The Official Medicare Set Aside Blog And Information Resource

CMS Issues Final Rule for Medicare Advantage and Part D Pricing

CMS, Medicare Advantage, Rx/Pharmacy on May 22, 2019
Posted by Jean S. Goldstein, JD

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

A Reversal of the Opioid Trend in California

Medicare Set-Asides, Opioids, Rx/Pharmacy on May 15, 2019
Posted by Leah King, PharmD, JD, Independent Pharmacy Consultant

In February, the California Workers’ Compensation Institute (CWCI) published a report that had some interesting findings regarding the use of prescription drugs. With respect to utilization, non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen now rank above opioids as the most commonly prescribed medication class for workers’ compensation claimants. In terms of reimbursement, CWCI […] Continue

FDA Grants Approval for Generic Narcan (naloxone HCL) Nasal Spray

FDA, Opioids, Rx/Pharmacy on May 6, 2019
Posted by Jean S. Goldstein, JD

Recently, the FDA approved the first generic Narcan nasal spray to treat opioid overdose.  Narcan temporarily reverses the effects of opioid analgesics and is essentially an antidote for opioid overdose.  While generics of the injectable version of this medication, Evzio, have been available for quite some time, a generic of the nasal spray has not.  […] Continue

Gabapentin Abuse on the Rise

FDA, MSAs, Rx/Pharmacy on April 25, 2019
Posted by Leah King, PharmD, JD, Independent Pharmacy Consultant

All of the focus on the opioid crisis may have overshadowed a growing trend of abuse and misuse for another drug that’s well known to those of us in the workers’ compensation industry . . . gabapentin. Ironically, the growing trend of gabapentin abuse is related to the opioid crisis. In an effort to adhere […] Continue

FDA Takes Interest in Compounding Medications; Does this Mean Compounded Medications Will be Included in WCMSAs in the Future?

FDA, MSAs, Rx/Pharmacy on April 10, 2019
Posted by Jean S. Goldstein, JD

Last week the Food and Drug Administration’s (FDA) Commissioner, Scott Gottlieb, M.D. and Deputy Commissioner, Anna Abram issued a statement on new 2019 efforts to improve the quality of compounded drugs.  The statement can be found here.  Interestingly in 2018, the FDA also announced a new and expanded compounded research project, for which the FDA announced […] Continue