Navigation Links
PMSI Advocacy Efforts Prompt CMS to Improve MSA Review Methodology

PMSI Settlement Solutions, a leading provider of solutions for the workers' compensation and liability markets, announced that it has received notification from the Centers for Medicare and Medicaid Services (CMS) of new prescription drug requirements pertaining to Medicare Set-Asides (MSA).

Tampa, Florida (Vocus) May 17, 2010 -- PMSI Settlement Solutions, a leading provider of solutions for the workers' compensation and liability markets, announced that it has received notification from the Centers for Medicare and Medicaid Services (CMS) of new prescription drug requirements pertaining to Medicare Set-Asides (MSA). In a memorandum dated May 14th, CMS states that "For a Part D drug to be covered by Medicare, and thus included properly in a WCMSA, the drug should be prescribed for an outpatient use that is approved under the Federal Food, Drug, and Cosmetic Act [21 U.S.C.A. Sec. 301 et seq.”.

This recent memorandum clarifies the exclusion of non-Medicare Part D covered prescription drugs from MSA calculations. Eileen Auen, PMSI's Chief Executive Officer stated, "Over the past ten years, rising prescription drug costs have been an industry wide issue. As the only significant MSA provider with extensive pharmacy experience, PMSI was uniquely qualified to work with CMS on this important issue. CMS' improved approach will help to drive allocations back to acceptable amounts and prevent inflated MSAs.”

"Pain management medications are a very significant cost driver in workers' compensation. Many of the medications commonly utilized for the treatment of chronic pain are not covered by Part D," commented Kent Takemoto, M.D., President, PMSI Settlement Solutions. "In recent PMSI analysis, the exclusion of non-Part D covered drugs affected about 65% of the most commonly used drugs in workers' compensation.”

In anticipation of CMS' policy memorandum, PMSI developed a methodology for prescription drug calculations based on its 34 years of experience as one of the largest providers of Pharmacy Benefit Management (PBM) services to the workers' compensation industry. PMSI's methodology incorporates the company's knowledge of occupational diagnoses, the treatment of pain management and the selection of replacement drugs for non-Part D covered prescriptions. In use for over nine months, this methodology reduced a MSA by $935,000 in one recent client case.

Takemoto continued, "PMSI applauds CMS for clarifying this important issue. We have valued the opportunity to meet with CMS numerous times over the past year and look forward to continuing our active dialogue with CMS on further refinement of the MSA drug review process and other issues impacting Medicare Set-Aside allocations.”

About PMSI Settlement Solutions:
PMSI Settlement Solutions is recognized as a pioneer in Medicare Set-Aside allocations. PMSI Settlement Solutions offers a comprehensive menu of services for workers' compensation and liability/no-fault auto claims that are focused on settling claims in the most timely, cost-effective manner and in compliance with all government requirements. On-staff specialists are experts in lien negotiations, future medical cost projections and allocation preparation for cases in workers' compensation and liability. PMSI Settlement Solutions is a division of PMSI, one of the nation's largest providers of specialty managed care services and products for workers' compensation and liability markets. To learn more about PMSI Settlement Solutions, our services and web-enabled, integrated capabilities visit us at or call us at 888.MSA.PMSI.

About PMSI:
PMSI is one of the nation's largest full-service providers of clinically driven services for Pharmacy, Medical Services and Equipment, and Settlement Solutions and is devoted exclusively to the workers' compensation and liability markets. For over 34 years, PMSI has led the industry and served as the trusted resource for thousands of insurance payers, state workers' compensation funds, employers, and third-party administrators. Today, PMSI continues its leadership position by managing millions of pharmacy, medical services and equipment, and settlement transactions each year. For more information, please refer to the PMSI website at

PMSI Contact:
Shelia Chapman
Executive Director, Marketing

# # #

Read the full story at

Source: PRWeb
Copyright©2010 Vocus, Inc.
All rights reserved  

Related medicine news :

1. Veteran Advocacy Group to Announce New Program to Reform the VA
2. ASTRO awards 17 Advocacy Day travel grants
3. The Elizabeth Birt Center for Autism Law and Advocacy (EBCALA) Objects to Media Reports Tainting Autism Doctors and Misrepresenting Autism Treatments
4. Illinois State Senator Cullerton Recognized for Advocacy Work on Mental Health Issues
5. Father Channels His Grief into Advocacy, Promotes Simple Actions to Make Hospitals Safer for Children
6. Gladstones Robert Mahley to receive Research!America advocacy award
7. AT&T Connects Healthy Moms and Babies Nationwide, Embraces text4baby With Free Texts and Advocacy
8. Healthcare Partners, IPA, CEO Dr. Richard Merkin, Salute Enrollees Honored for Health Care Advocacy With Members of Congress
9. Protocol Q1 2010 Philanthropic Efforts a Resounding Success
10. NACDS Foundation Contributes $150,000 to Haiti Relief Efforts
11. Founder of the LEAP Foundation to be Honored for Haiti Aid Efforts at The Aesthetic Meeting 2010
Post Your Comments:
Related Image:
PMSI Advocacy Efforts Prompt CMS to Improve MSA Review Methodology 
(Date:11/30/2015)... ... November 30, 2015 , ... RoamRight, a leading provider ... with Public Television’s Travel With Kids to promote family vacations around the ... as they explore international destinations and educate families about the people and places of ...
(Date:11/30/2015)... ... November 30, 2015 , ... Advocare Orthopedic ... orthopedic care. Led by John Vitolo, M.D., the center offers their patients ... team at Advocare Orthopedic & Sports Medicine is ready to help their patients ...
(Date:11/30/2015)... Pittsburgh, PA (PRWEB) , ... November 30, 2015 ... ... according to a new study by UPMC and KingMed Diagnostics ... UPMC over three years found that consultation with UPMC pathologists resulted in significantly ...
(Date:11/30/2015)... ... ... The American Society for Clinical Pathology (ASCP) announced today that it has ... 30, ASCP shared its “Give a minute. Get tested. Find a cure.” icon and ... getting tested for HIV. , ASCP has asked members to replace their Facebook, Twitter, ...
(Date:11/30/2015)... ... November 30, 2015 , ... An inventor from Charlottesville, ... the womb. "My last baby had high blood pressure due to loud noises," she ... protect their babies from noise pollution as well as radio waves and microwaves." , ...
Breaking Medicine News(10 mins):
(Date:11/30/2015)... BOSTON , Nov. 30, 2015  Kevin ... of Sensium Healthcare, a global pioneer in wireless ... Boston, MA , Mr. Smith ... of Sensium,s global commercial strategy.  He will also ... universities, to build clinical evidence for SensiumVitals, the ...
(Date:11/30/2015)... , Nov. 30, 2015  The fee-for-service ... in U.S. medical imaging is on its ... accountable care payer-provider contracts are set to ... their wake, alter provider-vendor relationships. The shift ... push forward new purchasing frameworks in the ...
(Date:11/30/2015)... WOODCLIFF LAKE, N.J. and SAN ... Inc. and Arena Pharmaceuticals, Inc. (NASDAQ: ARNA ) ... (FDA) has accepted for filing the New Drug Application ... approved, the extended release formulation will offer patients a ... ® ) is currently approved as ...
Breaking Medicine Technology: