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Association for Molecular Pathology

Webcasts in 2016

The Who, What, and When of the PAMA Final Rule

June 30, 2016

Presenter:

Erika Miller, JD

Government Affairs Consultant to AMP Economic Affairs Committee

Senior Vice President and Counsel, CRD Associates, LLC

 

Host:

Tara Burke, PhD
AMP Senior Policy Analyst

Bethesda, MD

 

Description:

Just released are the final regulations of The Protecting Access to Medicare Act (PAMA) Section 216. PAMA significantly revises the Medicare payment system for clinical diagnostic laboratory tests by requiring that Medicare payment for clinical laboratories be based on the weighted median of private payer rates along with a number of other provisions.

 

Please note that details on this final rule are still being elucidated and additional specifics are expected to be introduced by CMS in the coming months. Therefore, this webcast is just the first AMP educational event on PAMA implementation. The AMP Economic Affairs Committee will continue to update membership as details emerge and the committee is organizing a session on PAMA at this year's annual meeting. During and after the webcast we encourage attendees to submit their questions. These questions and answers will be compiled into a document and will be available as a supplement to the archived version of this webcast.


Learning Objectives:

  • Provide a brief background on PAMA and present details on the implementation timeline
  • Review the contents of the final rule. Topics will include:
    • Definition of "Applicable Laboratory"
    • Ratesetting Process and Penalties
    • Advanced Laboratory Diagnostic Tests (ADLTs)
    • Coding and other provisions
  • Explain how and to what extent molecular pathology professionals and their laboratories will be affected.

Level of Instruction: Basic


Number of Contact Hours: 1.0


Emerging Fronts in Molecular Pathology: Promise and Pitfalls of Circulating Tumor DNA

June 9, 2016

Presenter:

Christina Lockwood, PhD, DABCC, FACB

University of Washington Medical Center

Seattle, WA

 

Host:
Cecilia Yeung, MD

T&E Committee Member

Fred Hutchinson Cancer Research Center

Seattle, WA

 

Description:
In oncology, there are a variety of potential clinical applications for a minimally invasive blood test for DNA released from tumor cells. Such applications include detecting early stage disease, tracking response to therapy, prompt identification of disease relapse or recurrence, and recognition of clonal evolution.  Numerous small-scale studies have demonstrated that quantitation of mutations in circulating tumor DNA (ctDNA) is feasible from the blood of cancer patients. The increased adoption of targeted cancer therapies underscores the need to augment invasive tissue biopsies with alternative detection methods that rapidly monitor treatment response. Although most studies have been proof of principle, ctDNA methods hold great promise in cancer diagnostics.

 

Learning Objectives:

1. Define circulating, cell-free tumor DNA (ctDNA)

2. Explain the pre-analytic and standardization challenges associated with ctDNA

3. Summarize the clinical utility of ctDNA in lung cancer and breast cancer

 

Level of Instruction: Basic


Number of Contact Hours: 1.0


Emerging Fronts in Molecular Pathology: Bacterial and Fungal Typing by Sequence-based Methods

May 27, 2016

Presenter:

Lynn Bry, MD, PhD

Brigham & Womens Hospital / Harvard University

Boston, MA

 

Host:
Colleen Kraft, MD

T&E Committee Member

Emory University

Atlanta, GA

 

Description:

This presentation will discuss current methods used to identify bacteria by 16S rRNA gene sequencing and fungi by use of the ITS (Internal Transcribed Spacers) and D1/D2 regions, including both technical and bioinformatic analyses. Additional content will cover use of these methods to identify pathogens in primary samples, example cases and clinical reporting, potential application of next generation sequencing (NGS)-based methods, and considerations for labs developing and implemeting these assays.

 

Learning Objectives:

  • Utilize sequence-based methods to type bacteria and fungi isolated in the clinical microbiology lab
  • Discuss bioinformatic and informatic infrastructure needed to support assays and their interpretation
  • Use potential applications for testing on primary samples


Level of Instruction: Basic


Number of Contact Hours: 1.0


Emerging Fronts in Molecular Pathology: Targetable Genetic Bases for Immune Evasion in Lymphomas

May 9, 2016

Presenter:
Margaret A. Shipp, MD
Dana-Farber Cancer Institute

Boston, MA

 

Host:
Jennifer Dunlap, MD

T&E Committee Member

Oregon Health Sciences University

Portland, OR

 

Description:
Dr. Shipp will discuss genetic and adaptive mechanisms of immune evasion focusing on checkpoint blockade.She will also discuss associated approaches to treatment and the preliminary results of the most recent trials of PD-1 blockade in Hodgkin lymphoma.

 

Learning Objectives:

  • Review bases for tumor immune evasion with a focus on PD-1 signaling.
  • Review genetic bases for PD-1 mediated tumor immune evasion in lymphoid malignancies.
  • Review the results of recently completed and ongoing trials of PD-1 blockade in specific lymphoid malignancies with a focus on Hodgkin lymphoma.

Level of Instruction: Advanced

 

Number of Contact Hours: 1.0


Zika Virus: Diagnostic Testing and Front-Line Management

An Educational Event Collaboration Between the Association for Molecular Pathology and the Pan American Society for Clinical Virology

April 29, 2016

Presenters:

Cecilia Perret, MD

Pontifica Universidad Catolica de Chile

Santiago, Chile

 

Benjamin Pinsky, MD, PhD
Stanford University Medical Center

Palo Alto, CA

 

Host:
Kevin Alby, PhD

T&E Committee Member

University of Pennsylvania, Perelman School of Medicine

Philadelphia, PA

 

Descriptions:

"Zika in Latin America: Clinical Aspects" by Dr. Perret
A review the epidemiology of the Zika outbreak in Latin America, some clinical aspects, evidence of a Zika infection, and its complications (congenital disease and Guillain Barre Syndrome). In addition, she will discuss the local response to a series of travelers infected with Zika, including a pregnant woman and a sexually transmitted infection.

 

"Zika Virus Diagnostics" by Dr. Pinsky
Zika virus (ZIKV) is an Aedes mosquito-borne flavivirus that emerged in Brazil in 2015 and then rapidly spread throughout the tropical and subtropical Americas. Based on clinical criteria alone, ZIKV cannot be reliably distinguished from infections with other pathogens that cause an undifferentiated systemic febrile illness, including infections with two common arboviruses, dengue virus and chikungunya virus. This presentation details the methods that are available to diagnose ZIKV infection.

 

Course Objectives:

1. Identify Zika epidemiology in Latin America (Perret)
2. Discuss clinical aspects of Zika infection (Perret)
3. Discuss complications of Zika infections in recent studies (Perret)
4. Discuss the advantages and disadvantages of Zika virus antibody testing (Pinsky)
5. Discuss the advantages and disadvantages of Zika virus RNA testing (Pinsky)
6. Explore the utility of multiplex testing for co-circulating arboviruses (Pinsky)

 

Level of Instruction: Basic to Intermediate


Number of Contact Hours: 1.0


Emerging Fronts in Molecular Pathology: Building Synthetic Immunity to Cancer Using Chimeric Antigen Receptors

April 27, 2016

Presenter: Michael C. Milone, MD, PhD
University of Pennsylvania, Perelman School of Medicine

Philadelphia, PA

 

Host: Kevin Alby, PhD

T&E Committee Member

University of Pennsylvania, Perelman School of Medicine

Philadelphia, PA

 

Description:

This webinar will provide an broad overview of chimeric antigen receptors (CARs) and their application to the treatment of cancer using adoptive T cell immunotherapy. CAR therapy targeting CD19 will be discussed in detail including some of the unique toxicity associated with this novel therapeutic and the challenges to broadly applying this technology for B-cell leukemia and lymphoma.

 

Learning Objectives:

  • Discuss the basic concept of a chimeric antigen receptor (CAR).
  • Describe the current applications of CAR technology to cancer therapy, specifically leukemia and lymphoma.
  • Recognize some of the unique challenges to using CAR-based therapies.

 

Level of Instruction: Basic


Number of Contact Hours: 1.0


Molecular Coding, Coverage, and Reimbursement 101

A Webinar Presented by the Economic Affairs Committee

March 8, 2016

Presenter: Samuel K. Caughron, MD

Chair, AMP Economic Affairs Committee (EAC)

MAWD Pathology Group, P.A.

North Kansas City, MO

 

Host: Aaron D. Bossler, MD, PhD

EAC Vice-Chair, New Codes Subcommittee

University of Iowa
Iowa City, IA

 

Description:

Ever wondered how a molecular test gets paid for but were too afraid to ask? The AMP Economic Affairs Committee invites you to a webinar where Dr. Caughron will provide an overview of coding, coverage and reimbursement determination processes, with an emphasis on the Centers for Medicare and Medicaid Services' (CMS) methods used by the Medicare Administrative Contractors (MACs).  The entire process is dependent on input from the broad laboratory community to ensure that tests are covered and reimbursed appropriately by Medicare.  This webinar will provide AMP members with a better understanding of the different parts of the process and will educate members on how to become engaged in the AMP's efforts on their behalf.

 

Learning Objectives:

  • Provide a brief overview of the molecular pathology and genomic sequencing procedure coding structure
  • Explain the CMS processes for coverage and reimbursement including gapfill, crosswalk, and local coverage determinations

  • Identify ways you can assist the EAC to ensure patient access to appropriate test procedures

Level of Instruction: Basic


Number of Contact Hours: 1.0


Emerging Fronts in Molecular Pathology: Clonal Hematopoiesis of Indeterminate Potential

January 26, 2016

Presenter: Benjamin L. Ebert, MD, PhD

Harvard Medical School

Stem Cell Institute

Boston, MA

 

Host: Cecilia Yeung, MD

AMP T&E Committee Member

Fred Hutchinson Cancer Research Center
Seattle, WA

 

Description:

Clonal hematopoiesis of indeterminate potential (CHIP) is a common, age-associated condition. CHIP is defined by the presence of clonal, somatic mutations in the blood. The mutations identified in CHIP are the same as those found in hematologic malignancies, including acute myeloid leukemia (AML). Indeed, the mutations identified in CHIP, including mutations in DNMT3A, TET2, and ASXL1, are lesions that are commonly acquired early in the genetic ontogeny of AML. Consistent with the concept that CHIP is the first step on a pathway to malignancy, CHIP is associated with an increased risk of hematologic malignancy. Approximately 0.5 to 1% of individuals with CHIP progress to hematologic malignancy per year. Individuals with CHIP, generally bearing just a single mutation in a driver gene, do not have altered blood counts. In contrast, patients with AML generally have mutations in multiple genes as well as the disease-defining defects in hematopoietic differentiation and the accumulation of bone marrow blasts. The identification of clonal mutations that can act as founding genetic lesions that predispose individuals to the development of hematologic malignancies has implications both for the identification of individuals at risk for hematologic malignancy and for the clonal mutations that persist after therapy for AML.

 

Learning Objectives:

  • Review the concept of clonal hematopoiesis as a pre-malignant state
  • Review the genetic lesions most commonly found in clonal hematopoiesis
  • Discuss the genetics progression of clonal hematopoiesis to myelodysplastic syndrome and acute leukemia

Level of Instruction: Intermediate

 

Number of Contact Hours: 1.0