December 2017 Medical Policy Updates:
REVISED MEDICAL POLICIES:
- Bone Morphogenetic Protein
- Molecular Analysis for Targeted Therapy of Non-Small-Cell Lung Cancer
- Vagus Nerve Stimulation
CLARIFICATIONS TO MEDICAL POLICIES:
- Allogeneic Hematopoietic Cell Transplantation for Genetic Diseases and Acquired Anemias
- Medical Technology Assessment Investigational (Non-Covered) Services List
- Outpatient Psychotherapy
- Patient-Specific Cutting Guides for Knee Arthroplasty
- Stereotactic Radiosurgery and Stereotactic Body Radiotherapy
- Use of Common Genetic Variants (Single Nucleotide Variants) to Predict Risk of Nonfamilial Breast Cancer
RETIRED MEDICAL POLICIES:
- Thoracic-LumboSacral Orthosis with Pneumatics
REVISED PHARMACY MEDICAL POLICIES:
- Benign Prostatic Hyperplasia – BPH
- Bisphosphonate, Oral
- Diabetes Step Therapy
- Dificid® (fidaxomicin)
- Dopamine Agonists, non-ergot derived
- Follitropin Step Therapy
- Immune Modulating Drugs
- Ophthalmic Prostaglandins
- Overactive Bladder Medications
- Phosphodiesterase Type-5 Inhibitors for Pulmonary Arterial Hypertension
- Topical Testosterone
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.