April 2018 Medical Policy Updates:
- Afrezza (human insulin)
- Endari™ (L-glutamine)
- Hereditary Angioedema (Berinert, Cinryze, Firazyr, Haegarda, Kalbitor, Ruconest)
- Idiopathic Pulmonary Fibrosis (Esbriet®/pirfenidone, Ofev®/nintedanib)
- Kalydeco (ivacaftor), Orkambi (lumacaftor/ivacaftor)
- Multiple Sclerosis Agents
- New to Market Drugs: Including Hemlibra® (emicizumab)
- Tysabri® (natalizumab), Lemtrada™ (alemtuzumab), and Ocrevus® (ocrelizumab) (IV Multiple Sclerosis Agents)
- Xermelo (telotristat)
- Adjustable Cranial Orthoses for Positional Plagiocephaly and Craniosynostoses
- Cardiac Rehabilitation in the Outpatient Setting
- Chelation Therapy for Off-Label Uses
- Continuous Passive Motion in the Home Setting
- Continuous or Intermittent Monitoring of Glucose in Interstitial Fluid
- Corneal Collagen Cross-Linking
- Corneal Topography/Computer-Assisted Corneal Topography/Photokeratoscopy
- Gastric Electrical Stimulation
- Genetic Testing for Predisposition to Inherited Hypertrophic Cardiomyopathy
- Intravenous Antibiotic Therapy and Associated Diagnostic Testing for Lyme Disease
- Optical Coherence Tomography (OCT) of the Anterior Eye Segment
- Photodynamic Therapy for Choroidal Neovascularization
- Postsurgical Home Use of Limb Compression Devices for Venous Thromboembolism Prophylaxis
- Scanning Computerized Ophthalmic Diagnostic Imaging Devices
- Self Administered Oncology Agents
- Ultrasound Accelerated Fracture Healing Device
- Cardiovascular Magnetic Resonance (CMR)
- Contrast-Enhanced Coronary Computed Tomography Angiography (CCTA) for Coronary Artery Evaluation
- Lysis of Epidural Adhesions
Policy Alerts monitors Commercial and Medicare medical policies for changes. While Payers typically update medical policies annually, there are many reasons why a Payer might review or update a policy. When reviews occur out of cycle, they may go unnoticed. Policy Alerts keeps you informed of upcoming and unexpected coverage changes affecting your product. Quickly understanding the changes Payers make can help you adjust reimbursement strategies impacting your business.
Policy Alerts continuously monitors Commercial and Medicare Payer coverage information to keep you up-to-date on Payer decisions in real-time. Whenever changes occur, email notifications containing a summary of those changes are delivered to your inbox. Clients can access detailed coverage reports and medical policies on the interactive Dashboard portal. Save time and keep focused on the important Payer medical policy reviews and coverage decisions affecting your product!
Policy Alerts takes a client-focused hands-on approach and works hard to provide our customers with helpful insights and actionable analytics over raw data. We understand what our clients need and we are dedicated to making sure we provide timely, accurate and always up-to-date reports that can be used to implement and support a successful reimbursement strategy.
Health economic and reimbursement information provided by Policy Alerts is gathered from third-party sources and is subject to change without notice as a result of complex and frequently changing laws, regulations, rules and policies. This information is presented for illustrative purposes only and does not constitute reimbursement or legal advice.