Category Archives: Company News

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, […]

RJ Health Systems will be exhibiting at several healthcare trade shows Spring 2017. We will be attending the following tradeshows: 14th Annual World Health Care Congress Convenes decision makers from all sectors of health care to catalyze meaningful partnerships and change. In 2017, faculty focus on policy and market forces impacting the health care business environment […]

Setting a familiar tone for the Specialty Drug landscape, the presentation by Express Scripts during AMCP’s opening session (Speaker: Aimee Tharaldson, PharmD) included staggering cost increases within both the medical and pharmacy benefit, however encouraging news of emerging treatments.  Beyond that “given” (and the fact that oncolytics represent their industry), here are ten (10) observations worth […]

RJ Health Systems is hitting the road this spring! Our team will be attending and exhibiting at several conferences to share our solutions with Payors, PBMs, Specialty Pharmacies, Infusion Companies, Medicaid Organizations, Physicians and Medical Billing companies. Visit our booth to learn how we can help you save time and money managing specialty drug trend. […]