Oncology Newsfeed

CMS Reminder to Update Billing Information to Receive APM Incentive Payments

The Centers for Medicare & Medicaid Services (CMS) Quality Payment Program website includes 2020 Alternative Payment Model (APM) incentive payment details. To access information on the incentive amount and organization paid, clinicians and surrogates can log in to the QPP website using their HARP credentials. In order to receive payments, certain clinicians will need to verify their Medicare billing information by November 13, 2020.

Eligible clinicians who were qualifying APM participants have already begun receiving their 2020 APM incentive payments last month based on their 2018 performance. If you are a clinician and have already received your payment, you do not need to update anything.

CMS also posted a new 2020 APM Incentive Payment Fact Sheet to explain:

• Who is eligible to receive an APM incentive payment in 2020?

• How CMS determines your 2020 APM incentive payment.

• Frequently asked questions and answers.

For any questions, contact the CMS Quality Payment Program at QPP@cms.hhs.gov or 1.866.288.8292. To receive assistance more quickly, consider calling during non-peak hours—before 10 a.m. and after 2 p.m. ET.

Posted 11/11/20

CMS Announces 2021 Federal Health Insuance Exchange Open Enrollment Period

The Centers for Medicare & Medicaid Services (CMS) announced that the open enrollment period for the federal health insurance exchange will officially begin on Sunday, November 1 and run through Tuesday, December 15, 2020. Coverage will begin as soon as January 1, 2021.

Consumers can log in to HealthCare.gov and CuidadodeSalud.gov, or they can call 1-800-318-2596 to fill out an application and enroll in a 2021 exchange health plan. 

Please note: Current enrollees who don’t update their application and enroll in a plan by the deadline on December 15, 2020 will be automatically enrolled in the same plan, or another plan with the same insurance company intended to be as similar as possible. If that’s not available, they will generally be enrolled in another plan with a different insurance company.

Consumers who miss the deadline to re-enroll in a plan of their choice during open enrollment will also not be able to make any plan changes until the next coverage year, unless they qualify for certain special enrollment periods.

Read the CMS fact sheet for more information.

Posted 11/02/2020

CMS Announces Radiation Oncology Model Delay

The Centers for Medicare & Medicaid Services (CMS) has received feedback from a number of stakeholders about the challenges of preparing to implement the Radiation Oncology (RO) Model by January 1, 2021. Based on this feedback, it intends to delay the RO Model start date to July 1, 2021, and is pursuing rulemaking to make this change.

Read the CMS announcement.

Posted 10/22/2020

FDA Approves Venetoclax in Combination for Untreated AML

On October 16, 2020, the U.S. Food and Drug Administration (FDA) granted regular approval to Venclexta® (venetoclax) in combination with azacitidine, decitabine, or low-dose cytarabine (LDAC) for the treatment of newly diagnosed acute myeloid leukaemia (AML) in adults 75 years or older, or who have comorbidities precluding intensive induction chemotherapy.

Venetoclax was initially granted accelerated approval for this indication in November 2018.

Read Roche's announcement and the FDA announcement.

Posted 10/19/2020

Immunomedics Announces New C-Code for Trodelvy™, Effective October 2020

FDA Approves Expanded Indication of Pembrolizumab for R/R cHL

FDA Approves Nivolumab + Ipilimumab Immunotherapy Treatment for Mesothelioma

On October 2, 2020 the U.S. Food and Drug Administration (FDA) approved the combination of Opdivo® (nivolumab) and Yervoy® (ipilimumab) as a first-line treatment for adult patients with unresectable malignant pleural mesothelioma.

Read the FDA Announcement.

Read the Bristol Myers Squibb Announcement.

Posted 10/5/2020 

COA Position Statement on Telehealth in Cancer Care Post-COVID-19

The Community Oncology Alliance (COA) has released a position statement on the continued use of telehealth in cancer care beyond the COVID-19 public health emergency. COA board of directors support telehealth visits "as a valuable supplement to in-person visits during the COVID-19 (novel coronavirus) pandemic and continued usage when appropriate after the pandemic has subsided."

Though telehealth has been widely adopted by oncology providers and patients, COA states that as an effective substitute for some patients, it cannot be applied to all. It further states that in-person visits for cancer care should continue beyond the COVID-19 public health emergency.

“Prior to the COVID-19 pandemic, telehealth regulations were extremely cumbersome and limiting at the state and federal levels, with poor reimbursement," COA Medical Director Mark Thompson, MD, said in a statement. "The rapid response of Federal policymakers to loosen telehealth restrictions and raise reimbursement rates were a true lifesaver for patients and practices. Community oncology practices are resilient and quickly integrated telehealth into their workflow thanks to these changes."

COA states that telehealth should not replace in-person care. It supports the "continued use of telehealth as a care tool" and will act as a  voice when "the time comes to integrate telehealth into the normal regulation structure."

Read COA's news release and position statement.

Posted 9/25/2020

FDA Approves Two Liquid Biopsy Companion Diagnostics for Osimertinib

On August 7, the U.S. Food and Drug Administration (FDA) approved FoundationOne^® Liquid CDx and Guardant360^® CDx as next generation sequencing based liquid biopsy companion diagnostics for osimertinib (Tagrisso^®) for the first-line treatment of patients with metastatic non-small cell lung cancer (NSCLC) whose tumors have epidermal growth factor receptor (EGFR) exon 19 deletions or exon 21 L858R mutations, as detected by an FDA-approved test; and for patients with metastatic EGFR T790M mutation-positive NSCLC, as detected by an FDA-approved test, whose disease has progressed on or after EGFR tyrosine kinase inhibitor (TKI) therapy.

See full prescribing information.

About FoundationOne^® Liquid CDx.

About Guardant360^® CDx.

Posted 9/24/2020

CMS Releases RO Model Final Rule

On Friday, September 18, 2020 the Centers for Medicare & Medicaid Services (CMS) released the final rule for the Radiation Oncology (RO) Model. The RO Model seeks to improve the quality of care for cancer patients receiving radiotherapy (RT) and move toward a simplified and predictable payment system. The RO Model tests whether bundled, prospective, site neutral, modality agnostic, episode-based payments to physician group practices, hospital outpatient departments, and freestanding radiation therapy centers for RT episodes of care reduces Medicare expenditures while preserving or enhancing the quality of care for Medicare beneficiaries. The RO Model has a five-year Model performance period that begins on January 1, 2021 and runs through December 31, 2025.

For additional information on the final rule and the model, please visit the radiation oncology website. The following resource documents about RO may also be helpful: Press Release, Fact Sheet, and Final Rule. For questions regarding the RO Model, please reach out to the RO Model Helpdesk by phone: 1.844.711.2664, option 5; or email: RadiationTherapy@cms.hhs.gov.

Posted 9/18/2020