HHSC: Combined Rate Hearing for Levulan Kerastick (J7308) & 2018 Annual Healthcare Common Procedure Coding System (HCPCS)

Regulatory
January 11, 2018
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Hearing.  The Texas Health and Human Services Commission (HHSC) conducted a public hearing to receive public comment on the proposed Medicaid payment rate for Levulan Kerastick (J7308).  In addition, HHSC held a hearing on proposed Medicaid payment rates for the 2018 Annual Healthcare Common Procedure Coding System (HCPCS) Updates.  The hearings were held in compliance with Texas Human Resources Code §32.0282, which requires public notice of and hearings on proposed Medicaid reimbursements. Proposal.  The payment rate for Levulan Kerastick (J7308) is proposed to be effective January 1, 2018. This is a unique situation where the Drug Utilization Review panel had recommended removal of the drug from the payment schedule because the manufacturer was no longer offering a rebate. Subsequent to the DUR action, it was discovered that two other companies that provide the drug actually do provide rebates. As such the purpose of this hearing is to add back this drug to the payment schedu

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