Category Archives: Company News

Last week a portion of the RJ Health team left our corporate headquarters to help with the Dog Days Adoption Intake Day, in preparation for the Dog Days Adoption Event that was held the weekend of October 20 – 21. Our day began with the highly anticipated arrival of the puppy transport.  The crew of […]

INSIDE THIS ISSUE Code Updates: Large Price Changes Reminder – NEW HCPCS Q-Codes effective July 1, 2018  CMS NEWS: April 1, 2018 NOC Pricing File Updated Drug Reimbursement Code Price Updates  Drugs/Devices: New Clinical and Billing Information New Webinar: Shedding Light on Medically Covered Specialty Drug Pricing Methods Let’s discuss Specialty Drug Pricing Methods… WAC. […]

INSIDE THIS ISSUE Webinar:         •  Solving for Incorrectly Mapped NDC to HCPCS/CPT® Codes And Improperly Reported NDC Units Blog Updates:         •  Hemlibra Introductory Pricing Drugs/Devices:         •  New/Updated Billing and Clinical Information Code Updates:         •  Large Price Changes         •  HCPCS/CPT Codes With Price Changes         •  Reminder – New HCPCS Drug Codes for 2018   WEBINAR Solving for Incorrectly Mapped NDC to HCPCS/CPT® […]

INSIDE THIS ISSUE WEBINAR – February 1st, 2:00PM EST:         • Solving for Incorrectly Mapped NDC to HCPCS/CPT® Codes And Improperly Reported NDC Units Blog Updates:         • Rituxan (Rituximab) Biosimilars – 2018 Drug Pipeline Review         • Trends in FDA approval of Specialty Drugs 1990 through 2017 HCPCS Drug Code Updates:         • Large Price Changes         • Reminder – NEW HCPCS […]

Did you know : that healthcare fraud estimates in the United States exceed $68 billion annually? Did you know : the Federal Government won or negotiated over $2.5 billion in health care fraud judgments and settlements worth a total of over $1.9 billion in FY 2015? Did you know : that when differentiating fraud from waste and abuse, the […]

Are you weighing the decision to enforce an NDC mandate on ALL Medical Pharmacy Claims? RJ Health’s Analytics team shares the pro’s & con’s of NDC mandates across Pricing, Formulary, and Network Quality Considerations. Here are some practical examples to help illustrate how, at the end-of-the-day, RJ Health believes the answer to the NDC vs. […]

On August 3, 2017 the Food and Drug Administration approved a liposome-encapsulated combination of daunorubicin and cytarabine (VYXEOS™, Jazz Pharmaceuticals, Inc.) for the treatment of adults with newly-diagnosed therapy-related acute myeloid leukemia (t-AML) or AML with myelodysplasia-related changes (AML-MRC), which are two types of AML having a poor prognosis. VYXEOS is the first agent that […]

In an effort to contain growing healthcare costs, Congress enacted the Omnibus Budget Reconciliation Act of 1990 (OBRA’90) and created the Medicaid Drug Rebate Program. Pharmaceutical manufacturers’ participation in the program became a prerequisite for Medicaid coverage of outpatient prescription drugs. Since then, states have been required to collect associated drug rebates to receive federal […]

Biosimilars are intricate in their makeup and the process for FDA approval is even more multidimensional.  Todd Cooperman’s (PharmD, MBA, R.Ph.) recent whitepaper provides insight into biosimilars in the U.S. healthcare marketplace.  Below is a caption from the introduction of the whitepaper. Initial Food and Drug Administration (FDA) guidance on the biosimilar pathway was intentionally vague, […]