ONCOLOGY ISSUES - Association of Community Cancer Centers
←
→
Page content transcription
If your browser does not render page correctly, please read the page content below
Creating an oncology practice Tailoring distress screening to A curbside clinic offers patients
plan that can change with the meet the needs of specific patient another option for accessing
times | 24 populations | 30 cancer care | 44
ONCOLOGY
ISSUES
This publication is a benefit of membership
Association of Community Cancer Centers
Vol. 36 | No. 5 | 2021
A digital screening tool
connects patients to critical
supportive care services
Association of Community Cancer Centers
ACCC 38th
STRATEGIES
NATIONAL
ONCOLOGY
CONFERENCE
INNOVATION TO ACTION
Austin, TX >>> OCTOBER 20–22, 2021
Hear actionable “how-to insights” on program operations
and patient care—LIVE in Austin!
• Real-world strategies and practical takeaways from the
2021 ACCC Innovator Award winners
• Small-group workshops delve into equity and implicit bias,
supportive care, finding joy at work, and coalition building
• Peer-to-peer networking, community service activities,
social events, and more!
Not sure if you
>>>
can join us
REGISTER at accc-cancer.org/NOC to in Austin this year?
save $125. EARLY BIRD RATES EXTENDED! Stay tuned for details
on a one-day virtual event
in November.
contents Oncology Issues
Vol. 36 | No. 5 | 2021
24 Creating an Oncology Practice Plan
That Can Change with the Times
by James L. Weese, Amy J. Bock, Jacob C. Frick,
Federico A. Sanchez, Marija Bjegovich-Weidman,
E. Stuart Arnett, and Corey J. Shamah
30 Tailoring Distress Screening in Oncology
Populations
Timing distress screening in
surgically resectable esophageal cancer
18
by Laura Melton, Michelle Bunch, Lisa J. Wingrove,
Megan D. Marsh, Ashley E. Glode, Stephen Leong,
S. Lindsey Davis, Tracey E. Schefter, Supriya K. Jain,
Lindel C.K. Dewberry, Karyn Goodman, W. Thomas
Purcell, and Martin D. McCarter
Demonstrating
36 Mining Data to Improve Care Coordination
of Patients with Hematologic Malignancies
by Rachel Dragovich and Jan Kover
Measurable Value:
Distress Screening
44
A digital tool connects
Cancer Care from the Comfort of Your Car
Moffitt’s Curbside Clinic gives patients another patients to critical
option for accessing care supportive care services
by Barbara A. Gabriel, MA Learn how this digital screening tool
is integrated with the EHR, ensuring
52 What Does Leading with Mindfulness that biopsychosocial screening is
and Compassion Look Like? built into standard of care.
by Amanda Patton, MA by Amanda Patton, MA
58 Improving Care Coordination for Advanced
NSCLC: Results From a National Quality
Survey for Pathologists and Pulmonologists
by Michelle Shiller, David J. Feller-Kopman, Nabil Chehab,
and Leigh M. Boehmer
70 Care Coordination: The Role of Pharmacy to Help Manage Patients with
Cancer on Oral Oncolytics
D E PA RTM E N T S
2 From the Editor | A Focus on Our Staff 14 Tools | Approved drugs, and more
3 President’s Message | Compassionate Healthcare 16 Spotlight | Maryland Oncology Hematology
4 Fast Facts | How is medical debt affecting our finances, and more 75 Action | An update on an ASCO-ACCC joint
initiative, and more
6 Issues | How Reimbursement Impacts Supportive Cancer Care Services
76 Views | Celebrating Cancer Survivors During
7 Compliance | Highlights from the CY 2022 MPFS and HOPPS
Proposed Rules
COVID-19
OI | Vol. 36, No. 5, 2021 | accc-cancer.org 1
FROM THE EDITOR
A Focus on Our Staff
ONCOLOGY ISSUES BY SIBEL BLAU, MD
The Official Journal of the
Association of Community Cancer Centers
A
Editor-In-Chief
Sibel Blau, MD s we and allowed staff to get to know each other
Executive Director
enter an better. We instituted weekly departmental
Christian G. Downs, JD, MHA era of manager meetings to increase transparency
Chief Medical Officer “rebound” from a and ensure that all staff receive clear
Leigh Boehmer, PharmD, BCOP harsh, bleak year communication about practice changes. This
Managing Editor of COVID-19, most increased awareness from our management
Monique J. Marino of us have mixed team is translating into staff feeling increased
Associate Editors feelings of appreciation and respect. Our medical
Barbara Gabriel excitement, hope, director also hosts a monthly town hall. All of
Maddelynne Parker fatigue, sadness, these internal communication efforts help
EDITORIAL BOARD and confusion. our staff to understand and align with our
Jennifer Bires, LICSW This amalgam of organization’s vision and goals.
Stephen Cattaneo, MD
Linda Corrigan, MHE, RHIT, CTR conflicting emotions is only compounded by We are looking to bolster resiliency in other
Sarah Hudson-DiSalle, PharmD, RPh economic challenges in every aspect of our ways as well. For example, even though staff
Jeff Hunnicutt lives. Moreover, the pandemic and resultant are extremely busy, we hold intentional
Bridget LeGrazie, APN
public health emergency transformed the way training opportunities aimed at improving
Anne Marie F. Rainey
Kelay Trentham, MS, RDN, CSO we practice medicine. staff confidence on specific topics and
Gretchen Van Dyck As oncologists, we have done our best to workflows. Other staff take online courses.
Jenna VanGilder, MHA, RN, OCN, CENP care for our patients safely since the onset of To try to balance work schedules and allow
ACCC EXECUTIVE COMMITTEE COVID-19. This required a huge amount of more quality time at the office, our staff are
President time and resources to develop and put into often cross-trained and encouraged to cover
Krista Nelson, MSW, LCSW, OSW-C, FAOSW
practice a wide range of new safety measures. work for each other. Instituting flexible work
President-Elect Many oncology practices and cancer schedules and remote work opportunities for
David R. Penberthy, MD, MBA
programs are now experiencing severe non-patient-facing positions has also
Treasurer
staffing shortages, placing undue burden on improved practice morale.
Nadine J. Barrett, PhD, MA, MS
existing staff and clinicians. To improve staff Our management team needs support as
Secretary
Olalekan Ajayi, PharmD, MBA
retention, teams are being assembled to well, and our practice provides advance
tackle issues from mundane technical work leadership training with a focus on ways to
Immediate Past President
Randall A. Oyer, MD to strategies for improving employee support and interact with direct reports.
satisfaction to processes to create and keep a Several years ago, our social work team
ACCC Board of Trustees
Robert R. Buras, MD safe work environment. The question of how developed a mental health program for
Amy Ellis to pay for these changes and improvements patients, and we are now branching this out
Jorge J. García, PharmD, MS, MHA, MBA, FACHE remains a major issue. to include staff. Since the start of the
Pablo Gutman, MD, MBA
Amanda Henson, MSHA, MBA, FACHE
At Northwest Medical Specialties, we, too, pandemic, social work has sent regular
Una Hopkins, RN, FNP-BC, DNP face challenges from staff stress and wellness reminders to staff, including
Ginah Nightingale, PharmD, BCOP exhaustion. To address and overcome these information on mental health awareness. As
David Spigel, MD challenges, our management team has made we know, a focus on mental health is key to
Wendi Waugh, BS, RT(R)(T), CMD, CTR
it a priority to bolster the resiliency of our helping our staff and clinicians recover from
staff. So, what are we doing? the stress and heavy workload they have
Oncology Issues serves the multidisciplinary
At the start of the public health emergency, carried for more than a year now.
specialty of oncology care and cancer our practice implemented a COVID-19 If there is a silver lining from this global
program management. Hardship Fund to help staff. Support came pandemic, it is that the experience shed light
from paid time off donated by staff and on the innovation and creativity of the
financial contributions from managers and oncology workforce. We all learned ways to
clinicians. Today this fund is still available to survive and to pivot into practice transforma-
Oncology Issues (ISSN: 1046-3356) is published
bimonthly for a total of 6 issues per year by
all staff. tion that allowed us to continue providing
Taylor & Francis Group, LLC, 530 Walnut Street, With the understanding that communica- life-saving care to our patients. The cancer
Suite 850, Philadelphia, PA 19106, on behalf of the tion is key, we instituted weekly “pod” community must continue to work together,
Association of Community Cancer Centers (ACCC),
1801 Research Blvd, Suite 400, Rockville, MD 20850- meetings so that team members can openly share our best practices—what works and
3184, USA. US Postmaster: Please send address talk about issues or ask questions—with an what does not work—and remember to take
changes to Oncology Issues, c/o The Sheridan Press, end goal of identifying solutions to those moments to breathe and engage in mindful-
PO Box 465, Hanover, PA 17331. Copyright © 2021
by the Association of Community Cancer Centers. All problems or answers to those questions. ness to improve our resiliency and help us
rights reserved. No part of this publication may be These meetings improved communication continue this difficult journey.
reproduced, stored, transmitted, or disseminated in any
form or by any means without prior written permission
from the publisher, Taylor & Francis Group, LLC.
2 Vol. 36, No. 5, 2021 | OI
ACCC PRESIDENT’S MESSAGE Coming in Your 2021
Compassionate Healthcare ONCOLOGY ISSUES
BY KRISTA NELSON, MSW, LCSW, OSW-C, FAOSW Integrating Spiritual Care in the
Outpatient Oncology Setting
H
Use of Pharmacy Informatics to
ow do Between the stimulus and response there is a Standardize Pharmacist Review
we define space.
of Oral Oncolytic Medications
compassion- In that space is our power to choose our
ate healthcare? response. for Hospitalized Patients
Compassion means, In our response lies our growth and our
An Investigation of Self-
“to suffer together.” freedom.
Compassion is often Determined Work Motivation
We can use this space for outward reflection
defined as the Among Young Adult Central
and to help us find meaning in suffering. We
feeling you get can also use this space to choose compassion Nervous System Cancer
when you are for ourselves when we have made a mistake or Survivors
confronted with when we are experiencing challenges.
others’ suffering and Self-compassion, as defined by Dr. Kristin Mixed-Method Study Examining
feel motivated to alleviate or lesson that Neff, an associate professor of Educational Initial Interactions of Oncology
suffering. Psychology at the University of Texas at Austin Patients with Multidisciplinary
In oncology, we often have long-term and author of the books Self-Compassion: The
relationships with our patients and, therefore, Cancer Care
Proven Power of Being Kind to Yourself and Fierce
when their cancer progresses or takes the Self-Compassion: How Women Can Harness A Virtual Integrative Oncology
patient’s life, we experience suffering. This Kindness to Speak Up, Claim Their Power and
emotion is on top of everything that goes on Program Supports Patients
Thrive, is treating yourself with kindness and
outside the clinic or hospital walls—like a global with Cancer Throughout the
understanding, acknowledging your feelings in
pandemic! a non-judgmental way, and recognizing that Treatment Continuum
It is the nature of those who work in cancer everyone struggles sometimes.
care. We sit daily with our patients who are Auricular Acupuncture for the
I’d like to pause here and ask you to reflect
suffering, acknowledging the emotion and then on a question: How would it be to show the Treatment of Cancer-Related
trying to alleviate it in some way. Many times, same compassion for yourself that you show Pain
being present, allowing the grief, and letting for the people you care for daily at your cancer
our patients know they aren’t alone is the only program or practice? And let’s not forget that Implementation of a Nurse
“treatment” we have. the compassion—and care—we provide Practitioner Fellowship Within
So, what sustains us? How do we do this encompasses family members and many an Academic Medical Center
every day? others who support patients with cancer.
Oncology Issues recently interviewed Dr. Leigh Though this concept seems simple, in the A Model for Integrating APPs in
Weiss, who has taught compassion courses at context of our current reality—having to do a Radiation Oncology Satellite
the Stanford School of Medicine, the U.S. more with fewer resources, a mass exodus of
Department of Veterans Affairs, the Boston Clinic
exhausted and burned-out cancer care team
Center for Refugee Health and Human Rights, members from the healthcare workforce, Spotlight on the Sutter Institute
and the Alzheimer’s Association, among others. ongoing racial inequity, and, yes, a global
On pages 52-56, Dr. Weiss shares her thoughts for Advancing Health Equity
pandemic—compassion may sometimes be
about a compassionate leadership model that I too much of a reach. An Oncology Nurse Residency
found thought- But it is a reach worth taking. We must
provoking. Program Improves Knowledge
continue to talk about race and what we can of Delirium in Older Patients
One point that resonated with me was her do to improve equity, inclusion, and diversity.
call out to recognize opportunities to work on We must continue to openly share our distress, with Cancer
creating more compassionate interactions. To exhaustion, and other difficult feelings. We
me, this type of mindfulness or attention is An APP-Physician Model
must continue to do the best we can each day.
exactly what Dr. Victor Frankl, an Austrian But perhaps most importantly, we must Improves Risk Stratification and
neurologist, psychiatrist, philosopher, author, continue to collaborate, listen to each other, Palliative Care
and Holocaust survivor, is talking about in one and be understanding of our colleagues so
of his most famous quotes. that we can continue to show our patients and
Remote Monitoring of Patients
their loved ones the compassion and care our with Cancer During COVID-19
field is known for.
Developing a Cancer Care and
Community Paramedicine
Partnership
OI | Vol. 36, No. 5, 2021 3
more online @
accc-cancer.org
BLOG
Cancer Care’s Road to Recovery from
the Global Pandemic
Debra Patt, MD, PhD, MBA, FASCO, executive vice president, Public
fast
Policy and Strategic Initiatives at Texas Oncology, talks to ACCCBuzz
about how delays in cancer screening and treatment during
COVID-19 are translating into cancer mortality. But the news is not
all bad. Dr. Patt shares some silver linings, including how innovative
approaches adopted as a result of the global pandemic have the
potential to reduce disparities in cancer care. Read the full
interview at accc-cancer.org/acccbuzz. Then make plans to attend Got Trust?
the ACCC 38th National Oncology Conference, Oct. 20-22, in
Austin, Texas, where Dr. Patt will deliver the luncheon keynote. • Nearly 1 in 3 physicians (30%) say their trust in the U.S.
Register today at accc-cancer.org/NOC. healthcare system and healthcare organization leadership
decreased since COVID-19; only 18% report increased trust.
Billing and Coding Fundamentals
WEBINAR for Leaders in Oncology • Physicians report high levels of trust for other physicians
This webinar addresses high-level information related to coding (94% trust doctors within their practice; 85% trust doctors
and billing basics for oncology services. Learn how coding and
outside of their practice) and nurses (89%).
billing varies by the setting where the services are performed, the
geographic location of those services, and payer policies. This • Only 2/3 of physicians (66%) trust healthcare organization
session focuses on common terminology related to coding and
leaders and executives.
billing for oncology outpatient services, how these terms apply
to the various care delivery settings, and resources related to • During the pandemic, physicians report increased trust for
this information. Register and listen today at accc-cancer.org/ fellow physicians (41%) and for nurses (37%).
billing-coding-fundamentals-webinar.
• From the patient perspective, older adults (90%), white
Biomarker Testing Implementation people (82%), and high-income individuals (89%) say they
RESOURCE Roadmap for NSCLC trust their doctors.
This online learning tool helps multidisciplinary cancer care teams
obtain the knowledge they need to implement, expand, and • Among people who report lower trust in their doctors, 25%
sustain biomarker testing for patients with advanced NSCLC. The say their doctor spends too little time with them and 14%
Roadmap offers users information about how to lay the ground-
say their doctor does not know or listen to them.
work for biomarker testing, train and prepare their care teams to
offer testing, implement the testing, and evaluate ongoing • Yet patients trust clinicians—doctors (84%) and nurses
progress. For example, in the Roadmap’s “Lay the Groundwork” (85%)—more than the U.S. healthcare system (64%).
section, learn the basics of biomarker testing, assess your
institution’s buy-in, and act by conducting an organizational • About 1 in 3 patients (32%) say their trust in the healthcare
readiness assessment. accc-cancer.org/nsclc-roadmap. system decreased during the pandemic, compared to 11%
whose trust increased.
CANCER BUZZ Podcast Highlights
PODCAST the Role APs Can Play in Research • Nearly all physicians (90%) believe patients can easily
In this episode, Christa Braun-Inglis, MS, APRN, FNP-BC, AONP, schedule appointments, but nearly 1 in 4 patients
nurse practitioner and clinical researcher at the University of (24%) disagree.
Hawai‘i Cancer Center in Honolulu, Hawaii, explores how
oncology advanced practitioners (APs) can play a greater role in • Almost all physicians (98%) say that spending an appropri-
clinical research and, according to a recent national study, have a ate amount of time with patients is important, but only 77%
strong interest in doing so. Hear how APs can leverage their deep
of patients think their doctor spends an appropriate amount
role in day-to-day cancer care decisions to improve diversity in
clinical trials by bringing their experience to trial design and the of time with them.
accrual process. Find this podcast and two others that share key Source. Building Trust: An Initiative of the American Board of Internal Medicine
themes and findings from a virtual summit co-hosted by ACCC Foundation. buildingtrust.org.
and Harborside that helped define the role of APs in equitable
cancer care delivery at accc-cancer.org/podcast.
4 accc-cancer.org | Vol. 36, No. 5, 2021 | OI
facts One study reported
a 60% reduction
How is Medical Debt
Impacting Our Finances? in new oncology trials
globally during the first
• 60% of Americans have been in debt due to medical wave of the COVID-19 pandemic
bills. 37% owe medical debt, and 23% have had medical
(January 2020 to May 2020).
debt in the past. On average, these individuals owe
Source. Lamont EB, et al. Trends in oncology clinical trials launched before and during the COVID-19
between $5K to $10K. pandemic. JAMA Netw Open. 2021;4(1):e2036353. doi:10.1001/jamanetworkopen.2020.36353.
• Top drivers of medical debt are often unpredictable,
unavoidable procedures, like ER visits (39%), doctor or
specialist visits (28%), surgery (26%), childbirth (22%),
and dental care (20%). 5 Questions Bosses Ask
• 72% of those who have medical debt said it prevents to Cultivate Commitment
them from achieving key milestones. 34% said it
1. When do you feel most proud of
prevents them from saving for retirement. 1 in 5 (19%)
what you do?
said it’s preventing them from buying a home, and
10% said it prevents them from having kids. 2. What are the challenges you face
in your work that I don’t see?
• 3 in 4 people who have had medical debt tried to
negotiate their bill. Nearly all of those who did negotiate 3. Who on your team have you come
(93%) had their bill reduced or dropped altogether. to count on the most?
Source. Lending Tree. lendingtree.com/personal/medical-debt-survey. 4. What do you need from me that
you aren’t getting?
5. If you were to leave this job, what
would be the reason?
Source. Joe Mull & Associates. joemull.com. #bossbetter.
Black women are almost 1.5 times more likely
to receive longer breast cancer radiotherapy
regimens than White women, resulting in
increased pain, financial hardship, emotional
stress, and higher mortality.
Source. Emerson MA, et al. Breast cancer treatment delays by socioeconomic and health care access latent
classes in Black and White women. Cancer. 2020;126(22):4957-4966.
OI | Vol. 36, No. 5, 2021 | accc-cancer.org 5
issues
How Reimbursement
Impacts Supportive
Cancer Care Services
BY KRISTIN MARIE FERGUSON, DNP, RN, OCN
A
CCC members across all different measure to show the value these services improves patient satisfaction and frees up
disciplines, including dietitians, bring to patients—not only to ensure physicians and APPs to see more patients,
social workers, pharmacists, nurse adequate reimbursement but to justify reducing wait times.
navigators, financial navigators, genetic increasing full-time employees in key roles, In terms of achieving health equity, data
counselors, and more, often share with me like those listed above. reflect the need for higher levels of support-
the same phrase, “I’m the only [insert Several bills were introduced to Congress ive care services for historically marginalized
discipline here] in my clinic.” Many times, this year advocating for reimbursement patient populations to help reduce—or even
these staff are supporting a large patient increases for different disciplines and roles, prevent—negative outcomes, such as
volume in key care coordination and including: financial toxicity, malnutrition, and/or
educational areas, such as nutrition, financial • The Access to Genetic Counselor Services untreated anxiety or depression.
advocacy, side effect management, and Act (H.R. 2144/S.1450) In her 2021-2022 ACCC President’s Theme,
genetic counseling. • The Medical Nutrition Therapy Act of 2021 Krista Nelson, MSW, LCSW, OSW-C, FAOSW,
Being the only staff member providing (H.R. 3108/S.1536) calls out the need to focus on health equity
certain services in a clinic location brings • The Improving Access to Mental Health and social justice, to offer high-reach,
challenges. For example, it limits the Act (S.870/H.R. 2035) high-impact supportive care services and
individual’s ability to participate in hospital • The Pharmacy and Medically Underserved innovative care delivery models that
or practice meetings where these team Areas of Enhancement Act (H.R. demonstrate measurable value, and to
members can share their experiences, 2759/S.1362). strengthen a culture that supports resiliency
communicate patient needs, and attend as an essential for practice. Ensuring that
continuing education events to maintain Elizabeth Fowler, JD, PhD, director for the
patients with cancer have access to
their license and update their learning. It can Center for Medicare & Medicaid Innovation
high-quality supportive care services and
also have a negative impact on resiliency, (The Innovation Center), recently commented
measuring the impact of these services are
morale, and workload. These clinicians worry that in the push toward a more value-based
essential to providing high-quality care.
when they take time off for their own healthcare system, The Innovation Center is
Ensuring that supportive care staff have the
medical appointments or vacations. They considering additional mandatory alternative
resources and time to reach all patients in
know that they will return to a large volume payment models. This means that cancer
need is essential to maintaining a resilient
of patient referrals and an immense amount programs and practices will need to focus in
workforce that can provide these high-qual-
of work because no one else could assist on how quality metrics are created, what
ity services.
patients in their absence. services impact patient outcomes, and how
Are you a program manager or administra-
Showing the value and measuring quality supportive care services can improve these tor looking to “Make the Case” for hiring
metrics for many supportive cancer care outcomes. Oftentimes, staffing shortages in additional supportive care staff? ACCC has
services is challenging. These challenges are supportive care services increase physician developed several business case studies to
one of the reasons that many supportive care and advanced practice provider (APP) help at: accc-cancer.org/hiring-new-staff. In
services are not reimbursed under our current workload as these clinicians take on the next 12 months, ACCC plans to add two
fee-for-service payment methodology. As the additional tasks, such as completing patient additional business case studies for oncology
United States healthcare system moves to paperwork, offering financial assistance, and social workers and oncology pharmacists.
value-based and bundled payments under educating patients about nutrition or genetic
alternative payment models, it is now more counseling. Having additional, highly trained Kristin Ferguson, DNP, RN, OCN, is the former
important than ever for cancer programs and staff members who can effectively deliver on senior director, Cancer Care Delivery & Health
practices to quantitatively and qualitatively these types of supportive care services Policy, Association of Community Cancer
Centers, Rockville, Md.
6 accc-cancer.org | Vol. 36, No. 5, 2021 | OI
compliance
Highlights from the CY 2022 MPFS
and HOPPS Proposed Rules
BY TERI BEDARD, BA, RT(R)(T), CPC
O
ver the past few months there has values are due to the adjustment of labor phase-in is done over a four-year transition,
been a flurry of activity from the values and the final year of the four-year similar to when the supply and equipment
Centers for Medicare & Medicaid supply and equipment updates. According to value changes were implemented in CY 2019
Services (CMS), Health and Human Services CMS, stakeholders requested updated labor and spread over a four-year timeline.
(HHS), and Health Resources and Services values to correspond with updated supply However, CMS is concerned that a phased-in
Administration (HRSA), including the release and equipment values. Clinical labor rates transition would result in the need to use
of the CMS calendar year (CY) 2022 proposed were last updated in CY 2002, and the agency outdated clinical labor pricing for the time
rules for the Medicare Physician Fee Schedule is proposing to update the values for CY 2022 the transition is taking place because each
(MPFS) and Hospital Outpatient Prospective using CY 2019 survey data from the Bureau year would use partial new values and older
Payment System (HOPPS), extension of the of Labor and Statistics and other supplemen- values to calculate payment. CMS estimates
public health emergency by HHS through tary data when these data are not available. that the effect of the labor pricing update
Oct. 18, 2021, and HRSA notification of Note: an increase in labor values is indicated alone is as follows:
post-payment reporting as part of the for all of the labor types reviewed by CMS and • Radiation oncology: −4 percent
Provider Relief Fund (PRF). Below is a because the values are maintained in a budget- • Hematology/oncology: −2 percent.
summary of how these notifications may neutral manner, increases for one specialty or
impact oncology. one code (or code set) are possible only Changes to E/M Services:
because it was taken or adjusted from Split (or Shared) Visits
MPFS Proposed Changes CMS indicated that when the American
another specialty or code (or code set).
On July 13, 2021, CMS issued the proposed Medical Association adopted new guidelines
Specifically, for some specialties, like
MPFS rule for CY 2022.1 Comments must be for outpatient and office setting evaluation
family practice, the labor has a higher-
submitted to CMS by 5:00 PM EST on Sept. and management (E/M) visits, CMS also
than-average share of the direct costs,
15, 2021. adopted these changes. In the months since
whereas for other specialties, such as
Payment Rates radiation oncology, the labor has a lower- implementation, the agency indicated a need
For CY 2022, CMS is reversing the 3.75 than-average share of the direct costs. to clarify or adjust previous guidelines to
percent increase outlined as part of the Specialties with a higher share of labor costs align more fully with the updates.
Consolidated Appropriations Act of 2021, are proposed to receive increased payments Specific to split (or shared) visits, CMS
which reversed the 10.2 percent cut finalized for their services, whereas specialties that indicated that these guidelines do not
to the conversion factor for CY 2022. have lower direct costs associated to clinical address:
Removing this and using a conversion factor labor will see decreases in payment for their • Who to bill when the visit (and services)
of 33.6319, CMS applied a budget neutrality services. are performed by different practitioners.
factor of −0.14 percent. This results in a CMS reviewed the anticipated impact that • Whether a substantive portion must be
proposed conversion factor of $33.5848, these labor value changes would have on performed by the billing practitioner.
which is slightly lower than the conversion various specialties and the payment for their • Whether practitioners must be in same
factor for CY 2020. services. The agency indicated that when group.
Table 1, page 8, outlines the combined updates to payment methodology result in • The setting where the split (or shared)
impact of the proposed relative value unit significant shifts in payments, it does visits may be furnished to be billed.
(RVU) changes for CY 2022 by specialty. The consider the possibility and impact of CMS is proposing to define a split (or shared)
RVU cuts specific to the practice expense phasing in the changes. Typically, this visit as an E/M visit performed (split or
OI | Vol. 36, No. 5, 2021 | accc-cancer.org 7
Table 1. CY 2022 PFS Estimated Impact on Total Allowed Charges by Specialty
(D) IMPACT
(C) IMPACT OF
(B) ALLOWED OF PRACTICE (E) IMPACT OF MP (F) COMBINED
(A) SPECIALTY WORK RVU
CHARGES (MIL) EXPENSE RVU RVU CHANGES IMPACT*
CHANGES
CHANGES
Hematology/
$1,737 0% -2% 0% -2%
oncology
Radiation oncology
$1,660 0% −5% 0% −5%
and radiation therapy
The decrease in the conversion factor does result in a decrease in many specialties and their proposed impact; however, CMS has also applied
additional decreases to many of the practice expense values, which reflect a deeper cut to certain specialties, such as interventional radiology,
radiation oncology, vascular surgery, and oral/maxillofacial surgery.
*Column F may not equal the sum of columns C, D, and E due to rounding.
shared) by both a physician and non- portion of the visit should be the one to sign • Documenting clinical information in the
physician practitioner (NPP) who are in the and date the patient note, but documenta- electronic or other health record
same group in accordance with applicable tion should include the names and creden- • Independently interpreting results (not
laws and regulations. The visit is provided in tials of both clinicians. Once the total times separately reported)
a facility setting in which payment for between the physician and NPP are added • Communicating results to the patient,
services furnished incident to is prohibited. family, and/or caregiver
together, the clinician with the majority of
In the non-facility setting, when the • Care coordination (not separately
the time will bill the visit based on the total
physician and NPP each perform compo- reported).
time documented. CMS has also proposed
nents of the visit, it can be billed under the CMS identified items that would not count
that prolonged services can be billed in
physician if the incident-to criteria are met. toward time spent in a visit:
The services are provided in accordance with addition to the visit when the time-based • Performance of other services that are
applicable laws and regulations; specifically, method is used with the total time between reported separately
either the physician or NPP could bill the the two clinicians. • Travel
payer directly for the visit in the facility The agency is proposing a list of services • Teaching that is general and not limited to
setting, rather than bill as a split (or shared) that would count toward the total time for discussion that is required for the
visit. CMS is also proposing to allow for split determining the substantive portion, management of a specific patient.
(or shared) visits to be billed for both new including: CMS is also proposing to create a modifier
and established E/M patient visits. • Preparing to see the patient (for example, for billing purposes to identify a visit as a
CMS is clarifying that only the physician review of tests) split (or shared) visit. This will allow Medicare
or NPP who performs the substantive • Obtaining and/or reviewing separately to collect data on the frequency and quality
portion of the split (or shared visit) can bill obtained history of visits provided in part by NPPs but paid to
for the visit. CMS is defining “substantive • Performing a medically appropriate physicians for the full rate.
portion” to mean more than half of the total If the physician and NPP are not in the
examination and/or evaluation
time spent by the physician or NPP perform- same group, they would each be expected to
• Counseling and educating the patient,
ing the visit. Due to the need to determine bill independently based on the full E/M
family, and/or caregiver criteria for the work provided. If neither
the amount of time spent by each clinician,
CMS is recommending that documentation • Ordering medications, tests, or practitioner meets the criteria to bill a visit,
of time be included in the patient note, even procedures modifier 52 for reduced services cannot be
if the medical decision-making method is • Referring and communicating with other applied to the E/M visit codes. In this
selected to code the visit. In addition, the healthcare professionals (when not scenario, neither professional would be able
clinician who performs the substantive separately reported) to bill for the visit.
8 accc-cancer.org | Vol. 36, No. 5, 2021 | OI
Evidence-based practice is a foundational principle that guides all
work at Oncology Nursing Society. A variety of curated resources from
ONS can assist in the implementation of these techniques in practice,
including the following:
• COURSES:
Introduction to Evidence-Based Practice: This free course
ONCOLOGY offers 1.25 contact hours in nursing continuing professional
development.
NURSING SOCIETY
• PODCASTS
OFFERS
• SYMPTOM INTERVENTIONS
NEW
• PRACTICE TOOLS
• ONS GUIDELINES™:
Incorporate published research with expert consensus on the
certainty of the evidence, the balance of benefits and harms and
EVIDENCE-BASED patient preferences and values.
PRACTICE Created with rigorous methodology, ONS Guidelines have been
RESOURCES reviewed and accepted by ECRI Guidelines Trust®, a publicly
available web-based repository of objective, evidence-based
clinical practice guideline content.
Learn more at
www.ons.org/learning-libraries/evidence-based-practice
Payment for the Services of Teaching physician was present can be included. 2.3 percent increase to the outpatient
Physicians Because Medicare already makes payment department fee schedule.
Stakeholders requested guidance on how for the program’s share of the resident’s
time spent by residents should be counted involvement, the agency does not feel that it Payments of Drugs, Biologicals, and
when selecting the appropriate E/M office would be appropriate to count the resident Radiopharmaceuticals
visit level. Section 1842(b) of the Social time toward the total time. Only the time of CMS is proposing to continue the payment
Security Act specifies, “In the case of the teaching physician would count. policy to pay for drugs purchased under the
physicians’ services furnished to a patient in 340B Drug Program at the average sales price
HOPPS Proposed Changes
a hospital with a teaching program, the (ASP) −22.5 percent. The agency is proposing
On July 19, 2021, CMS issued the proposed
Secretary shall not provide payment for such to continue to exempt rural sole community
rules for HOPPS for CY 2022.2 Comments
services unless the physician renders hospitals, children’s hospitals, and prospec-
must be submitted to CMS by 5:00 PM EST
sufficient personal and identifiable physi- tive payment system-exempt cancer
on Sept. 17, 2021.
cians’ services to the patient to exercise full, hospitals from this policy.
personal control over the management of Payment Rates Due to the proposal to use CY 2019 claims
the portion of the case for which payment is Because of the COVID-19 public health data for rate setting, CMS is proposing to
sought. Regulations regarding MPFS emergency (PHE) and pandemic, CMS is extend, for up to four quarters, an equitable
payment for teaching physician services.” proposing to use CY 2019 claims data for rate adjustment for 27 drugs and biologicals and
CMS is proposing that when total time is setting rather than CY 2020 claims date due one device, which would expire pass-through
used to determine the appropriate E/M office to the significant impact in utilization of status at various quarters in CY 2022 and
visit level, only the time the teaching services. Based on this, CMS is proposing a extend pricing through the end of CY 2022.
OI | Vol. 36, No. 5, 2021 | accc-cancer.org 9The agency is proposing to continue the RO Payment Model and varied. Various randomized trials do not
ASP+6 percent payment policy for all drugs, Below is a summary of the changes CMS is include radiation therapy as a first-line
biologicals, and therapeutic radiopharma- proposing to the Radiation Oncology (RO) therapy. CMS is proposing to only include 15
ceuticals granted pass-through status and Model. For additional information and cancer types.
update the list on a quarterly basis. resources, visit the RO Model website at: CMS is also proposing to remove
CMS is proposing to continue the innovation.cms.gov/innovation-models/ brachytherapy services from the list of
packaging threshold for drug administration radiation-oncology-model. CMS is proposing included radiation therapy services as part of
at less than or equal to $130; this is the same a new timeline for the RO Model to extend the RO Model. This proposal is due to
threshold from CYs 2020 and 2021. CMS is five years, beginning Jan. 1, 2022, and stakeholder feedback indicating that
proposing to make drug packaging running through Dec. 31, 2026—pending no because of the bundled payments, there
determination on a drug-specific basis rather legal or additional congressional interven- could be decreased utilization where
than on a Healthcare Common Procedure tion. The agency also indicated that no new combined external beam and brachytherapy
Coding System (HCPCS) code-specific basis episodes of care could begin after Oct. 3, would be clinically indicated, specifically for
for HCPCS codes that describe the same drug 2026, to allow for treatment completion cervical and prostate cancers. There is belief
with different dosages. prior to the scheduled end date on Dec. 31, that the bundling will ultimately result in the
The agency is proposing to continue the 2016. disincentive to refer patients to another
payment policy for biosimilar biologicals, RO Model participants will be selected radiation oncologist for treatment when the
with pass-through status eligibility made for using randomly selected core-based RO Model participant does not or cannot
the biosimilar biological product and not the statistical areas. CMS is proposing that deliver brachytherapy services themselves.
reference product. CMS is proposing to organizations that are part of the Pennsylva- CMS is also seeking comments on
continue paying for biosimilar biologicals nia Rural Health Model will only be excluded whether intraoperative radiotherapy should
purchased under the 340B Drug Program at from the RO Model for the time they are be included in the RO Model. CMS received
ASP−22.5 percent of the biosimilar biological, participating in the Pennsylvania Model. stakeholder feedback requesting that this
not the reference product, which is a Once a hospital outpatient department is no service be added. However, because it is only
continuation of the CY 2021 policy. longer participating in the Pennsylvania performed in the hospital setting, it is not
CMS is proposing to continue to establish Model and if they are in a selected core- setting agnostic, and it is limited to certain
payment rates for blood and blood products based statistical area (or ZIP code), they will cancer types, CMS has concerns about its
using its blood-specific cost-to-charge ratio be expected to participate in the RO Model. inclusion.
methodology, which has been the standard CMS is proposing to remove any incentive Table 2, right, lists the HCPCS codes
since CY 2005. for RO Model participants who change their
assigned per cancer type as well as the
taxpayer identification number (TIN) or CMS
national base rates proposed to begin Jan. 1,
COVID-19 Waivers and Extensions certification number (CCN) to become
2022. Rates are based on a weighted
CMS is seeking comments on several waivers eligible for the low-volume opt-out. To do
calculation from three years of claims data
and extensions as part of the COVID-19 PHE. this, CMS is proposing that an entity would
prior to the performance year.
Specifically, the agency is looking for not be eligible to opt out if its legacy TIN or
CMS expects the RO Model to meet the
feedback on whether certain provisions, legacy CCN was used to bill Medicare for 20
criteria to be an advanced APM (alternative
which were waived or extended during the or more episodes or RO episodes, as
payment model) and merit-based incentive
COVID-19 PHE, should continue for a limited applicable, of radiation therapy services in
payment system APM in performance year 1,
period of time or permanently, including: the two years prior to the corresponding
beginning Jan. 1, 2022. Final CMS determina-
• Hospital staff furnishing services remotely performance year in a selected core-based
tions of advanced APMs and merit-based
to beneficiaries in their homes through statistical area. The agency is proposing that
incentive payment system APMs for the 2022
use of communications technology. it would include episodes and RO episodes
performance period will be announced via
• Providers furnishing services in which the associated with a model participant’s
the Quality Payment Program website at:
direct supervision requirement for cardiac current CCN or TIN, as well as any attributed
qpp.cms.gov/.
rehabilitation, intensive cardiac rehabilita- to the participant’s legacy CCN(s) or TIN(s).
tion, and pulmonary rehabilitation CMS is proposing a change to the number HRSA Provider Relief Fund
services was met by the supervising of cancer types included in the RO Model. On June 11, 2021, HHS sent a notice to HRSA
practitioner being available through audio Initially 16 cancer types were finalized, but Provider Relief Fund recipients to inform
and video real-time communications after consideration and stakeholder feedback, them about the data elements they are
technology. the agency is proposing to remove liver required to report in the post-payment
• The need for specific coding and payment diagnosis from these cancer types. CMS reporting process.3 As part of the Coronavi-
to remain available under HOPPS for indicated that liver cancer and the radiation rus Aid, Relief, and Economic Security (CARES)
specimen collection for COVID-19. therapy services used to treat it are evolving (Continued on page 12)
10 accc-cancer.org | Vol 36, No. 5, 2021 | OITable 2. HCPCS Codes Assigned Per Cancer Type and National Base Rates
RO MODEL- INCLUDED
PROFESSION OR TECHNICAL NATIONAL BASE RATE
SPECIFIC CODES CANCER TYPE
M1072 Professional Anal cancer $3,104.11
M1073 Technical Anal cancer $16,800.83
M1074 Professional Bladder cancer $2,787.24
M1075 Technical Bladder cancer $13,556.06
M1076 Professional Bone metastases $1,446.41
M1077 Technical Bone metastases $6,194.22
M1078 Professional Brain metastases $1,651.56
M1079 Technical Brain metastases $9,879.40
M1080 Professional Breast cancer $2,059.59
M1081 Technical Breast cancer $10,001.84
M1082 Professional CNS tumor $2,558.46
M1083 Technical CNS tumor $14,762.37
M1084 Professional Cervical cancer $3,037.12
M1085 Technical Cervical cancer $13,560.15
M1086 Professional Colorectal cancer $2,508.30
M1087 Technical Colorectal cancer $12,200.62
M1088 Professional Head and neck cancer $3,107.95
M1089 Technical Head and neck cancer $17,497.16
M1094 Professional Lung cancer $2,231.40
M1095 Technical Lung cancer $12,142.39
M1096 Professional Lymphoma $1,724.07
M1097 Technical Lymphoma $7,951.09
M1098 Professional Pancreatic cancer $2,480.83
M1099 Technical Pancreatic cancer $13,636.95
M1100 Professional Prostate cancer $3,378.09
M1101 Technical Prostate cancer $20,415.97
M1102 Professional Upper GI cancer $2,666.79
M1103 Technical Upper GI cancer $14,622.66
M1104 Professional Uterine cancer $2,737.11
M1105 Technical Uterine cancer $14,156.20
National base rates are proposed to begin Jan. 1, 2022; rates are based on a weighted calculation from three years of claims data prior to the
performance year. CNS = central nervous system; GI = gastrointestinal.
OI | Vol. 36, No. 5, 2021 | accc-cancer.org 11Table 3. Summary of PRF Reporting Requirements
PAYMENT RECEIVED PERIOD (PAYMENTS DEADLINE TO USE
REPORTING TIME PERIOD
EXCEEDING $10,000 IN AGGREGATE RECEIVED) FUNDS
Period 1 April 10, 2020-June 30, 2020 June 30, 2021 July 1, 2021-Sept. 30, 2021
Period 2 July 1, 2020-Dec. 31, 2020 Dec. 31, 2021 Jan. 1, 2022-March 31, 2022
Period 3 Jan. 1, 2021-June 30, 2021 June 30, 2022 July 1, 2022-Sept. 30, 2022
Period 4 July 1, 2021-Dec. 31, 2021 Dec. 31, 2022 Jan. 1, 2023-March 31, 2023
(Continued from page 10)
Act and the Paycheck Protection Program 3. Skilled nursing facility and nursing home monies were used and that monies were
and Health Care Enhancement Act, monies infection control distribution payments used as intended as part of the terms and
were allocated to be distributed to health- use (if applicable) conditions to which the provider agreed
care providers as part of the Provider Relief 4. General and other targeted distribution when receiving the funds.5 The HHS HRSA
Fund. payments Provider Relief Fund Portal is active and open
If determined eligible, qualified providers 5. Net unreimbursed expenses attributable for reporting at: prfreporting.hrsa.gov/s. If
of healthcare services and support could to coronavirus providers are not already registered, they can
receive relief payments for healthcare-related 6. Lost revenue reimbursement. do so at the portal link. Several resources are
expenses for lost revenue due to COVID-19. available on the portal, which can be
These payments do not need to be paid back, Healthcare providers who received between accessed without logging in:
but if recipients received one or more $10,001 and $499,999 in aggregated relief • Portal FAQs:
payments exceeding $10,000 in the payments during each payment receipt prfreporting.hrsa.gov/HRSA_FileRender?
aggregate during a payment receipt period, period are required to report on two name=PortalFAQs
they must submit reporting requirements as categories of data: 1) general and adminis- • Registration User Guide:
agreed to in the terms and conditions of the trative expenses and 2) healthcare-related prfreporting.hrsa.gov/HRSA_FileRender?
specific funding.4 Because each distribution expenses. Those receiving $500,000 or more name=RegistrationUserGuide
are required to provide more detail in the • Reporting User Guide:
has its own terms and conditions, providers
two categories, including mortgage and rent, prfreporting.hrsa.gov/HRSA_FileRender?
must review the distribution they received to
fringe benefits, utilities, supplies and name=ReportingUserGuide
understand any specifics related to their
equipment purchased, information • Portal Worksheets:
agreement. Table 3, above, outlines the four
technology, and other healthcare-related prfreporting.hrsa.gov/HRSA_FileRender?
different periods of payments received, the
expenses. name=PortalWorksheets.
deadline to use the funds, and the reporting
time period. Healthcare providers must The use of the Provider Relief Fund is As oncology providers continue to work
report how they used the funds received if specific to costs incurred to prevent, prepare through 2021, it is not too early to begin
they reach the threshold amount. Reporting for, and respond to COVID-19. Providers are preparing for 2022. The many waivers and
is submitted in consolidated reports per the expected to ensure that documentation is extensions exercised for the past nearly two
normal basis of accounting. Per the notice, present and supports how the funds received years are now coming due in different ways,
data are reported in the following order: were used. According to the HHS website, the and it will be interesting to see how all of
1. Interest earned on PRF payment(s) burden of proof is on the provider to ensure this will play out as the impact for some may
2. Other assistance received that the documentation supports how the be more burdensome than it is for others.
12 accc-cancer.org | Vol 36, No. 5, 2021 | OITeri Bedard, BA, RT(R)(T), CPC, is executive Published July 13, 2021. Last accessed July 28, 3. Health and Human Services. Provider Relief Fund
director, Client & Corporate Resources, 2021. general and targeted distribution post-payment
notice of reporting requirements. Available online
Revenue Cycle Coding Strategies, Cedar Park, 2. Centers for Medicare & Medicaid Services and at: hhs.gov/sites/default/files/provider-post-pay-
Tex. Health and Human Services. Medicare program: ment-notice-of-reporting-require-
Hospital Outpatient Prospective Payment and ments-june-2021.pdf. Published June 11, 2021.
References Ambulatory Surgical Center Payment Systems and Last accessed June 29, 2021.
1. Centers for Medicare & Medicaid Services and quality reporting programs; new categories for 4. Health and Human Services. CARES Act Provider
Health and Human Services. Medicare program; hospital outpatient department prior authoriza- Relief Fund: for providers. Available online at: hhs.
CY 2022 payment policies under the physician fee tion process; clinical laboratory fee schedule: gov/coronavirus/cares-act-provider-relief-fund/
schedule and other changes to Part B payment laboratory date of service policy; overall hospital for-providers/index.html#terms-and-conditions.
policies; Medicare shared savings program quality star rating methodology; and physi- Published June 11, 2021. Last accessed June 29,
requirements; provider enrollment regulation cian-owned hospitals. Available online: 2021.
updates; provider and supplier prepayment and federalregister.gov/docu- 5. Health and Human Services. Provider Relief Fund
post-payment medical review requirements. ments/2020/08/12/2020-17086/medicare-pro- general information (FAQs). Available online at:
Available online at: federalregister.gov/ gram-hospital-outpatient-prospective-pay- hhs.gov/coronavirus/cares-act-provider-relief-
public-inspection/2021-14973/medicare-pro- ment-and-ambulatory-surgical-center-payment. fund/faqs/provider-relief-fund-general-info/index.
gram-cy-2022-payment-policies-under-the-physi- Published July 19, 2021. Last accessed July 29, html#auditing-reporting-requirements. Last
cian-fee-schedule-and-other-changes-to-part. 2021. accessed June 29, 2021.
Every 180 seconds, another
American is diagnosed with
a blood cancer. In the same
amount of time—three minutes—
you have the power to help.
September is Blood Cancer Awareness Month,
a time to raise awareness and support blood
cancer patients. In 180 seconds, you can connect
your patients to The Leukemia & Lymphoma
A LIFETIME Society’s (LLS) free blood cancer information,
education, and 1:1 support.
OF DIFFERENCE. Call 800-955-4572 or visit
www.LLS.org/blood-cancer-awareness
for more information.
The mission of The Leukemia & Lymphoma Society (LLS) is
to cure leukemia, lymphoma, Hodgkin’s disease and myeloma,
and improve the quality of life of patients and their families.
Find out more at www.LLS.org.
OI | Vol. 36, No. 5, 2021 | accc-cancer.org 13tools
Approved Drugs • On July 9, the FDA approved Padcev® non-Hodgkin’s lymphoma and is outside
(enfortumab vedotin-ejfv) (Astellas the FDA accelerated approved indication
• On June 16, the U.S. Food and Drug Pharma, Inc., astellas.com) for adult for the treatment of adult patients with
Administration (FDA) approved Ayvakit™ patients with locally advanced or relapsed follicular lymphoma who have
(avapritinib) (Blueprint Medicines, metastatic urothelial cancer who have received at least two prior systemic
blueprintmedicines.com) for adult previously received a programmed death therapies.
patients with advanced systemic receptor 1 or programmed death ligand 1
inhibitor and platinum-containing • Allogene Therapeutics, Inc. (allogene.com)
mastocytosis (SM), including patients announced that the FDA granted fast
with aggressive SM, SM with an associ- chemotherapy or patients who are
track designation to ALLO-605 for the
ated hematological neoplasm, and mast ineligible for cisplatin-containing
treatment of relapsed or refractory
cell leukemia. chemotherapy and have previously
multiple myeloma.
received one or more prior lines of
• On July 9, the FDA approved Darzalex therapy. • Ascentage Pharma (ascentagepharma.
Faspro™ (daratumumab and hyaluroni- com) announced that the FDA granted an
dase-fihj) (Janssen Biotech, Inc., janssen. • On July 16, the FDA approved Rezurock™
(belumosudil) (Kadmon Pharmaceuticals, orphan drug designation to alrizomadlin
com) in combination with pomalidomide (APG-115) for the treatment of stage IIB
and dexamethasone for adult patients LLC, kadmon.com) for adult and pediatric
patients 12 years and older with chronic to IV melanoma.
with multiple myeloma who have received
at least one prior line of therapy, including graft-versus-host disease after failure of • Agenus Inc. (agenusbio.com) announced
lenalidomide and a proteasome inhibitor. at least two prior lines of systemic that the FDA accepted its biologics license
therapy. application for balstilimab (AGEN2034)
• On July 6, the FDA approved an expanded for the treatment of recurrent or
label for Keytruda® (pembrolizumab) • On July 1, the FDA approved Rylaze™
(asparaginase erwinia chrysanthemi metastatic cervical cancer with disease
(Merck, merck.com) as a monotherapy for progression on or after chemotherapy.
the treatment of patients with locally (recombinant)-rywn) (Jazz
advanced cutaneous squamous cell Pharmaceuticals, jazzpharma.com) as a • Exelixis (exelixis.com) announced that the
carcinoma that is not curable by surgery component of a chemotherapy regimen FDA accepted its supplemental NDA for
or radiation. On July 21, the FDA approved to treat acute lymphoblastic leukemia Cabometyx® (cabozantinib) as a
Keytruda in combination with Lenvima® and lymphoblastic lymphoma in adult treatment for patients 12 years and older
(lenvatinib) (Eisai, us.eisai.com) for and pediatric patients who are allergic to with differentiated thyroid cancer who
patients with advanced endometrial the Escherichia coli-derived asparaginase have progressed following prior therapy
carcinoma that is not microsatellite products commonly used for treatment. and are radioactive iodine refractory (if
instability-high or mismatch repair radioactive iodine is appropriate).
deficient, who have disease progression Drugs in the News
following prior systemic therapy in any
• G1 Therapeutics, Inc. (g1therapeutics.
com) announced that the FDA granted
setting, and who are not candidates for • Bayer (bayer.com/en/) announced the
fast track designation to Cosela™
curative surgery or radiation. On July 26, submission of a supplemental new drug
(trilaciclib) for use in combination with
the FDA approved Keytruda for high-risk, application (NDA) to the FDA seeking
chemotherapy for the treatment of locally
early-stage triple-negative breast cancer approval of the investigational combina-
advanced or metastatic triple-negative
in combination with chemotherapy as tion of the anti-cancer treatments
breast cancer.
neoadjuvant treatment and then Aliqopa® (copanlisib) and rituximab. The
continued as a single agent as adjuvant submission is for the treatment of • CNS Pharmaceuticals Inc. (cnspharma.
treatment after surgery. patients with relapsed indolent B-cell com) announced that the FDA granted
14 accc-cancer.org | Vol. 36, No. 5, 2021 | OIYou can also read
