Guest guest Posted September 14, 2007 Report Share Posted September 14, 2007 There is a program with Roche, the pharmaceutical company, that you could inquire with about this situation. Here is a website with some information about it. It’s worth a try if you haven’t already gone down this road…. http://www.aegis.com/factshts/network/access/pa/tmp-b.html Meredith Gray Liver Transplant Financial Coordinator University of Rochester Strong Memorial Hospital 601 Elmwood Avenue Box 602 Rochester, NY 14642 (fax) (pager) This message contains information which may be confidential and privileged. Unless you are the addressee (or authorized to receive for the addressee), you may not use, copy or disclose to anyone the message or any information contained in the message (including attachments). If you have received the message in error, please advise sender by reply email and delete the message. Thank you! From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Mast, Deborah Sent: Friday, September 14, 2007 10:46 AM To: TxFinancialCoordinators Subject: Valcyte Hello all- I was wondering if anyone has had any problems with any of the Medicare D plans and obtaining auth for Valcyte for a post-lung transplant patient for CMV prophylaxis? We have never had a problem before; however, Sierra RX is now telling us that this is not FDA approved for lung transplant patients. Any advice would be appreciated. We have already gone through appeals with Maximus. Thanks Debbie Mast Supervisor, Senior Transplant Financial Coordinator Member, TFCA Heart Failure, Heart, Lung, Heart/Lung, Liver, Kidney, Pancreas, Intestinal Transplant Programs Phone: Fax: Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 14, 2007 Report Share Posted September 14, 2007 There is a program with Roche, the pharmaceutical company, that you could inquire with about this situation. Here is a website with some information about it. It’s worth a try if you haven’t already gone down this road…. http://www.aegis.com/factshts/network/access/pa/tmp-b.html Meredith Gray Liver Transplant Financial Coordinator University of Rochester Strong Memorial Hospital 601 Elmwood Avenue Box 602 Rochester, NY 14642 (fax) (pager) This message contains information which may be confidential and privileged. Unless you are the addressee (or authorized to receive for the addressee), you may not use, copy or disclose to anyone the message or any information contained in the message (including attachments). If you have received the message in error, please advise sender by reply email and delete the message. Thank you! From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Mast, Deborah Sent: Friday, September 14, 2007 10:46 AM To: TxFinancialCoordinators Subject: Valcyte Hello all- I was wondering if anyone has had any problems with any of the Medicare D plans and obtaining auth for Valcyte for a post-lung transplant patient for CMV prophylaxis? We have never had a problem before; however, Sierra RX is now telling us that this is not FDA approved for lung transplant patients. Any advice would be appreciated. We have already gone through appeals with Maximus. Thanks Debbie Mast Supervisor, Senior Transplant Financial Coordinator Member, TFCA Heart Failure, Heart, Lung, Heart/Lung, Liver, Kidney, Pancreas, Intestinal Transplant Programs Phone: Fax: Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 14, 2007 Report Share Posted September 14, 2007 There is a program with Roche, the pharmaceutical company, that you could inquire with about this situation. Here is a website with some information about it. It’s worth a try if you haven’t already gone down this road…. http://www.aegis.com/factshts/network/access/pa/tmp-b.html Meredith Gray Liver Transplant Financial Coordinator University of Rochester Strong Memorial Hospital 601 Elmwood Avenue Box 602 Rochester, NY 14642 (fax) (pager) This message contains information which may be confidential and privileged. Unless you are the addressee (or authorized to receive for the addressee), you may not use, copy or disclose to anyone the message or any information contained in the message (including attachments). If you have received the message in error, please advise sender by reply email and delete the message. Thank you! From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Mast, Deborah Sent: Friday, September 14, 2007 10:46 AM To: TxFinancialCoordinators Subject: Valcyte Hello all- I was wondering if anyone has had any problems with any of the Medicare D plans and obtaining auth for Valcyte for a post-lung transplant patient for CMV prophylaxis? We have never had a problem before; however, Sierra RX is now telling us that this is not FDA approved for lung transplant patients. Any advice would be appreciated. We have already gone through appeals with Maximus. Thanks Debbie Mast Supervisor, Senior Transplant Financial Coordinator Member, TFCA Heart Failure, Heart, Lung, Heart/Lung, Liver, Kidney, Pancreas, Intestinal Transplant Programs Phone: Fax: Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 14, 2007 Report Share Posted September 14, 2007 All the time, they think it’s a Part B drug and even when you give them proof its not they will not pay under D. Stoops Clarian Health Partners From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Mast, Deborah Sent: Friday, September 14, 2007 10:46 AM To: TxFinancialCoordinators Subject: Valcyte Hello all- I was wondering if anyone has had any problems with any of the Medicare D plans and obtaining auth for Valcyte for a post-lung transplant patient for CMV prophylaxis? We have never had a problem before; however, Sierra RX is now telling us that this is not FDA approved for lung transplant patients. Any advice would be appreciated. We have already gone through appeals with Maximus. Thanks Debbie Mast Supervisor, Senior Transplant Financial Coordinator Member, TFCA Heart Failure, Heart, Lung, Heart/Lung, Liver, Kidney, Pancreas, Intestinal Transplant Programs Phone: Fax: Quote Link to comment Share on other sites More sharing options...
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