Industry News Archive

  • Cabozantinib Prescribing Information and Resources

    Exelixis has issued prescribing information for cabozantinib (Cabometyx®), which is indicated for the treatment of patients with advanced renal cell carcinoma (RCC) and patients with hepatocellular carcinoma (HCC) who have been previously treated with sorafenib as well as a series of resources that you can utilize in your practice. 

    Access Prescribing Information and Resources.

    Posted 10/02/2020



  • 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 



  • 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 ReleaseFact 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



  • Sanofi Announces Permanent J-Code for Isatuximab-irfc

    On October 1, 2020, the isatuximab-irfc (Sarclisa®, Sanofi Genzyme) healthcare common procedure coding system (HCPCS) level II J code (J9227) will be effective. 

    Read the one pager

    Posted 9/18/2020



  • Lilly Announces Thyroid Cancer Testing Program

    Lilly announces their Thyroid Cancer Testing Program designed to provide access to molecular testing for appropriate advanced or metastatic medullary thyroid cancer (“MTC”) patients 12 years of age and older who require systemic therapy; and advanced or metastatic non-medullary thyroid cancer (“non-MTC”) patients 12 years of age and older who are radioactive iodine-refractory (if radioactive iodine is appropriate).

    Appropriate patients are eligible for one molecular test at no cost for the purpose of determining whether the patient has any actionable genetic alterations that may inform therapeutic decisions, without regard to purchase of any prescribed drug or any other product.*

    No patient, healthcare program, payer, or beneficiary shall be billed for any test ordered pursuant to the Thyroid Cancer Testing Program.

    Posted 9/16/2020

    To request a test for your patient <and understand further requirements>, you may download the Thyroid Cancer Testing Program Test Request Form.

    The Thyroid Cancer Testing Program is NOT available to New York State patients and facilities as the aforementioned NGS tests have not been approved by the New York State Department of Health.

    Posted 9/16/2020



  • CMS Issues FY2021 IPPS and LTCH Final Rule

    On September 2, 2020, the Centers for Medicare & Medicaid Services (CMS) issued the fiscal year (FY) 2021 Medicare Hospital Inpatient Prospective Payment System (IPPS) and Long Term Acute Care Hospital (LTCH) final rule, which includes important provisions designed to ensure access to potentially life-saving diagnostics and therapies for hospitalized Medicare beneficiaries. The changes will affect approximately 3,200 acute care hospitals and approximately 360 Long-Term Care Hospitals. CMS estimates that total Medicare spending on acute care inpatient hospital services will increase by about $3.5 billion in FY 2021, or 2.7 percent. 

    CMS’ rule creates a new Medicare Severity Diagnostic Related Group (MS-DRG) that provides a predictable payment to help adequately compensate hospitals for administering Chimeric Antigen Receptor (CAR) T-cell therapies.

    Also in the final rule, CMS approved a record number of 24 new technology add-on payments, which is an additional payment to hospitals for cases involving eligible new and relatively high cost technologies. This will provide additional Medicare payment for these technologies while real-world evidence is emerging, giving Medicare beneficiaries timely access to the latest innovations.

    Read the fact sheet and final rule from the Federal Register.

    Posted 9/2/2020



  • FDA Approves Azacitidine for AML Continued Treatment

    On September 1, 2020 the U.S. Food and Drug Administration (FDA) approved Onureg® (azacitidine) for the continued treatment of patients with acute myeloid leukemia (AML) who achieved first complete remission or complete remission with incomplete blood count recovery following intensive induction chemotherapy and are not able to complete intensive curative therapy.

    Read the Bristol Myers Squibb announcement.

    Read the FDA announcement.

    Posted 9/2/2020


  • NGS Alert for Pegfilgrastim Product Claims

    This alert is for all hospital outpatient departments. Pegfilgrastim and biosimilars claims are denying in error due to an internal systems issue in Jurisdiction 6 and Jurisdiction K, Part A outpatient providers. National Government Services (NGS) is in the process of reviewing the cause of the errors and will determine the action it will take. 

    No provider action is necessary at this time, however, please continue to check the production alerts section of the NGS website and future email updates for additional information regarding this issue

    If you have any questions, please contact NGS.

    Posted 8/24/20


  • FDA Approves Daratumumab + Carfilzomib and Dexamethasone for R/R MM

    On August 20, 2020 the U.S. Food and Drug Administration (FDA) approved Darzalex® (daratumumab) in combination with Kyprolis® (carfilzomib) and dexamethasone (DKd) for the treatment of adult patients with relapsed/refractory (R/R) multiple myeloma (MM) who have received one to three previous lines of therapy.

    Read Janssen's announcement.

    Read the FDA announcement.

    Posted 8/21/2020




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