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| PMSI Settlement Solutions Appeals to CMS on MSA Drug Review Standards |
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The Centers for Medicare and Medicaid Services (CMS) recently announced a new methodology for pricing prescription drugs in Workers’ Compensation Medicare Set-Asides (MSAs). The unintended consequence of the new pricing methodology will be grossly overinflated future drug cost allocations which in turn will adversely impact payors’ ability to settle claims.
Leveraging unique cross-industry expertise in MSA allocations and Pharmacy Benefit Management (PBM), PMSI Settlement Solutions is appealing directly to CMS for improvements to the new drug review methodology based on current standards of practice. Utilizing scientific and evidence-based rationale PMSI has created an alternative drug review methodology which will provide for fair and equitable allocations. PMSI will work with government affairs experts, industry consultants and other interested payors on the appeal.
For more about the CMS’ prescription pricing methodology and the appeal initiative, download the PMSI Perspective, Reaching Out for a Common Resolution. by clicking here.
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| Medicare Set-Aside and claim settlement solutions for workers’ compensation and liability
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PMSI Settlement Solutions delivers a comprehensive end-to-end solution for workers’ compensation and liability claims settlement and Medicare Secondary Payer Compliance (Medicare Set-Asides and Liability
Primary Payer Allocations).
From SCHIP/MMSEA111 reporting through Medicare Set-Asides (MSA) and Liability
Primary Payer Allocations (LPPA), CMS submission and post-settlement services, PMSI Settlement Solutions provides cost-effective, regulation-compliant services that close claims quickly and cost effectively.
As a leading provider of settlement services to over 150 carriers, third-party administrators (TPAs), self-insured employers and attorneys, PMSI Settlement Solutions knows the only good claim is a settled claim.
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