MOASC Membership Renewal Underway

We would like to thank you for being a loyal member and/or supporter of MOASC, and invite those who are not yet members, to join our collegial association and remind current members to renew your membership today.

Our association has a Board of Directors chosen from those who participate in our meetings and who desire to represent us. Our association has the purpose of representing oncologists in advising third party payers and governmental agencies regarding appropriate reimbursement for physician services, and insuring access to appropriate oncologic care for our patients.

NEW 07/30/07

<< Learn More About MOASC Membership Advantages >>

Physicians, DMHC Needs Your Comments/Complaints, Regarding Blue Cross of California - NEW 08/05/07

Dear MOASC Members,
The following is information for your opportunity to comment to the Department of Managed Health Care regarding your experiences with Blue Cross.  MOASC has presented all the concerns expressed to us by members to DMHC, and we will be attending this hearing on Tuesday.

Thank you,
Mariana

marianalamb@moasc.org

Send the following form to:  
Dept of Managed Health Care  
Via email: publiccomments@dmhc.ca.gov
Via Fax:  (916) 322-2579.

Blue Cross Complaint Form >>

DMHC Public Hearings on Blue Cross - NEW 08/05/07

The Dept of Managed Health Care will conduct public hearings regarding BLUE CROSS of California.

Date: Tuesday, August  07, 2007 ( 10 a.m. -- 3 p.m. )
Location: 320 West 4th Street , Los Angeles 90013
(in the Junipero Serra Building ’s Carmel Room Auditorium )

Get the Agenda >>

MOASC Reports on Their Meeting with Blue Cross - NEW 08/05/07

Dear MOASC Members,
I would like to report to you MOASC’s meeting with Blue Cross of California. On Tuesday, July 31, 2007, MOASC Chairman of the Board, Cary A. Presant, M.D., MOASC Director of Reimbursement, Pat Tyler and I met with representatives of Blue Cross of California, Jeff Kamil, M.D., Vice President, Chief Medical Officer; Zeinab Dabbah, M.D., Managing Medical Director, and Nidhi Jagani, Regional Vice President, Network Management.

We believe it was a good “first” foray into working collegially with Blue Cross.  They are VERY MUCH aware of their negative image with the medical, media and public communities.  They indicated they really want to change it. 

Read the Full Report >>

"My business manager spoke to the Blue Cross contract manager about the proposed fee schedule.  He wanted a "compelling" reason why I felt I needed more reimbursement than they were offering.

He was informed, among other things that Blue Cross pays less for chemotherapy than 80% of the drugs cost.  He retorted that he has 42 doctors in my area who are willing to give chemotherapy at a loss.  Therefore, loosing money on chemotherapy is not a compelling reason to abandon the cuts.

The moral of the story: Doctors are hurting themselves!  

As long as doctors are willing to provide chemotherapy to Blue Cross beneficiaries, Blue Cross feels that it is paying us too much.  This feeling is regardless of the economic fact that we lose money with each chemotherapy administration.

Doctors cannot make up this loss up by increasing their volume.  Seeing more Blue Cross patients will increase your losses.

Don't be part of the problem……. "

W.Fong, M.D.

Dr. Quinn, NHIC Medical Director Responds to MOASC ESA Questions NEW 08/05/07

MOASC posed five questions to California NHIC Medical Director, Dr. Bruce Quinn, regarding CMS’ NCD on ESA’s. 

Read the Q&A >>

CMS Reaches National Coverage Decision on ESA's in Cancer and Neoplastic Disease Treatment - NEW 07/30/07

This afternoon the Centers for Medicare & Medicaid Services (CMS) issued a final national coverage decision (https://www.cms.hhs.gov/mcd/viewdecisionmemo.asp?id=203) on the use of erythropoiesis stimulating agents (ESAs) in cancer and related neoplastic conditions. ASCO is currently reviewing the coverage decision in detail in order to provide members with a comprehensive summary.

Following is a brief synopsis of the key provisions in the final coverage determination as outlined by CMS.

1) CMS has not implemented any restrictions on the use of ESAs in patents with myelodysplastic syndrome (MDS).

2) CMS has determined that the use of ESAs is *not* reasonable and necessary for Medicare beneficiaries with the following conditions:

-Any anemia in cancer or cancer treatment patients due to folate deficiency, B-12 deficiency, iron deficiency, hemolysis, bleeding, or bone marrow fibrosis;

-The anemia associated with the treatment of acute and chronic myelogenous leukemias (CML, AML), or erythroid cancers;

-The anemia of cancer not related to cancer treatment;

-Any anemia associated only with radiotherapy;

-Prophylactic use to prevent chemotherapy-induced anemia;

-Prophylactic use to reduce tumor hypoxia;

-Patients with erythropoietin-type resistance due to neutralizing antibodies; and

-Anemia due to cancer treatment if patients have uncontrolled hypertension

3) CMS has determined that ESA treatment for the anemia secondary to myelosuppressive anticancer chemotherapy in solid tumors, multiple myeloma, lymphoma, and lymphocytic leukemia is only reasonable and necessary under the following conditions:

-The hemoglobin level immediately prior to initiation or maintenance of ESA treatment is < 10 g/dL (or the hematocrit is < 30%).

-The starting dose for ESA treatment is the recommended FDA label starting dose, no more than 150 U/kg/three times weekly for epoetin and 2.25 mcg/kg/weekly for darbepoetin alpha. Equivalent doses may be given over other approved time periods.

-Maintenance of ESA therapy is the starting dose if the hemoglobin level remains below 10 g/dL (or hematocrit is < 30%) 4 weeks after initiation of therapy and the rise in hemoglobin is > 1g/dL (hematocrit > 3%).

-For patients whose hemoglobin rises < 1 g/dl (hematocrit rise < 3%) compared to pretreatment baseline over 4 weeks of treatment and whose hemoglobin level remains < 10 g/dL after the 4 weeks of treatment (or the hematocrit is < 30%), the recommended FDA label starting dose may beincreased once by 25%. Continued use of the drug is not reasonable andnecessary if the hemoglobin rises < 1 g/dl (hematocrit rise < 3 %) compared to pretreatment baseline by 8 weeks of treatment.

-Continued administration of the drug is not reasonable and necessary if there is a rapid rise in hemoglobin > 1 g/dl (hematocrit > 3%) over 2 weeks of treatment unless the hemoglobin remains below or subsequently falls to < 10 g/dL (or the hematocrit is <30%). Continuation and reinstitution of ESA therapy must include a dose reduction of 25% from the previously administered dose.

-ESA treatment duration for each course of chemotherapy includes the 8 weeks following the final dose of myelosuppressive chemotherapy in a chemotherapy regimen.

4) CMS has confirmed that local Medicare contractors may continue to make reasonable and necessary determinations on all uses of ESAs that are not determined by NCD.

ASCO has contacted CMS to clarify the policy's implementation date and will follow up with additional information in this regard.

Therese M. Mulvey, MD
Chair, ASCO Clinical Practice Committee

Questions and Answers related to NCD 000383: ESAs in Cancer and Neoplastic Conditions - NEW 08/01/07

Read the Q&A's posted on the CMS website about the new ESA policy.

Save The Date!
Oncology Congress /ChicagoSupportive Oncology Conference - UPDATED 07/25/07

It is my pleasure to invite you to the Oncology Congress and the Chicago Supportive Oncology Conference.

Oncology Congress is September 6-9 at the Hilton San Francisco.  MOASC will host the Congress welcome reception on Friday evening where we hope to see many of our members.

Read More Details >>  
Get the Brochure >>

MOASC Members Receive Complimentary or Discounted Rates to Attend Oncology Conferences

The Oncology Congress presents comprehensive, practical information focused on patient care. Developed by a diverse board of advisors representing centers of excellence, the content focuses on current research findings and their impact on clinical practice and strategies for treating a wide range of cancers. This program encourages peer-to-peer interaction and debate. September 6-9 at the Hilton San Francisco . The first 50 members to register for Oncology Congress will receive complimentary registration, after that the rate is $695 for doctors and $295 for nurses – enter priority code VIP4 when registering to receive this discount.

While the Oncology Congress focuses primarily on curative therapies, with a handful of sessions available for discussion of the essential supportive care measures, the Chicago Supportive Oncology Conference concentrates on providing oncologists and clinicians an overview of state-of-the-art symptom and side-effect management, communication issues, and end-of-life care for patients with cancer. September 27-29 at the Hyatt Regency Chicago . Our discounts for this meeting are $295 for MDs, $195 for nurses and physician assistants, and free for fellows. Use priority code SP5 when registering at www.chicagosupportiveoncology.com.

Save The Date!
A Special Invitation from McKesson Specialty Oncology Services and MOASC - NEW 07/25/07

Learn how to achieve clear, concise, practice-level reimbursement analyses to help improve your bottom line and confidentially benchmark your financial performance against similar practices. Join us for a Web demo to see how TotalView™ will help your practice better understand claims and remittance data to maximize reimbursement for procedures performed at your facility.

Tuesday, September 11th 12pm, Pacific Time or
Wednesday, September 19th 1pm, Pacific Time

Download the Flyer >>

MOASC Partners With RemitData - Posted 06/20/07

Using just a few of RemitDATA’s management tools you too will be able to answer the key questions of successful practices, such as:

-How often am I being denied – for what reasons – on which procedures – by which payers?
-How do my reimbursement metrics above compare to my peers?
-Are we leaving any money on the table and if so where?
-How can I maximize my cash flow, and decrease my costs of collections?

Help MOASC set the standard of successful practices by utilizing this exciting new partnership with RemitDATA. And, for a limited time, MOASC members can try RemitDATA for 30 days at NO CHARGE to see if it would be a great resource for your practice.

Please call 866-885-2974 x 2011, or email mtrogdon@remitdata.com, or click www.remitdata.com for more info. RemitDATA – helping you ‘Get What’s Coming To You!’

See what practices have to say >>

Special J-Code Review Offer for MOASC Members - Posted 06/19/07

Leaverage the expertise of an oncology consultant pharmacist and enhance your practice performance. By working with Oncology Pharmaceutical Services, you can benefit from an on-site consultant pharmacist, powerful network drug contracting and related services.

To make arrangements for this J-Code Review offer please call Randy Harken at (310)-694-6871 or email at randy.harken@usoncology.com

For the past five years, it's been an annual cycle: CMS proposes pay cuts and outraged physicians and medical associations demand that Congress reform the broken payment system. Unable to come to an agreement on a long-term fix, Congress then acts at the last minute to stop the cuts. What makes this year different is the magnitude of the cut. Doctors face a 9.9 percent cut in 2008 because Congress blocked the scheduled cuts over the past five years, increasing rates 1.6 percent in 2003 and 1.5 percent in 2004 and 2005. Congress froze rates in 2006 and 2007.

Physicians must contact their members of Congress and tell them to stop the 10 percent cut, says CMA President Anmol S. Mahal, M.D. Physicians cannot sustain such an enormous cut when our rates are already less than those paid by Medicare in 2001.

If Congress fails to reform the flawed payment formula, projections have physician reimbursement being cut by roughly 40 percent over the next nine years. Practice costs are expected to increase 20 percent during that same time period.

CMA recently submitted to Congress a multipronged proposal to overhaul the broken payment system. The proposal would, among other things, eliminate the SGR formula and provide payment updates based on actual practice cost increases.

Democratic leaders in the U.S. House of Representatives are feverishly working on legislation that incorporates many elements from CMA's reform proposal. Their plan would stop the 10 percent physician pay cut and institute payment increases for two to three years or until a long-term alternative to the SGR payment system can be crafted. The legislation would also fund the reauthorization of the Healthy Families program that has covered uninsured children in California for nearly a decade.

These reforms would be paid for by increasing the tobacco tax, which would raise $35 billion, and equalizing Medicare Advantage health plan rates with fee-for-service rates. Currently, Medicare Advantage plans receive on average 12 percent more than fee-for-service physicians for providing the same services to Medicare beneficiaries. Bringing plan rates in line with fee-for-service physician rates could save as much as $65 billion. This legislation could come up for a vote in the next few weeks. '

Please contact your members of Congress immediately and tell them to support Medicare payment reform. Call AMA’s grassroots hotline at 800/833-6354, enter your zip code when prompted and you will be automatically connected with your representative.

Notice to Sole Proprietors and Solo Practitioners – NPI and Medicare - NEW 07/25/07

Changes in the enrollment process over the years have caused some differences between the NPI and Medicare identification number assignment process. This may require some providers to complete an 855I enrollment form in order for their NPI and Medicare numbers to match.

The enclosed decision chart is designed to assist you in determining if you will need to complete a new enrollment form for Medicare before you start using your NPI numbers. Providers particularly affected by the changes include solo incorporated practitioners (Professional Corporations, LLC, Professional Associations, Corporations). These providers are considered a group or entity for Medicare number assignment.

Contact Customer Service at 877-527-6613 if you require assistance.

Read the CMS Notice >>
Read the NPI Decision Chart >>

Prostate Cancer Research Institute - Posted 06/19/07

The Prostate Cancer Research Institute, an organization dedicated to educating Prostate Cancer patients and their families, is proud to announce the 2007 National Conference on Prostate Cancer, taking place Friday, September 7 through Sunday, September 9, 2007 at the LAX Marriott Hotel. www.pcri.org.

Download the brochure and registration information packet >>

Save The Date!
Seventh Annual Women's Cancer Conference - Posted 06/30/07

November 2-4, 2007
Wynn Hotel & Casino
3131 Las Vegas Blvd.
Las Vegas, NV 89109

Register Online Now!

Overview/Need
Breast, cervical and ovarian cancers are three of the most common cancers among American women, with over 212,060 newly diagnosed cases and 45,658 deaths projected for 2007 by the Cancer Institute.  Colorectal cancer will be diagnosed in another 74,630 American women and an estimated 26,180 will die of the disease by the end of 2007, making colorectal cancer the third leading cause of cancer death among American women. Recognizing that patient quality of life and survival rates for these cancers are significantly improved when they are detected early and treated appropriately. There is a need for physicians to remain current on the rapidly evolving approaches to their diagnosis and treatment.  Read More >>

Save The Date!
New Technologies and Innovative Treatment Strategies for Genitourinary Malignancies - Posted 06/30/07

September 28 to 30, 2007
Hotel Del Coronado
San Diego, California

Register Online Now!

Overview
Cancers of the genitourinary (GU) tract, namely prostate, bladder and kidney cancer, are quite common. Prostate cancer is the most frequently diagnosed solid tumor in men and second only to lung cancer as the leading cause of cancer related deaths among men in the U.S.. The American Cancer Society projected 61,420 new cases of bladder cancer and 13,060 bladder cancer deaths in the U.S. in 2006.  Since the 1950s, kidney cancer has increased at a rate of nearly 2 percent per year in the U.S. with 38,890 patients being diagnosed in 2006 and 12,840 dying from the disease. Read More >>

Medicare Coverage Convoy - Posted 06/30/07

Medicare will be conducting a billing and coverage workshop program at a location near you for the registration fee of $95.00.

NHIC, your Medicare Contractor for Part B in California, is offering these special workshop programs that consist of:

TOPICS	CLASS DESCRIPTION
New Biller Express	This Introduction to Medicare workshop covers billing basics including completion of the new 1500 claim form, Appeals, ABN and more
Medicare Updates - Setting Course for the Fall of 2007 into 2008	A review of the updates to the Medicare program for the Fall of 2007 continuing into 2008
The Route to Prompt PT/OT Payments	Billing and coverage requirements for Physical and Occupational Therapy
Pathway to Oncology	Oncology billing – the quickest way to proper payment
Modifier Mapping	Correct modifier usage and billing tips
Avoid Claim Payment Detours	New tips to eliminate and/or reduce claim payment errors
Navigating Evaluation and Management Documentation Guidelines	A look at the guidelines for proper E/M documentation and some tips on avoiding common pitfalls
Preventive Services - Your Map to Information	Find out what Preventive services are covered and the guidelines for coverage and billing
The Provider/Patient Financial Relationship	This session will discuss the financial responsibilities of both the provider and patient under Medicare Part B (eligibility, ordering/referring services, MSP, overpayments, ABN’s and more.)

Click Here for registration information >>