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Pacira’s Exparel Will Get Separate Medicare Payment; CMS Still Wants Better Opioid-Sparing Data

 
• By Michael McCaughan

US Centers for Medicare and Medicaid Services proposes a change to its reimbursement policies for non-opioid pain therapies which will benefit a single product: Pacira’s Exparel. However, the broader message for that company is mixed.

Hospital exterior
CMS proposes to unbundle payment for Pacira's Exparel in ambulatory surgical centers but not in the much larger hospital outpatient department setting.

Pacira Pharmaceuticals Inc.’s campaign to secure better reimbursement for its liposomal bupivacaine formulation Exparel appears to have paid off – at least partially – with a proposal by the US Centers for Medicare & Medicaid Services (CMS) to unbundle payment for the drug when it is used in Ambulatory Surgical Centers (ASCs).

CMS announced the proposed change as part of the annual update to the Hospital Outpatient Prospective Payment System rule...

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