Jun 3, 2009
As issued in the April 3, 2009 policy memorandum, CMS began independently
pricing prescription drug treatment costs/expenses in Workers' Compensation
Medicare Set Aside (MSA) allocations on June 1, 2009.
On June 2nd, CMS
released a document addressing a number of situational questions and concerns
received from submitters of WC MSAs. Topics addressed by CMS in this
document include the following:
- The source used for evaluating the sufficiency of the prescription drug
component of WC MSAs
- Required documentation to support the proposed MSA
- Tapering of drug use
- Experiation of patents
- Off-label drug use
- Drug utilization review findings
- Brand name or generic drugs
- Multiple manufacturers of a particular drug
The full CMS document
is available by clicking on the 'Full Story' link below.
Full Story
May 28, 2009
CMS has realesed its schedule for all remaining 2009 NGHP Technology and
Policy related teleconferences for Mandatory Insurer Reporting.
One teleconference for each topic will be held per month for the remainder of
the year. All calls will be held from 1 pm - 3 pm EST and will utilized
the same call in number and passcode for participant convenience.
For the complete list of teleconference dates and related information, please
click on the 'Full Story' link below.
Full Story
May 14, 2009
CMS has issued an "Alert" amending information provided in the NGHP User
Guide and providing a summary of changes to the implementation
timeline.
The Alert addresses the following issues:
- Extension of Registration Period
- Change/Delay in teh Testing Period for the Claim Input File and in the Start
Date for the Live Production Submission of the Claim Input File
- Start Date for Query Function Availability
- Exception Regarding Total Payment Obligation to the Claimant (TPOC)
Reporting Dates and Reporting for Multiple TPOC Amounts where the Reporting
Threshold is a Consideration
- Summary of Changes to the Implementation Timeline
To view the alert please click on 'Full Story'.
Full Story
May 13, 2009
CMS has issued a Quick Reference Guide for Section 111 Registration for all
Responsible Reporting Entities (RRE). Please note:
This guide is intended as a reference to assist Section 111 RREs with the
registration process. It is not a substitute for reading the applicable
and existing instructions.
To view the guide click on the 'Full
Story' link below.
Full Story
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