For Tower MSA Partners, LLC
CEO Rita Ayers discusses pharmacy trends, including the use of off-label drugs, in workers’ compensation Medicare Set-Asides during NAMSAP’s Annual Meeting and Educational Conference on April 25.
Ayers and other NAMSAP members created the organization’s Data and Development Committee to improve quality and consistency in WCMSA outcomes through data analytics. The DDC analyzes data from Center for Medicare and Medicaid Services (CMS) responses to the pharmacy portion of WCMSA submissions and responses. This presentation shows its results, including patterns and trends in the usage and cost of specific procedures, medical devices and medications and cites the medications most often included in WCMSAs as well as drugs frequently excluded by CMS.
Ayers delves into trends in submissions and responses noting incorrect and inconsistent pricing by both submitters and CMS and price updates after submissions. She also discusses the top five off-label drugs in workers’ compensation and CMS’ inclusion/exclusion patterns. “More than 21 percent of all prescriptions are written for off-label use, making this a critical area of focus,” she said.
Other panelists are Moderator Fran Provenzano, president and CEO of MSA Specialists, Inc., Leslie Schumacher, president of PlanPoint MSA and Eileen Atkinson, a National MSA Specialist with Genex Services, Inc. NAMSAP’s annual conference takes place April 25 and 26 at the Hyatt Regency Baltimore. For more information, please see
Headquartered in Delray Beach, Fla., Tower MSA Partners provides Medicare Secondary Compliance services for workers’ compensation and liability. With more than 50 years combined experience in pharmacy and PBM technology, workers’ compensation legal oversight and medical care, Tower MSA Partners offers customers a proactive operational model focused on staging claims prior to settlement and the MSA to identify legal, medical and pharmacy issues that create obstacles. Leveraging internal systems and professional expertise, Tower MSA Partners works collaboratively with its clients to identify issues, intervene to modify outcomes, and to remain involved through resolution, MSA and settlement. This model enables customers to provide better care to claimants, reduce claim cost as well as the cost of the MSA and obtain CMS acceptance of the Medicare Set Aside. For more information, visit .