Our client contracted with us to support coverage and payment for their flagship biologic products. The GIRS Payer Advocacy Compass®[…]
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Case Study – GIRS Payer Advocacy Work with a Michigan Health Plan Improves Patient Access to Two Advanced Tissue-Repair Products
The Client: A Large, International Medical Device Manufacturer and Distributor The Need: Market Uptake for Two Extracellular Matrices (ECM) Used[…]
Read moreThe GIRS Value Pointer Outcomes Strategies™ Team can Assist to Develop Payer Desired Clinical and Cost Outcomes for Coverage and Payment!
Two radiation oncologists, Eric Ojerholm, MD and Christine Hill-Kayser, MD, at the Roberts Proton Therapy Center of the University of[…]
Read moreLet GIRS Assist you to Analyze the Impact of the 2018 Medicare Inpatient Rehabilitation Facilities Payment and Policy Changes
On July 31, 2017, the Centers for Medicare & Medicaid Services (CMS) released its final rule for the 2018 payment[…]
Read moreCMS Releases Proposed Changes to Hospital Outpatient Prospective Payment System for 2018
On July 13, 2017, the Centers for Medicare & Medicaid Services (CMS) issued the Calendar Year (CY) 2018 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System proposed rule (CMS-1678-P) that includes updates to the 2018 rates and quality provisions, and proposes other policy changes. CMS is proposing a number of policies that would support care delivery; reduce burdens for providers, especially in rural areas; lower beneficiary out of pocket drug costs for several drugs; enhance the patient-doctor relationship; and promote flexibility in healthcare. For additional information on this proposal and to comment on it, please contact us at info@girsinc.com.
Read moreUnitedHealth Group to Implement Bundled Payment Models
UnitedHealthcare, a subsidiary of UnitedHealth Group, followed in the Centers for Medicare & Medicaid Services (CMS)’s footstep by recently announcing[…]
Read moreElimination of Medicare Appeals Backlog Ordered by 2020
A federal judge recently decided that the Secretary of Health and Human Services (HHS) must eliminate the Medicare appeals backlog[…]
Read moreEvidence Review Conducted by the GIRS Value Pointer Clinical Outcomes Strategies Team Sets the Stage for 2017 Payer Advocacy Strategies
The GIRS Value Pointer Clinical Outcomes Strategies™ Team conducted an evidence review for a drug that resulted in integrated clinical[…]
Read moreMedicare Part B Policy Change for Discarded Drugs and Biologics for 2017
In addition to paying for the amount of drug that has been administered to a Medicare patient/beneficiary, Medicare Part[…]
Read moreCMS Delays the Inclusion of U.S. Territories Under MDRP Until 2020
The Center for Medicare and Medicaid Services (CMS) released an interim final rule (IFR), Medicaid Program; Covered Outpatient Drugs; Final[…]
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