Medicare and Prialt

[Mister Mxyzptlk]

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Members don't see this ad.

Just got a letter from Trailblazer, our regional carrier. They will not pay for Prialt except as monotherapy. Basically, they are now playing the "Not in the PDR" game that the private carriers routinely use to deny expensive medications.

Not only that, but they are going back through previous charges and demanding refunds for every patient that had combination therapy with Prialt.

I give up.

 

[Ligament]

You know, Prialt may not be a bad choice for monotherapy...