs Webinar (August 9) Visit med.noridianmedicare.com/web/ jeb/education/training-events for more information and to register. EDUCATION [Editor s Note: ANCO organizes clinical and professional education meetings throughout the year and throughout Northern California.] ANCO s ASCO Highlights 2018 ANCO s ASCO Highlights will take place on August 25 th at The Claremont Resort in Oakland. Download the meeting announcement and registration form at ASCOHL2018.pdf. SAVE THE DATE ANCO s 2018 Hematologic Malignancies Updates ANCO is organizing a series of Hematologic Malignancies Updates in These updates are supported by AMGEN, Janssen Oncology, Jazz Pharmaceuticals, Novartis Oncology, and Seattle Genetics. The next Update is scheduled for September 15 th in Palo Alto. Watch for a meeting announcement/registration form in early August. SAVE THE DATE ANCO s 2018 Professional Education Meeting ANCO will host its 2018 professional education meeting on September 19 th at The Claremont Resort. The agenda included will focus on the oncology care model. Watch for a meeting announcement in early August. Additional Education Meetings August 3 rd Proposed 2018 Medicare Regulations: Offices and Hospital Outpatient onpoint Oncology Lunch & Learn Webinar ( =aat4byabozrr&campaign=6fu6rm9aaskw) August 23 rd Highlights from the 2018 ASCO Annual Meeting: (Part I of Your Guide to the Latest Cancer Research and Treatment) CancerCare Connect Education Workshop (

5 Page 5 of 9 ANCO FAX News ( July 27 th, 2018 August 28 th Highlights from the 2018 ASCO Annual Meeting: (Part II of Your Guide to the Latest Cancer Research and Treatment) CancerCare Connect Education Workshop ( September 7-8 th ASH Meeting on Hematologic Malignancies ASH Chicago ( September 13 th The Emerging Role of Immunotherapy in the Treatment of Lymphoma CancerCare Connect Education Workshop ( September th Advocacy Summit ASCO Washington, D.C. ( September 27 th Oncology Practice Conference: The Business of Cancer Care ASCO Phoenix ( November 17 th Best of World Conference on Lung Cancer International Association for the Study of Lung Cancer San Francisco ( complimentary registration for ANCO members when you register for an Early Bird ANCO Member ticket) Please contact the ANCO office for more information about these meetings. ASSOCIATION & MEMBERSHIP NEWS, RESOURCES, & BENEFITS [Editor s Note: All ANCO members are also eligible for several tangible benefits.] Board of Directors The ANCO Board of Directors meets by teleconference and occasionally in person to discuss issues affecting the Association, clinical and professional education, and ways to better serve the membership. Board teleconferences/meetings are open to individual physician members. The next regularly scheduled ANCO Board of Directors meeting is scheduled for August 25 th. Please call José Luis González, ANCO Executive Director, at (415) if you wish to participate in a future teleconference/meeting. Individual Member News The Conquer Cancer Foundation (CCF) of the American Society of Clinical Oncology (ASCO) is now accepting applications for the 2019 Young Investigator Award (YIA). The Association of Northern California Oncologists (ANCO) is funding one 2019 YIA for a qualified northern California applicant, and urges all eligible northern California physicians to apply. The YIA is a one-year, $50,000 grant that provides research funding to promising physicians to support their transition from final years of training to faculty appointment and to encourage and promote quality research in clinical oncology. YIA applications are now being accepted and are due by 11:50PM ET on September 25 th. Eligibility criteria, award details, and the request for proposals are available on the CCF website ( For questions about the YIA or assistance with your application, please grants@conquer.org. In addition, ASCO is accepting applications for Career Development Aswards (CDAs) that provide research funding to clinical investigators who have received their initial faculty appointment as they work to

6 Page 6 of 9 ANCO FAX News ( July 27 th, 2018 establish an independent clincal cancer research program. Applications for CDAs are also due by September 25 th at ASCO is looking for tomorrow s leaders today and ANCO encourages members to apply for the year-long ASCO Leadership Development Program. Participants will gain extensive exposure to the roles and mission of ASCO, its leadership, and the Society s powerful place in developing the future of cancer care. Applicants must be ASCO members who have completed their final subspecialty training between 2000 and Learn more and apply at A current Directory of Members is available online at as a.pdf document. We urge all ANCO members to download their own edition of The ANCO Directory of Members. Please verify your Directory entry and contact the ANCO office at execdir@anco-online.org with any corrections, additions, and/or deletions. Group Member News ANCO initiated a Group Membership in 2008 based on a mutual set of perceived values and benefits and a mutual set of interests. The ANCO Board believes that the Association and The Permanente Medical Group (TPMG) will each receive value from Group Membership. ANCO initiated a Multi Site Group Membership in 2010 to encourage all physicians (medical and radiation oncologists) from multi-site and multidisciplinary practices to join. ANCO thanks Annadel Medical Group/St Joseph s Heritage Healthcare, Diablo Valley Oncology & Hematology Medical Group, EPIC Care, Marin Cancer Care, Pacific Cancer Care, and Palo Alto Medical Foundation for their multi site group memberships. Institutional Member News ANCO initiated an Institutional Membership in Department(s) of Hematology and/or Oncology of accredited, degree granting teaching universities or research institutions are eligible for institutional membership. ANCO thanks the following Institutional Members for their support: Stanford Cancer Center University of California, Davis, Cancer Center University of California, San Francisco Corporate Member News ANCO thanks the following Corporate Members for their generous support that enables ANCO to provide services to the hematology/oncology community in northern California, and to provide its members and their patients with substantial benefits in the areas of advocacy, education, and information dissemination: AbbVie Agios Pharmaceuticals Alexion Pharmaceuticals AMGEN AMAG Pharmaceuticals Array BioPharma Astellas Oncology AstraZeneca Bayer Healthcare Pharmaceuticals Boehringer Ingelheim Pharmaceuticals Bristol-Myers Squibb Oncology Celgene Clovis Oncology Daiichi Sankyo Eisai EMD Serono Exelixis Foundation Medicine Genentech BioOncology Genomic Health Gilead Sciences Guardant Health Helsinn Oncology Heron Therapeutics Incyte Janssen Oncology Jazz Pharmaceuticals Kite Pharmaceuticals Lexicon Pharmaceuticals Lilly Oncology Merck Novartis Oncology Pfizer Oncology Pfizer US Biosimilars Pharmacyclics Puma Biotechnology Sandoz Biopharmaceuticals Sanofi Genzyme Seattle Genetics Taiho Oncology Takeda Oncology TerSera Therapeutics Tesaro Teva Oncology

7 Page 7 of 9 ANCO FAX News ( July 27 th, 2018 We especially wish to thank and welcome AMAG Pharmaceuticals and Lexicon Pharmaceuticals as new Corporate Members for Agendia, Ariad Pharmaceuticals, Biotheranostics, Cardinal Health Specialty Solutions, nanosstring, and Oncology Suypply/International Oncology Network did not renew their memberships for Please visit assistance.html for Corporate Member drug reimbursement and patient assistance program information. ANCO encourages all member practices to use this resource and enroll all patients at the start of treatment in all available and appropriate patient assistance programs. Array BioPharma informs ANCO that the National Comprehensive Cancer Network (NCCN) has updated its Clinical Practice Guidelines in Oncology for Melanoma to include Braftovi in combination with Mektovi as a firstline treatment option for BRAF (V600E) or BRAF (V600K)-mutant metastatic or unresectable melanoma as a Category 1 recommendation. Agios Pharmaceuticals informs ANCO that the United States Food and Drug Administration has approved Tibsovo for adult patients with relapsed or refractory acute myeloid leukemia (AML) with a susceptible IDH1 mutation as detected by an FDA-approved test. Astellas Oncology and Pfizer Oncology inform ANCO that the United States Food and Drug Administration has approved Xtandi for the treatment of patients with non-metastatic castration-resistant prostate cancer (CRPC). Genentech BioOncology informs ANCO that the United States Food and Drug Administration has granted Breakthrough Therapy Designation for Tecentriq in combination with Avastin as an initial (first-line) treatment for people with advanced or metastatic hepatocellular carcinoma (HCC), the most common form of liver cancer. Novartis Oncology informs ANCO that the United States Food and Drug Administration has approved Kisqali in combination with an aromatase inhibitor for pre/perimenopausal women with HR-positive, HER2-negative advanced or metastatic breast cancer, as initial endocrine-based therapy. Pfizer US Biosimilars inform ANCO that the United States Food and Drug Administration has approved Nivestym (filgrastim-aafi), a biosimilar to Neupogen (filgrastim), for all eligible indications of the reference product. Sanofi Genzyme informs ANCO that they are hosting an evening discussion entitled What s Behind Your Patient s Hematological Abnormalities with Bradley Lewis, M.D., on Wednesday, August 29 th at 6PM. The discussion will take place at The Cavalier, 360 Jesse Street, San Francisco. RSVP to Lorin Sylvia at lorin.sylvia@sanofi.com; (415) Publications, Resources, Services, & Surveys ANCO and MOASC are jointly conducting a 2018 staff salary survey. The survey was USPS mailed and ed/faxed to all members in mid-may and is available online at A $50 Visa gift card for respondents is included in this year s survey. Return your completed survey no later than September 30 th ; results will be analyzed and reported in 4Q2018. ASCO invites you to participate in the 2018 ASCO Practice Census. This annual survey of the entire U.S. oncology practice community aims to capture key information on what is happening in oncology practice today and is chronicled as part of ASCO s State of Cancer Care in America initiative. Complete the Census at apps.asco.org/oncology-practicecentral/survey/#/. ASCO s Volunteer Corps offers meaningful and rewarding volunteer opportunities, short-term and virtual assignments, and flexible time commitments to ASCO members eager to volunteer, share their expertise, and give back to

8 Page 8 of 9 ANCO FAX News ( July 27 th, 2018 the oncology community. Learn more at volunteer.asco.org. ASCO University has updated its Chemotherapy Administration and Safety course at university.asco.org/chemotherapy-administrationand-safety. The Society for Immunotherapy of Cancer (SITC) is pleased to announce the publication of its Cancer Immunotherapy Guidelines for the treatment of non-small cell lung cancer (NSCLC) in the Journal of ImmunoTherapy of Cancer (JITC), the Society s open access, peer-reviewed online journal. Read the Guideline at s The ASCO Guidelines App is your go-to tool for implementing guideline recommendations into practice. This user-friendly app provides health care providers, patients, and caregivers with the recommended cancer care options for a variety of cancer types. It also includes interactive tools to inform treatment decisions at the point of care, thus increasing the quality of care provided to patients. The app is free to members and nonmembers, kept up to date, and will continue to grow as more guidelines and tools are added. Download the app at or ASCO s Clinical Affairs Department provides services, education, and resources to support oncology practices. It offers hands-on assistance in areas such as practice management, quality care assessment and improvement, and efficiency and business intelligence to meet the needs and demands of the current oncology landscape. Resources on the business of oncology, practice management (staffing, technology), practice transformation, and market analysis are available from the Department. For more information, visit ASCO recently launched myconnection, a new online community platform that provides ASCO members with the opportunity to connect, collaborate, participate in in-depth discussions, and receive feedback and resources with the nearly 45,000 members in ASCO s global network. Get started today at myconnection.asco.org/home. ASCO Practice Consulting Services & Support offers personalized services to help practices achieve operational goals. Their team of nationally recognized consultants in oncology practice management is dedicated to assisting practices succeed in today s constantly evolving practice environment. Services include readiness assessment, practice operational assessment, practice transformation implementation support, analytical services, triage pathways. For more information, read the article (featuring Peter Paul Yu, M.D., former ANCO and ASCO President) at connection.asco.org/magazine/features/ascopractice-consulting-services-and-support or visit practice.asco.org. ASCO s Practice Engagement Program helps administrators, physicians, and other members of the care team navigate ASCO tools, programs, and resources available to help oncology practices respond to the changes occurring in the cancer care delivery system. ASCO is launching ASCO Practice Central, a new website that serves as an online information hub to help oncology professionals navigate a complicated and ever-changing practice environment while providing high-quality patient care. ASCO Practice Central offers oncology practices easy-to-access information, tools, and resources that are designed to foster effective business practices and support highquality patient care. Bookmark ASCO Practice Central at practice.asco.org. ASCO s PracticeNET is a collaborative network in which practices share and receive insights to enhance their business operations and quality of care. A new video overview of PracticeNET explains how the network gives practices a unique opportunity to see how they compare to others and learn from their peers. Watch the video at

9 Page 9 of 9 ANCO FAX News ( July 27 th, 2018 Qc3BgEsyxfo&feature=youtu.be&list= PLwVG_3RvChvHZn6e86LNy_Ie9eSbZvNff. ASCO s Journal of Oncology Practice has launched a new blog to facilitate discussions on care delivery topics. The new care delivery blog, JOP DAIS (Discussion & Analysis in Short), will serve as a forum for commentary and analysis on issues affecting the mechanisms of oncology care deliver. Learn more at The July 2018 issue of ASCO s Journal of Oncology Practice (JOP) is available online and features articles entitled A New Look at the State of Cancer Care; State of Cancer Care in America; Implementation to Optimization: A Tailored, Data-Driven Approach to Improve Provider Efficiency and Confidence in Use of the Electronic Medical Record. Visit ascopubs.org/toc/jop/ current for more information. In an effort to provide a timely and in-depth examination of critical issues in cancer care, ASCO is pleased to announce the State of Cancer Care in America (SOCCA) series in the Journal of Oncology Practice. The SOCCA series will feature ASCO special articles, original research, editorials, and commentaries from ASCO leaders and invited stakeholders that explore the current challenges, opportunities, and trends in the delivery of high-quality cancer care. Learn more at ascopubs.org/doi/full/ / JOP ?cmpid=sk_jop_socca_dcn_- _all_ _read. ASCO s Education Essentials for Oncology Fellows (EEOF) has been developed specifically for Fellows as they pursue training in the field of oncology and offers access to educational content from ASCO University at a significantly reduced price. Fellows receive unlimited access to over 100 ASCO University elearning courses. Learn more at ASCO-SEP, 6 th Edition, the most comprehensive, must-have self-evaluation resource for general oncology education, is now available for purchase at ASCO University (university.asco.org/ascosep -6th-edition). Data abstraction for ASCO s QOPI Round 2 opened on July 5 th and will close on December 4 th. Round 2 final reports will be available on December 18 th. Learn more at advocacy-policy/asco-in-action/data-abstractionqopi-round now-open. ACCC s 2018 Trending Now in Cancer Care Survey is open. This survey helps cancer programs assess their strengths and areas for improvement. Participants will receive a customized report comparing their own data to national results and results will help guide the creation of tools and resources for the entire cancer care team. Complete the Survey by August 3 rd at Trending-Now-in-Cancer-Care-Survey. The Patient Access Network (PAN) Foundation is dedicated to connecting patients with the financial assistance they need to ensure access to critical medical treatment. Join them for a webinar on July 31 st at 11AM; register at NCCN has published and/or updated their Chemotherapy Order Templates, Clinical Practice Guidelines in Oncology, Drugs & Biologics Compendium, Evidence Blocks, Guidelines for Patients, Imaging Appropriate Use Criteria, and/or Radiation Therapy Compendium for: acute lymphoblastic leukemia (V1.2018), bladder cancer (V5.2018), genetic/familial high-risk assessment: colorectal (V1.2018), Hodgkin lymphoma (V3.2018), melanoma (V3.2018), multiple myeloma (V1.2019), myelodysplastic syndromes (V1.2019), rectal cancer (V2.2018), thyroid carcinoma (V1.2018). Go to for more information.