Ocular Therapeutix (NSDQ:OCUL) said today that the Centers for Medicare and Medicaid Services has assigned a specific and permanent reimbursement J-code for its Dextenza ophthalmic insert, which is approved for the treatment of ocular inflammation and pain following ophthalmic surgery. The code assigned to Dextenza through the Healthcare Common Procedure Coding System will become effective […]
Centers for Medicare and Medicaid Services (CMS)
Intersect ENT wins preliminary CMS reimbursement code
Shares in Intersect ENT (NSDQ:XENT) got a boost yesterday on news that the Centers for Medicare and Medicaid Services (CMS) had assigned the company’s Sinuva corticosteroid-eluting sinus implant a preliminary J-code. Intersect ENT stock, which had been bumping along just under $30 per share last week, jumped to $33.13 per share at Monday’s market open, […]
Insulet lands Medicare Part D coverage for Omnipod insulin delivery system
The Centers for Medicare and Medicaid Services issued guidance today noting that Insulet‘s (NSDQ:PODD) Omnipod tubeless insulin delivery device can be covered by the Medicare Part D prescription drug program. The Billerica, Mass.-based company estimated that its latest reimbursement win extends access to the Omnipod system to 450,000 people with Type I diabetes across the U.S. […]
Abbott nabs CMS reimbursement for FreeStyle Libre continuous glucose monitor
Abbott (NYSE:ABT) said today that its FreeStyle Libre continuous glucose monitor is now available to Medicare patients, after the Centers for Medicare & Medicaid Services determined that the device can be classified as a therapeutic CGM. The FreeStyle Libre is designed to read glucose levels through a sensor worn on the back of a person’s upper […]
Report: Drugmakers may have ducked $1.3B in Medicaid rebates
Without calling out any drug companies by name, the U.S. Dept. of Health and Human Services’ Office of Inspector General revealed this week that 10 potentially misclassified drugs may have resulted in $1.3 billion in lost rebates to Medicaid between 2012 and 2016. The issue of ducking rebates came to the public’s attention earlier this […]
Mylan inks $465m settlement with DOJ over EpiPen Medicaid classification
Mylan (NSDQ:MYL) said today that it inked a $465 million deal with U.S. Dept. of Justice to settle claims that it misclassified its EpiPen allergy auto-injector device with the Medicaid Drug Rebate Program. In October last year, The Centers for Medicare & Medicaid Services said that Mylan had been overcharging Medicaid for its EpiPen device for years, […]
Kentucky doc gets jail time for bad opioid prescription habits & Medicaid fraud
Dr. George Kudmani, an OB/GYN from Kentucky, was sentenced to 4 years in prison this week after a federal jury ruled that he was guilty of inappropriately doling out opioids and Medcaid fraud. The jury found Kudmani guilty of 19 counts of unlawful distribution of controlled substances and 8 counts of health care fraud. After Kudmani serves his […]
Trump proposes deep cuts to Medicaid, NIH funding
President Donald Trump’s proposed budget would slash Medicaid funding and cut support for major biomedical research programs at the National Institutes of Health and the Centers for Disease Control & Prevention. The budget blueprint drew condemnation from healthcare advocates and lawmakers from both sides of the aisle. Senate majority whip Sen. John Cornyn (R-Texas) reportedly said earlier […]
EpiPen purchasers level class action against Mylan over price hikes
Mylan (NSDQ:MYL) was hit with another class action lawsuit over the price of its EpiPen device yesterday. The lawsuit, which was filed in the Washington Western District Court, alleges that Mylan engaged in a scheme with pharmacy benefit managers to dominate the market and overcharge customers. Although the Canonsburg, Penn.-based company has been hit with several lawsuits […]
CMS updates on criteria for Dexcom G5 coverage
Shares in DexCom Inc. (NSDQ:DXCM) jumped 9% today after the Centers for Medicare & Medicaid Services updated the criteria for coverage of the company’s G5 Mobile continuous glucose monitor. The device is the only therapeutic CGM classified as durable medical equipment under Medicare Part B. Patients covered by Medicare who have Type I or II diabetes and […]
