Apple Health (Medicaid) Provider Alert

What is changing? 

There is no change to the agency’s current process for hospice 5-day notification for Washington Apple Health (Medicaid) clients. 

When does the agency require a completed hospice 5-day notification?

The agency requires a completed hospice 5-day notification form (HCA/Medicaid Hospice Notification, HCA 13-746) when the client is enrolled in hospice and resides in a nursing home, or may be admitted to a nursing home, and is one of the following: 

  • A Medicare client whose Medicaid eligibility is pending or who has not yet applied for Medicaid; or
  • A dual-eligible client (currently enrolled in Medicare and Medicaid). 

Please review the HCA/Medicaid Hospice Notification (HCA 13-746) form for complete and valid information, including current attending physician. The agency will return incomplete or incorrect forms by fax. To download an agency provider form, go to HCA’s Billers and provider’s web page, select Forms & publications.

When does the agency NOT require a completed hospice 5-day notification? 

Do not send an HCA/Medicaid Hospice Notification form to the agency for anyone who is private pay and not enrolled in Washington Apple Health (Medicaid). 

New FDA Approval for TALZENNA®

Pfizer announced the FDA approval of TALZENNA® (talazoparib) on October 16, 2018. 

Prescribing Information: click here

FDA Approves a New Dosing Frequency for  KYPROLIS® (carfilzomib) and dexamethasone

On October 1, 2018 Amgen announced that the U.S. Food and Drug Administration (FDA) has approved the supplemental New Drug Application (sNDA) to expand the Prescribing Information for KYPROLIS® (carfilzomib) to include a once-weekly dosing option in combination with dexamethasone (once-weekly Kd70) for patients with relapsed or refractory multiple myeloma. 

Click Here to read the entire Press Release

Click Here for more information on Kyprolis

FDA Approval of LORBRENA® (lorlatinib)

Pfizer Oncology is proud to announce the FDA approval of LORBRENA® (lorlatinib) on Friday, November 2, 2018.

Click here  to read the Press Release.

Visit LORBRENA U.S. Physician Prescribing Information to read the full PI.

New FDA Approval for Empliciti

On November 6, 2018 Bristol-Myers Squibb announced that the U.S. Food and Drug Administration (FDA) approved Empliciti (elotuzumab) injection for intravenous use in combination with pomalidomide and dexamethasone (EPd) for the treatment of adult patients with multiple myeloma who have received at least two prior therapies, including lenalidomide and a proteasome inhibitor.

Click Here to read the entire Press Release

Click Here to read the Prescribing Information

New FDA Approval for KEYTRUDA®

On October 30, 2018 Merck announced that the U.S. Food and Drug Administration (FDA) has approved KEYTRUDA, Merck’s anti-PD-1 therapy, in combination with carboplatin and either paclitaxel or nab-paclitaxel, for the first-line treatment of patients with metastatic squamous non-small cell lung cancer (NSCLC) based on results from the KEYNOTE-407 trial. In the pivotal Phase 3 trial of patients regardless of tumor PD-L1 expression status, KEYTRUDA in combination with chemotherapy (carboplatin and either paclitaxel or nab-paclitaxel) significantly improved overall survival (OS), reducing the risk of death by 36 percent compared to chemotherapy alone (HR=0.64 [95% CI, 0.49, 0.85]; p=0.0017). This approval marks the first time an anti-PD-1 regimen has been approved for the first-line treatment of squamous NSCLC regardless of tumor PD-L1 expression status.

Click Here to read the entire Press Release

Click Here for the Prescribing Information

Click Here for the Keytruda Medication Guide

New FDA Approval for KEYTRUDA®

On November 9, 2018 Merck announced that the U.S. Food and Drug Administration (FDA) has approved KEYTRUDA, Merck’s anti-PD-1 therapy, for the treatment of patients with hepatocellular carcinoma (HCC) who have been previously treated with sorafenib. This indication is approved under accelerated approval based on tumor response rate and durability of response. Continued approval for this indication may be contingent upon verification and description of clinical benefit in the confirmatory trials.

Click Here to read the entire press release

Click Here to read the Prescribing Information

Click Here to read the Keytruda Medication Guide

New NCCN Breast Cancer Guidelines Elevate Oncotype DX Breast Recurrence Score® as the Only Preferred Multi-gene Test to Predict Chemotherapy Treatment

On Oct. 9, 2018, Genomic Health, Inc., announced that its Oncotype DX Breast Recurrence Score® test has been categorized as the only "preferred" test for chemotherapy treatment decision-making for patients with node-negative early-stage breast cancer by the National Comprehensive Cancer Network (NCCN) in its 2018 guidelines for invasive breast cancer chemotherapy treatment. The only test elevated to "strongly consider" guideline inclusion with level 1 evidence, Oncotype DX continues to be distinguished as the only genomic test predictive of chemotherapy benefit. 

NCCN's guidelines update follows the recent publication of results of Trial Assigning IndividuaLized Options for Treatment (Rx), or TAILORx, led by ECOG-ACRIN Research Group. The largest adjuvant treatment breast cancer trial to date, TAILORx involved 10,273 women across 1,100 trial sites in six participating countries. The study results, published in The New England Journal of Medicine,  demonstrated that the Oncotype DX Breast Recurrence Score test definitively identifies the vast majority of women with early-stage breast cancer who receive no benefit from chemotherapy, and the important minority of women for whom chemotherapy benefit can be life-saving. 

Additionally, the NCCN guidelines elevated Oncotype DX into the algorithm for chemotherapy treatment of patients with micrometastases and one to three positive lymph nodes.

Click Here to read the entire Press Release