The Centers for Medicare & Medicaid Services (CMS) recently added an item to the Unified Agenda, which may have an impact on your claims. The Unified Agenda of Federal Regulatory and Deregulatory actions is a semiannual compilation of information about regulations under development by federal agencies published in the spring and fall. The item added […] Continue
You may recall our earlier blog this week about Lyrica in the News. Once again, the spotlight is on Lyrica. First, after Pfizer was awarded a six-month patent extension based on a new pediatric indication for the drug. Earlier this month, the Supreme Court in the United Kingdom ruled against Pfizer in a longstanding patent […] Continue
Lyrica and its manufacturer Pfizer have been in the news quite frequently this month, and the publicity has not been positive. Most recently, on November 14th, the Supreme Court of the United Kingdom (U.K.) ruled against Pfizer in a patent infringement lawsuit that has spanned the past several years. It’s no secret that pharmaceutical manufacturers […] Continue
On November 14, 2018, the Food and Drug Administration (FDA) issued a safety communication to all patients with implanted intrathecal pumps, their caregivers and health care providers, and medication compounding companies warning of the dangers of utilizing medications in intrathecal pumps that have not specifically been approved for intrathecal pump use. Intrathecal pumps are programmable devices that […] Continue
You may recall that several months ago, CMS held an informative webinar regarding the benefits of using the Medicare Secondary Payment Recovery Portal (MSPRP). During this webinar, CMS also announced several future enhancements coming to the MSPRP. One of the upcoming enhancements is the ability to self-report. CMS announced today that effective January 7, 2019, authorized […] Continue
Last month, at the annual National Alliance of Medicare Set-Aside Professionals’ Annual Conference, Performant Financial (Performant), the current contractor for the Commercial Repayment Center (CRC), held a timely panel question and answer session. You may recall that we recently blogged about how the current conditional payment recovery process continued to terrorize many non-group health plans. […] Continue
This blog series is devoted to better understanding the efforts our Federal government is undertaking to combat the opioid epidemic in America. Earlier this year, the Department of Health and Human Services (HHS) announced a five-part strategy that will be utilized to combat the opioid epidemic. In previous posts, we have focused on parts one […] Continue
You may recall that we recently blogged about whether the Medicare Secondary Payer (MSP) Act, a Federal law, preempts State law. A Maryland case quite succinctly addressed this question several months ago finding that State law is not preempted by the MSP if certain conditions are met. This question was also addressed recently in a […] Continue
An updated Workers’ Compensation Medicare Set-Aside (WCMSA) reference guide has been issued. The revised guide, version 2.8, can be found here. The revised WCMSA reference guide includes the following updates: Fields formerly labeled as “HICN” have been relabeled as “Medicare ID” and can accept either an Health Insurance Claim Number (HICN) or the new Medicare Beneficiary […] Continue
This blog series is devoted to better understanding the efforts our Federal government is undertaking to combat the opioid epidemic in America. Earlier this year, the Department of Health and Human Services (HHS) announced a five-part strategy that will be utilized to combat the opioid epidemic. In part one of this series, we examined the […] Continue