MOASC General Membership Meeting

November 15, 2007 aboard the Queen Mary

*NOTED SPEAKERS*

Honorable Ed Hernandez, State Assemblyman
Patricia A. Winger, CCRC, Director of USON’s Clinical Research Network
Lesli Lord, MPN (MOASC Purchasing Network) Executive Director

Download the Meeting Flyer >>

Fundraiser for Honorable Ed Hernandez, State Assemblyman - NEW 09/05/07

It is absolutely critical that we involve ourselves in the legislative process in our state. State laws control everything from the way we conduct our practices to the way we interact with health insurance companies to how we treat our patients.

Fortunately, we have people like Assemblyman Ed Hernandez serving in Sacramento. As a health care professional, Assemblyman Hernandez understands the challenges we face as practicing oncologists in California.

In that regard, MOASC is hosting a fundraising event for Assemblyman Hernandez on November 15, 2007 at the Queen Mary in Long Beach during our general membership meeting. We invite your participation and support.

Read the Announcement >>

ONS Meeting Reminder - NEW 08/29/07

Attention  ONCOLOGY NURSES !

I would like to remind you of the Certification in Chemotherapy/Biotherapy Course scheduled for Friday, October 26 & Saturday, October 27. 

To ensure adequate space and materials are provided, please respond to the MOASC Office immediately. 

Please COPY AND PASTE the following into an email or FAX to the MOASC office at (909)985-8581 and indicate your choices appropriately:

Need a room reservation? Y/N
(If more than one are attending from one practice, we encourage you to share a room. Thank you.)
Arrival Thursday, October 25, 2007? Y/N            
Double Queen Room? Y/N
Single King Room? Y/N

If you have any questions, please call or email me at the MOASC Office at (909) 985-9061.

Thank you,
Stella Cruzalegui
Medical Oncology Association of Southern CA
email: moasc@moasc.org

The 2007 ASH State-of-the-Art Symposium - NEW 08/29/07

September 28-29, 2007
Philadelphia, PA

The 2007 ASH State-of-the-Art Symposium (SAS) will feature leading hematology experts exploring the latest research and treatment options for hematologic malignancies. This informative CME conference is a clinically focused event where you can interact with experts in the field and discuss some of the most rapidly evolving developments in the treatment of leukemia, lymphoma, myeloma, and stem cell transplantation, as well as the best practices for pay-for-performance.

Advance registration is now open! Learn more >>

This meeting is presented by the American Society of Hematology (ASH) in conjunction with the Pennsylvania Society of Oncology and Hematology (PSOH).

CMA: You Wanted to Know: Do State-Approved Security Prescriptions Meet Federal Medicaid Standards?- NEW 08/31/07

Answer: Yes. California’s security prescription requirements exceed the new federal Medicaid security prescription standards.

A federal law that takes effect October 1 requires that all Medicaid prescriptions be written on tamper-resistant prescription pads. Specifically, the law requires that Medi-Cal prescriptions be written on pads that have one or more industry-recognized features that prevent unauthorized copying, erasure or other modification, or counterfeiting. By October 1, 2008, pads must meet all three standards.

Read the article >>

California Physicians and Groups Received RICO Settlement Checks Worth $18.6 Million this Month - NEW 08/31/07

As reported two weeks ago in CMA Alert, checks were recently mailed to the nearly 12,000 California physicians and physician groups that filed claims under the Health Net settlement. CMA has learned that California physicians received a total of $13.5 million, which represents over one third of the $40 million settlement.

Read the article>>

According to a press release by Pharmion, Vidaza™ (azacitidine) significantly improves survival compared with conventional care in the treatment of myelodysplastic syndromes.

Myelodysplastic syndromes (MDS) are a group of blood (hematologic) disorders that are diagnosed in 10,000 to 20,000 individuals annually in the U.S. MDS occurs when immature blood cells do not mature properly and cannot perform their intended function. They instead crowd out normal blood cells in the bone marrow, often keeping other cells from performing their intended functions. Read More >>

Blue Cross Begins Paying PPO Patients Directly - NEW 08/29/07

CMA last week learned that Blue Cross has begun reimbursing patients, rather than physicians, for nonemergency out-of-network PPO services. Letters regarding this policy change, which took effect June 23, went out to brokers and employers but neither patients nor physicians were notified of this change. 

In the past, Blue Cross paid nonnetwork physicians directly for services that were covered under a patient’s benefit plan. Now, Blue Cross will send the patient a check, and the patient will be responsible for paying the physician. Read More >>

More Articles on Blue Cross
================================

LA Times Article on Hearing >>

Cumulative Articles on Blue Cross >>

Blue Cross Anthem Merger Agreement 2004 >>

The Reopening Process – Updated- NEW 08/31/07

NHIC, Corp. often receives requests to correct a claim as a result of a billing error, carrier error, or a
change in a fee schedule which is retroactive to an earlier part of the year. These are referred to as
reopenings. Reopenings may be requested within one year of the initial claim decision (date of remittance),
and are granted at the carrier’s discretion. Reopenings may be pursued as a:
1. Telephone reopening
2. Written request for a reopening

Read the Update >>

Lifting the National Provider Identifier (NPI) Crosswalk Bypass Logic - NEW 08/30/07

Since October 2, 2006, providers have been encouraged to submit both the NPI and Medicare legacy identifier (PIN) on their claims.  During this timeframe providers were not penalized for invalid NPI/legacy ID combinations.

Effective September 17, 2007 , NHIC, Inc. will begin editing the NPI/legacy ID combinations for validity against the NPI crosswalk file. Where a match cannot be located on the crosswalk, claims will be rejected or returned to the provider. 

Read the Notice >>

CMS Issues Final Rule Prohibiting Physician Self-Referral - NEW 08/29/07

CMS today issued final regulations prohibiting physicians from referring Medicare patients for certain items, services and tests provided by businesses in which they or their immediate family members have a financial interest.

This regulation is the third phase of the final regulations implementing the physician self-referral prohibition commonly referred to as the Stark law.

“These rules protect beneficiaries from receiving services they may not need and the Medicare program from paying potentially unnecessary costs,” said Herb Kuhn, CMS acting deputy administrator.

This third phase of rulemaking (Phase III) responds to public comments on the Phase II interim final rule published March 26, 2004 in the Federal Register.  The rule does not establish any new exceptions to the self-referral prohibition, but rather makes certain refinements that could permit or, in some cases, require restructuring of some existing arrangements, CMS officials explained.

For view the entire press release, please click here: http://www.cms.hhs.gov/apps/media/press_releases.asp

To read the final rule, which was put on display, and will be publish in the September 5, 2007 Federal Register click here: http://www.cms.hhs.gov/PhysicianSelfReferral/

PRG Schultz Audit Help - NEW 08/29/07

For those of you being audited by PRG Schultz, below is the website link on the CMS website for 2004 MMA drug payment limits. Click Here >>

Special Comment from Mariana Lamb, MOASC Executive Director Regarding PRG Schultz Audits

DEAR MOASC MEMBERS,

THROUGH  MANY TELECONFERENCES BETWEEN CMS, PRG SHULTZ AND MOASC BOARD MEMBERS;  AND MANY FOLLOW-UP PHONE CALLS BY PAT TYLER, MOASC’S DIRECTOR OF REIMBURSEMENT, TO CMS AND PRG SCHULTZ, WE HAVE BEEN ASSIGNED A SPECIFIC PERSON AT PRG SCHULTZ TO WORK WITH MOASC IN RESOLVING MOASC MEMBER ISSUES REGARDING THE CMS/PRG SCHULTZ AUDIT.

 MOASC HAS BEEN SUCCESSFUL IN RESOLVING MANY SPECIFIC MEMBER ISSUES WITH THE CMS/PRG SCHULTZ AUDIT.

MOASC IS AWARE OF CONTINUED MEMBER PROBLEMS WITH THE CMS/PRG SCHULTZ AUDIT.

NOW THAT MOASC HAS A SPECIFIC REPRESENTATIVE TO RESOLVE MOASC MEMBER ISSUES,  PLEASE CONTINUE TO FORWARD YOUR PROBLEMS REGARDING THE CMS/PRG SCHULTZ AUDIT TO PAT TYLER.

 PLEASE PROVIDE PAT WITH:

1)       A SYNOPSIS OF THE PROBLEM,

2)       HOW MANY PATIENTS,  OR DATES OF SERVICE, THIS ONE PROBLEM REPRESENTS,

3)       ONE COPY OF THE CMS/PRG SCHULTZ LETTER REFLECTING THIS SYNOPSIS,  AND

4)       ONE COPY OF THE  EOMB AND ONE COPY OF THE RELATED CLAIM REPRESENTING THE PROBLEM.

E-MAIL TO PAT@MOASC.ORG OR FAX TO 909-985-8581 ATTN: PAT.

THANK YOU FOR ALLOWING US TO ASSIST YOU IN RESOLVING YOUR CMS/PRG SCHULTZ AUDIT PROBLEMS. 

SINCERELY,
MARIANA

Billing Guidelines for ESA's - NEW 08/29/07

The following link should take you to the September Medicare B Resource Newsletter, where you will find the Billing Guidelines for ESA's on Page 113.

http://www.medicarenhic.com/news/provider_news/mbr_sept07.pdf

Special Comment from Pat Tyler, MOASC Director of Reimbursement emailed to the MOASC membership 08/29/07:

TO ALL MOASC MEMBERS;

THE MOASC OFFICE NOTIFIED YOU THAT THE SEPTEMBER MEDICARE B RESOURCE HAD PUBLISHED BILLING GUIDELINES FOR ERHTHROPOIETIN STIMULATING AGENTS (ESAS) IN CALIFORNIA ONLY.

THIS GUIDELINE IS MISLEADING.

THE NATIONAL COVERAGE DETERMINATION (NCD) PUBLISHED ON JULY 30, 2007, STATE CHANGES FOR ANEMIA DUE TO CHEMOTHERAPY (Hgb to 10), AND NO COVERAGE FOR ANEMIA OF CANCER UNRELATED TO CHEMOTHERAPY, DUE TO LACK OF EVIDENCE.

THE NCD MAKES NO CHANGES OTHER THAN JUST DISCUSSED.

THE LOCAL COVERAGE DETERMINATION WOULD COVER OTHER DIAGNOSTIC CRITIERA.  

PLEASE READ THE BILLING GUIDELINES CAREFULLYI

PLEASE CALL THE MOASC OFFICE WITH ANY QUESTIONS.

Pat Tyler
Medical Oncology Association of Southern CA

Save The Date!
Oncology Congress /ChicagoSupportive Oncology Conference - Posted 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 - Posted 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

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 >>