The Official Medicare Set Aside Blog And Information Resource

CMS Issues Proposed Decision to Cover Acupuncture for Medicare Beneficiaries

CMS, Medicare Set-Asides, Opioids on July 16, 2019
Posted by Jean S. Goldstein, JD

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

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

The Opioid Crisis: What is The Government Doing About It? Part 5 – Improving the Quality of Research on Pain and Addiction

CMS, Opioids, Rx/Pharmacy on February 15, 2019
Posted by Complex Claims Division

This blog series is devoted to better understanding the efforts our Federal government is undertaking to combat the opioid epidemic in America. Last 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 the first four […] Continue

CMS Targets Medical Providers and “Other Interested Stakeholders” in Upcoming Part D Opioid Overutilization Policies Call

CMS, Medicare Set-Asides, Opioids on February 7, 2019
Posted by Jean S. Goldstein, JD

Next week, CMS will be holding a telephone call to discuss and answer questions regarding CMS’ new opioid policies for Medicare drug plans.  CMS finalized new policies for the Part D plans to follow starting January 1, 2019.  Through this initiative, CMS is seeking to strengthen and broaden its partnership with providers to address the […] Continue