Last week, TACOS joined with the Association of Community Cancer Centers (ACCC), American Society of Clinical Oncology (ASCO), the Community Oncology Alliance (COA), and approximately 100 other organizations in a letter to HHS Secretary Sylvia Burwell and Acting CMS Administrator Andy Slavitt expressing “strong concern” about the agency’s plans to put forward a proposed rule for the Medicare Part B Drug Payment Model and asking the agency not to proceed with the initiative.
The rule is scheduled to be published in the March 11 Federal Register. Comments on the proposed rule are due by May 9.
AstraZeneca announced that the FDA has approved a new indication expanding the use of Faslodex®(fulvestrant) to include use in combination with palbociclib. The combination use is for the treatment of women with hormone receptor-positive (HR+), human epidermal growth factor receptor 2 negative (HER2-) advanced or metastatic breast cancer (MBC) whose cancer has progressed after endocrine therapy.
Faslodex has been approved since 2002 as a monotherapy for the treatment of postmenopausal women with HR+ MBC whose cancer has progressed following antiestrogen therapy.
Read the full corporate announcement here.
To raise awareness and advance cancer treatment and science, the American Cancer Society and Genentech have teamed up to provide About Clinical Trials (ACT).
ACT is a series of unbiased videos and patient resources. Study participants, clinicians, thought leaders, nurses, and others share their experience in order to educate and inspire patients, caregivers, and physicians to act by considering enrollment in cancer clinical trials. Society Chief Medical Officer Otis W. Brawley, MD, is featured.
Go to LearnAboutClincialTrials.org to learn more about clinical trials and access resources to help patients make educated decisions about their treatment, including the American Cancer Society's Clinical Trials Matching Service. Constituents may also call the American Cancer Society National Call Information Center (NCIC) at 800.227.2345 to receive a free patient kit, which contains an educational brochure with a DVD and USB drive, and also directs inquiries to the Clinical Trials Matching Service.
August 27 at Noon, EST, join Niesha Griffith, RPh, MS, FASHP, Administrator of Oncology Pharmacy and Infusion Services at the Arthur G. James Cancer Hospital and Richard J. Solove Research Institute at The Ohio State University and Bill McGivney, PhD, Principal of McGivney Global Advisers for a complimentary webinar to discuss the intricate coverage and reimbursement issues related to immuno-oncology agents. Brought to you by the Institute for Clinical Immuno-Oncology (ICLIO) An Institute of ACCC.
Discussion will include:
-Determination of coverage and reimbursement for I-O agents
-Present coverage for I-O agents
-Impact of new Oncology Value Metrics
-Institutional considerations and needs
-Assurance of explicit, timely, and clear coverage policies
-Reimbursement issues in contracting, pilot projects etc.
Click here to register.
August 14, 2015
ACCC members are invited to join Dr. Michael Postow for an interactive webinar on the role of immunotherapy in treating patients with advanced melanoma. As part of the Principles and Application of Immunotherapy of Cancer series, this free, CME/ANCC/APCE-certified webinar will be held this Friday, May 22, from 7:30 am - 8:30 am ET.
View the agenda and register for the May 22 webcast today! Please share this webinar with all members of your team who provide care for patients with melanoma.
Your cancer program can host a private webinar on integrating immunotherapy into the treatment of melanoma or lung cancer, at no charge. Email Lorna Lucas or call 866.690.9902 for more information.
May 20, 2015
The Association of Community Cancer Centers (ACCC), on behalf of TACOS, has joined HHS' Health Care Payment Learning and Action Network, a collaborative network of payers, employers, providers, patients, states, and consumer groups, who will work together to generate knowledge, capture best practices, disseminate information, and apply lessons learned that support the increased adoption of value-based payments in Medicare.
The network was created in tandem with HHS Secretary Burwell's January announcement that set tangible goals to shift Medicare payments towards value-based payments.
April 3, 2015
On Feb. 18, 2015, Celgene Corporation announced that the U.S. Food and Drug Administration (FDA) has expanded the existing indication for Revlimid (lenalidomide) in combination with dexamethasone to include patients newly diagnosed with multiple myeloma.
Read company press release here.
March 3, 2015
Principles and Application in Immunotherapy of Cancer is a CME/ANCC/ACPE certified education series designed for multidisciplinary oncology care teams. Presented in an interactive webinar format, the series will provide a full overview of the core principles of immunotherapy and a review of issues related to the clinical application of these therapies in Melanoma and Lung Cancer from the convenience of your own office. Cancer practices can choose to participate in one or both of these 60-minute tumor-specific tracks. The series has been developed by a faculty committee composed of 1 physician expert and 1 nurse practitioner along with input from 10 additional presenting faculty.
This private webcast provides your practice with exclusive access. The format is designed so that your team members can learn and connect directly with expert faculty well versed in immunotherapy principles and clinical application. The opportunity is available at no cost to participating practices.
This series is jointly provided by Postgraduate Institute for Medicine and Clinical Care Options, LLC, in partnership with ACCC.
If your cancer practice is interested in participating, or if you would like more information, please contact me at directly at firstname.lastname@example.org.
February 3, 2015
Pharmacyclics, Inc. has made some changes to the YOU&i™ Instant Savings Program. New and current eligible patients will benefit from a lower out-of-pocket cost per month and a higher yearly maximum benefit.
September 16, 2014
On July 28, 2014, the U.S. Food and Drug Administration (FDA) expanded the approved use of Imbruvica (ibrutinib) to treat patients with chronic lymphocytic leukemia (CLL) who carry a deletion in chromosome 17 (17p deletion), which is associated with poor responses to standard treatment for CLL. Imbruvica received a breakthrough therapy designation for this use.
The FDA is also approving new labeling to reflect that Imbruvica’s clinical benefit in treating CLL has been verified. In February 2014, Imbruvica received accelerated approval to treat CLL based on its effect on overall response rate. New clinical trial results examining progression-free survival and overall survival have confirmed the drug’s clinical benefit.
Read the FDA press release here.
August 13, 2014
Sign up today for an informational webinar on claims and coding for Xofigo®. Presenters will provide information on payer requirements for the coding and billing of Xofigo®, as well as considerations for claims submission and appeal.
The presenters will also provide an update on:
• Coding specifics for Xofigo® in the freestanding center and hospital outpatient department
• MAC billing and coding trends
• Claims submission and an overview of the appeals process.
To reserve your space, please visit www.regonline.com/XofigoWebinars to
register. Download this brochure for the full schedule of webinars and more information.
August 1, 2014
Pharmacyclics Inc. announced that the U.S. Food and Drug Administration (FDA) has approved Imbruvica™ (ibrutinib) as a single agent for the treatment of patients with chronic lymphocytic leukemia (CLL) who have received at least one prior therapy. This indication is based on overall response rate (ORR). An improvement in survival or disease-related symptoms has not been established. Imbruvica is the first oncedaily, single-agent, oral kinase inhibitor for patients with CLL who have received one prior therapy and is being jointly developed and commercialized by Pharmacyclics and Janssen Biotech, Inc. Read the full press release here.
April 21, 2014
Yesterday the Arizona House of Representatives unanimously passed legislation that would make oral anti-cancer treatments more affordable and accessible to patients. The measure passed 57-0 and is now heading to the Senate Health Committee for review.
As you know, insurance companies often create inequity for patients by requiring cost-sharing to be much higher for oral chemotherapies that are covered under the pharmacy benefit (some percentage of the total cost of the drug), as compared to coverage under the medical benefit for IV-infused therapies (generally a copay of $50 or less). The legislation prohibits insurance companies from imposing a higher co-payment, deductible, or co-insurance for an oral drug than required for comparable IV-infused therapy.
This is great news but there is still work to be done! The bill now moves to the Senate for review and hopefully passage. Please contact your state senator today to encourage support for HB2078. TACOS remains very active in the Fair Access to Cancer Treatment (FACT) Coalition and State Patient Equal Access Coalition (SPEAC), both of which are focused on bringing oral parity legislation to Arizona. We will keep you updated on this important legislation.
March 7, 2014
On November 29, 2013, CMS released the Healthcare Common Procedure Coding System (HCPCS) code set updates that will be effective January 1, 2014.
For the full Prescribing Information on Neupogen® (filgrastim), please go to:
December 16, 2013
On July 23, the House Energy and Commerce Health Subcommittee voted to approve legislation that would repeal the sustainable growth rate (SGR) formula in the current Medicare physician payment system and create a fee-for-service system in which providers report quality measures. Providers would also have the ability to leave the fee-for-service system and opt for new ways of delivering care.
Under the proposed legislation, physicians would receive a 0.5 percent annual increase per year for the first five years of the new payment system. Beginning in 2019, they would be eligible for an additional 1 percent update based on their performance against quality measures.
Lawmakers have yet to identify ways to pay for the legislation. However, that task is not quite as challenging as it could be, since the projected 10-year cost to replace the current SGR formula was recently lowered from $245 billion to $138 billion.
Information from BNA Health Care Daily Report.
July 24, 2013
TACOS is pleased to partner with the American Society of Hematology (ASH) to present the 2013 ASH® State-of-the-Art Symposium (SAS), taking place October 11-12 in Los Angeles. This meeting is designed to provide attendees with ample opportunities to discuss actual patient cases and practice challenges. The meeting's content will cover the most recent advances in hematologic malignancies including a special focus on myelodysplastic syndromes.
ASH is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians and designates this educational activity for a maximum of 10.5 AMA PRA Category 1 Credits™.
As a member of TACOS you receive a special discounted registration rate to attend this meeting. For a registration discount code, email ASH at email@example.com.
Best of ASCO Los Angeles is coming to you! Join your colleagues on August 16-17 for the 2013 Best of ASCO Meeting and experience the top science and education from the world's premier oncology event, ASCO's Annual Meeting. 2013 Meeting Highlights include:
Every member of the oncology team should take advantage of this year's dynamic and engaging program. Can't make it to Los Angeles? Consider attending a Best of ASCO Meeting in Chicago (August 9-10), or Boston (August 23-24).
There is still time to register and save! Registration fees increase onsite; register now!
This live activity has been approved for a maximum of 15.5 AMA PRA Category 1 CreditsTM.
On Feb. 8, the U.S. Food and Drug Administration (FDA) approved Pomalyst (pomalidomide) to treat patients with multiple myeloma whose disease progressed after being treated with other cancer drugs.
Read the FDA press release here.
The U.S. FDA has approved Synribo (omacetaxine mepesuccinate) for Injection, for subcutaneous use, for the treatment of adult patients with chronic or acclerated phase chronic myeloid leukemia (CML) with resistance and/or intolerance to two or more tyrosine kinase inhibitors (TKIs).
Medicare covers the use of Pegfilgrastim (Neulasta), J2505, to decrease the incidence of infection, as manifested by febrile neutropenia in patients with nonmyeloid malignancies receiving myelosuppressive anti-cancer drugs associated with a clinically significant incidence of febrile neutropenia. The initial 2002 FDA approval and label specified administration starting 24 hours after and no sooner than 14 days before delivery of cytotoxic chemotherapy.
Within two years of drug approval, presentations on the utility and non-inferiority of same day dosing of Neulasta with chemotherapeutic agents appeared as abstracts. By 2009, Whitworth and Schuman independently proclaimed the administration of “pegfilgrastim on day 1 appears to be safe, effective and convenient” and “same day…may be determined to be a convenient, safe and effective approach” respectively. A 2010 metaanalysis concluded “the results indicated that same-day administration was statistically non-inferior to next-day administration according to neutropenia duration.”
Based on the evidence, the administration of same-day pegfilgrastim has become an accepted standard of care and in particular, in situations where patients are believed to be a higher risk of potential non-compliance with day 2 administration.
Noridian Administrative Services has revised their coverage of Pegfilgrastim. Read their article, which offers a number of useful sources on same-day and less than 14-day dosing.
InsideHealthPolicy featured an article on Arizona's duals plan, which aims to to better coordinate care for the vulnerable duals population by placing all 120,000 dually eligible beneficiaries who are already enrolled in Medicaid managed care plans into a Medicare Advantage special needs plan (D-SNP) operated by the same insurer.
Click here to access the complete article (log in required.)
Noridian has updated information about temporary coverage and coding information in response to provider queries about leucovorin and doxil shortages.
Noridian has listed revisions effective April 15, 2012, to the codes used to describe Positron Emission Tomography (PET) scans and the diagnoses that may justify use of the scan if all other Medicare requirements for coverage are met.
The Centers for Medicare and Medicaid Services (CMS) has issued J9307, a new national permanent Healthcare Common Procedure Coding System (HCPCS) J-code for Allos Therapeutics Inc.'s FOLOTYN® (pralatrexate injection).
Healthcare professionals and patients may call the Allos Support for Assisting Patients (ASAP) program for questions about the new HCPCS code, or any other coverage, coding, or payment issues related to FOLOTYN at 1-877-ASAP102.
Click here for more information.
HealthDataInsights, Inc., the Medicare Recovery Audit Contractor (RAC) for Region D, identified on its website CMS-approved audit issues.
The following claims will be edited automatically and monies recouped in these areas if they were billed incorrectly: