OIG Issues Unfavorable Advisory Opinion to Specialty Pharmacy For Support Service Payments
On August 15, 2014, the OIG issued an unfavorable Advisory Opinion to a specialty pharmacy in connection with the pharmacy’s proposal to pay local retail pharmacies for support services that they provide in connection with patient referrals to the specialty pharmacy. The specialty pharmacy dispensed specialty pharmaceuticals that are often unavailable to retail pharmacies. Under […]
Medicare Joins New Jersey Medicaid In Mandating Pre-Authorization for Non-Emergency Ambulance Transports
CMS has announced that it will be transitioning to us of a prior authorization requirement for repetitive non-emergency ambulance transports. New Jersey Medicaid already has a pre-authorization requirement. Under the prior authorization requirement, ambulance suppliers will need submit a request for provisional affirmation of coverage before a non-emergency, repetitive ambulance transport is rendered to a […]