Last week, we provided an update that the Centers for Medicare and Medicaid Services (CMS) updated the Unified Agenda as related to the proposed rulemaking for guidance regarding how to satisfying Medicare Secondary Payer (MSP) obligations. The Unified Agenda was also recently updated with respect to the proposed rule regarding civil monetary penalties for MSP […] Continue
You may recall our blog from last week announcing the long awaited FDA approval of generic versions of the drug, Lyrica (pregabalin). While the FDA’s announcement sparked joy among all in the workers’ compensation industry, it was not until today that pregabalin became available for pricing and allocation in CMS’ maintained Workers’ Compensation Medicare Set-Aside […] Continue
The Centers for Medicare and Medicaid Services (CMS) released two new updated guides earlier this month: an updated Section 111 Medicare Secondary Payer Reporting User Guide, and an updated Workers’ Compensation Medicare Set-Aside Portal User Guide. Both of these guides contain very minor updates, which will not have a significant impact on the claims handling process. […] Continue
Yesterday, the Centers for Medicare & Medicaid Services (CMS) issued a proposed decision to cover acupuncture for Medicare patients with chronic low back pain (cLBP) who are enrolled participants either in clinical trials sponsored by the National Institutes of Health (NIH) or in CMS-approved studies. Currently, acupuncture is not covered by Medicare. You may recall […] Continue
Last week, the Centers for Medicare and Medicaid Services (CMS) issued a final rule, (CMS-4180-F) impacting Medicare Advantage Plans (MAP) and Part D programs. The rule aims to ensure that patients have greater transparency into the cost of prescription drugs, so that beneficiaries can compare options and also enables MAPs to negotiate better prices for […] Continue