RE: RE: Infusion coverage :Solaris

[Guest guest]

The manufacturer of Solaris has a team devoted to researching the coverage for you, I think.  Why not turn this over to them for investigation? on Transplant Financial Coordinator Legacy Good Samaritan Hospital Legacy Transplant Services 1040 NW 22nd Ave Ste 480 Portland OR 97210 direct main office toll-free fax lmorriso@... ü Please consider the environment - think before you print! From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Deidra M. SimanoSent: Monday, August 20, 2012 7:37 AMTo: TxFinancialCoordinators Subject: RE: Infusion coverage :Solaris Hi Caryn, This question has come up at our facility as well. Use of this drug for organ transplant rejection is considered ‘off label’ use. My understanding is that Medicare will not cover off label use of medications. I tried to search on the web – CMS - and could not find anything conclusive. I am interested in what our peers have to offer. Deidra M. SimanoTransplant Operations AnalystDepartment of Transplant SurgeryDartmouth-Hitchcock LebanonPhone: (603) 653.3689 / Fax: (603) 676.4287Transplant Secretary (603) 653.3931Dartmouth-Hitchcock.org From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Riley, CarynSent: Monday, August 20, 2012 8:14 AMTo: TxFinancialCoordinators Subject: Infusion coverage :Solaris Good morning, My pharmacy would like to know if Soliris (Eculizumab) is covered by Medicare for rejection prevention. I’m told that it is a very expensive drug, does anyone have any insight or know where I could verify? Any help would be greatly appreciated. Thanks & happy Monday! Caryn Riley Transplant Financial Coordinator University of Illinois Hospital & Health Sciences System840 S Wood St Suite 402Chicago, Illinois 60612Tel No. Fax No. railey1@... *********************EMAIL DISCLAIMER*********************This email and any files transmitted with it may be confidential and areintended solely for the use of the individual or entity to whom they areaddressed. If you are not the intended recipient or the individualresponsible for delivering the e-mail to the intended recipient, any disclosure, copying, distribution or any action taken or omitted to be taken in reliance on it, is strictly prohibited. If you have received thise-mail in error, please delete it and notify the sender or contact Health Information Management .IMPORTANT NOTICE REGARDING THIS ELECTRONIC MESSAGE:This message is intended for the use of the person to whom it is addressed and may contain information that is privileged, confidential, and protected from disclosure under applicable law. If you are not the intended recipient, your use of this message for any purpose is strictly prohibited. If you have received this communication in error, please delete the message and notify the sender so that we may correct our records.

[Guest guest]

I have done that twice and they would not help because it was off label use….

Deidra M. Simano

Transplant Operations Analyst

Department of Transplant Surgery

Dartmouth-Hitchcock Lebanon

Phone: (603) 653.3689 / Fax: (603) 676.4287

Transplant Secretary (603) 653.3931

Dartmouth-Hitchcock.org

From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ]

On Behalf Of on, :LPH Trnsplnt

Sent: Monday, August 20, 2012 1:24 PM

To: TxFinancialCoordinators

Subject: RE: RE: Infusion coverage :Solaris

The manufacturer of Solaris has a team devoted to researching the coverage for you, I think. Why not turn this over to them for investigation?

on

Transplant Financial Coordinator

Legacy Good Samaritan Hospital

Legacy Transplant Services

1040 NW 22nd Ave Ste 480

Portland OR 97210

direct

main office

toll-free

fax

lmorriso@...

ü

Please consider the environment - think before you print!

From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ]

On Behalf Of Deidra M. Simano

Sent: Monday, August 20, 2012 7:37 AM

To: TxFinancialCoordinators

Subject: RE: Infusion coverage :Solaris

Hi Caryn,

This question has come up at our facility as well. Use of this drug for organ transplant rejection is considered ‘off label’ use. My understanding is that Medicare will not cover

off label use of medications. I tried to search on the web – CMS - and could not find anything conclusive. I am interested in what our peers have to offer.

Deidra M. Simano

Transplant Operations Analyst

Department of Transplant Surgery

Dartmouth-Hitchcock Lebanon

Phone: (603) 653.3689 / Fax: (603) 676.4287

Transplant Secretary (603) 653.3931

Dartmouth-Hitchcock.org

From:

TxFinancialCoordinators

[mailto:TxFinancialCoordinators ]

On Behalf Of Riley, Caryn

Sent: Monday, August 20, 2012 8:14 AM

To: TxFinancialCoordinators

Subject: Infusion coverage :Solaris

Good morning,

My pharmacy would like to know if Soliris (Eculizumab) is covered by Medicare for rejection prevention. I’m told that it is a very expensive drug, does anyone have any insight or know where I could verify? Any help would be

greatly appreciated.

Thanks & happy Monday!

Caryn Riley

Transplant Financial Coordinator

University of Illinois Hospital & Health Sciences System

840 S Wood St Suite 402

Chicago, Illinois 60612

Tel No.

Fax No.

railey1@...

*********************EMAIL DISCLAIMER*********************

This email and any files transmitted with it may be confidential and are

intended solely for the use of the individual or entity to whom they are

addressed. If you are not the intended recipient or the individual

responsible for delivering the e-mail to the intended recipient, any

disclosure, copying, distribution or any action taken or omitted to be

taken in reliance on it, is strictly prohibited. If you have received this

e-mail in error, please delete it and notify the sender or contact Health

Information Management .

IMPORTANT NOTICE REGARDING THIS ELECTRONIC MESSAGE:

This message is intended for the use of the person to whom it is addressed and may contain information that is privileged, confidential, and protected from disclosure under applicable law. If you are not the intended recipient, your use of this message for

any purpose is strictly prohibited. If you have received this communication in error, please delete the message and notify the sender so that we may correct our records.

IMPORTANT NOTICE REGARDING THIS ELECTRONIC MESSAGE:

This message is intended for the use of the person to whom it is addressed and may contain information that is privileged, confidential, and protected from disclosure under applicable law. If you are not the intended recipient, your use of this message for

any purpose is strictly prohibited. If you have received this communication in error, please delete the message and notify the sender so that we may correct our records.

[Guest guest]

Of course!  I forgot our patient was on it for atypical HUS.  I can confirm that writing to your Medicare FI Medical Director is worth the effort.  Good Luck! on Transplant Financial Coordinator Legacy Good Samaritan Hospital Legacy Transplant Services 1040 NW 22nd Ave Ste 480 Portland OR 97210 direct main office toll-free fax lmorriso@... ü Please consider the environment - think before you print! From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Deidra M. SimanoSent: Monday, August 20, 2012 11:59 AMTo: TxFinancialCoordinators Subject: RE: RE: Infusion coverage :Solaris I have done that twice and they would not help because it was off label use…. Deidra M. SimanoTransplant Operations AnalystDepartment of Transplant SurgeryDartmouth-Hitchcock LebanonPhone: (603) 653.3689 / Fax: (603) 676.4287Transplant Secretary (603) 653.3931Dartmouth-Hitchcock.org From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of on, :LPH TrnsplntSent: Monday, August 20, 2012 1:24 PMTo: TxFinancialCoordinators Subject: RE: RE: Infusion coverage :Solaris The manufacturer of Solaris has a team devoted to researching the coverage for you, I think. Why not turn this over to them for investigation? on Transplant Financial Coordinator Legacy Good Samaritan Hospital Legacy Transplant Services 1040 NW 22nd Ave Ste 480 Portland OR 97210 direct main office toll-free fax lmorriso@... ü Please consider the environment - think before you print! From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Deidra M. SimanoSent: Monday, August 20, 2012 7:37 AMTo: TxFinancialCoordinators Subject: RE: Infusion coverage :Solaris Hi Caryn, This question has come up at our facility as well. Use of this drug for organ transplant rejection is considered ‘off label’ use. My understanding is that Medicare will not cover off label use of medications. I tried to search on the web – CMS - and could not find anything conclusive. I am interested in what our peers have to offer. Deidra M. SimanoTransplant Operations AnalystDepartment of Transplant SurgeryDartmouth-Hitchcock LebanonPhone: (603) 653.3689 / Fax: (603) 676.4287Transplant Secretary (603) 653.3931Dartmouth-Hitchcock.org From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Riley, CarynSent: Monday, August 20, 2012 8:14 AMTo: TxFinancialCoordinators Subject: Infusion coverage :Solaris Good morning, My pharmacy would like to know if Soliris (Eculizumab) is covered by Medicare for rejection prevention. I’m told that it is a very expensive drug, does anyone have any insight or know where I could verify? Any help would be greatly appreciated. Thanks & happy Monday! Caryn Riley Transplant Financial Coordinator University of Illinois Hospital & Health Sciences System840 S Wood St Suite 402Chicago, Illinois 60612Tel No. Fax No. railey1@... *********************EMAIL DISCLAIMER*********************This email and any files transmitted with it may be confidential and areintended solely for the use of the individual or entity to whom they areaddressed. If you are not the intended recipient or the individualresponsible for delivering the e-mail to the intended recipient, any disclosure, copying, distribution or any action taken or omitted to be taken in reliance on it, is strictly prohibited. If you have received thise-mail in error, please delete it and notify the sender or contact Health Information Management .IMPORTANT NOTICE REGARDING THIS ELECTRONIC MESSAGE:This message is intended for the use of the person to whom it is addressed and may contain information that is privileged, confidential, and protected from disclosure under applicable law. If you are not the intended recipient, your use of this message for any purpose is strictly prohibited. If you have received this communication in error, please delete the message and notify the sender so that we may correct our records.IMPORTANT NOTICE REGARDING THIS ELECTRONIC MESSAGE:This message is intended for the use of the person to whom it is addressed and may contain information that is privileged, confidential, and protected from disclosure under applicable law. If you are not the intended recipient, your use of this message for any purpose is strictly prohibited. If you have received this communication in error, please delete the message and notify the sender so that we may correct our records.

[Guest guest]

Great, thanks!

Deidra M. Simano

Transplant Operations Analyst

Department of Transplant Surgery

Dartmouth-Hitchcock Lebanon

Phone: (603) 653.3689 / Fax: (603) 676.4287

Transplant Secretary (603) 653.3931

Dartmouth-Hitchcock.org

From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ]

On Behalf Of on, :LPH Trnsplnt

Sent: Monday, August 20, 2012 3:06 PM

To: TxFinancialCoordinators

Subject: RE: RE: Infusion coverage :Solaris

Of course! I forgot our patient was on it for atypical HUS. I can confirm that writing to your Medicare FI Medical Director is worth the effort. Good Luck!

on

Transplant Financial Coordinator

Legacy Good Samaritan Hospital

Legacy Transplant Services

1040 NW 22nd Ave Ste 480

Portland OR 97210

direct

main office

toll-free

fax

lmorriso@...

ü

Please consider the environment - think before you print!

From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ]

On Behalf Of Deidra M. Simano

Sent: Monday, August 20, 2012 11:59 AM

To: TxFinancialCoordinators

Subject: RE: RE: Infusion coverage :Solaris

I have done that twice and they would not help because it was off label use….

Deidra M. Simano

Transplant Operations Analyst

Department of Transplant Surgery

Dartmouth-Hitchcock Lebanon

Phone: (603) 653.3689 / Fax: (603) 676.4287

Transplant Secretary (603) 653.3931

Dartmouth-Hitchcock.org

From:

TxFinancialCoordinators

[mailto:TxFinancialCoordinators ]

On Behalf Of on, :LPH Trnsplnt

Sent: Monday, August 20, 2012 1:24 PM

To: TxFinancialCoordinators

Subject: RE: RE: Infusion coverage :Solaris

The manufacturer of Solaris has a team devoted to researching the coverage for you, I think. Why not turn this over to them for investigation?

on

Transplant Financial Coordinator

Legacy Good Samaritan Hospital

Legacy Transplant Services

1040 NW 22nd Ave Ste 480

Portland OR 97210

direct

main office

toll-free

fax

lmorriso@...

ü

Please consider the environment - think before you print!

From:

TxFinancialCoordinators

[mailto:TxFinancialCoordinators ]

On Behalf Of Deidra M. Simano

Sent: Monday, August 20, 2012 7:37 AM

To: TxFinancialCoordinators

Subject: RE: Infusion coverage :Solaris

Hi Caryn,

This question has come up at our facility as well. Use of this drug for organ transplant rejection is considered ‘off label’ use. My understanding is that Medicare will not cover

off label use of medications. I tried to search on the web – CMS - and could not find anything conclusive. I am interested in what our peers have to offer.

Deidra M. Simano

Transplant Operations Analyst

Department of Transplant Surgery

Dartmouth-Hitchcock Lebanon

Phone: (603) 653.3689 / Fax: (603) 676.4287

Transplant Secretary (603) 653.3931

Dartmouth-Hitchcock.org

From:

TxFinancialCoordinators

[mailto:TxFinancialCoordinators ]

On Behalf Of Riley, Caryn

Sent: Monday, August 20, 2012 8:14 AM

To: TxFinancialCoordinators

Subject: Infusion coverage :Solaris

Good morning,

My pharmacy would like to know if Soliris (Eculizumab) is covered by Medicare for rejection prevention. I’m told that it is a very expensive drug, does anyone have any insight or know where I could verify? Any help would be

greatly appreciated.

Thanks & happy Monday!

Caryn Riley

Transplant Financial Coordinator

University of Illinois Hospital & Health Sciences System

840 S Wood St Suite 402

Chicago, Illinois 60612

Tel No.

Fax No.

railey1@...

*********************EMAIL DISCLAIMER*********************

This email and any files transmitted with it may be confidential and are

intended solely for the use of the individual or entity to whom they are

addressed. If you are not the intended recipient or the individual

responsible for delivering the e-mail to the intended recipient, any

disclosure, copying, distribution or any action taken or omitted to be

taken in reliance on it, is strictly prohibited. If you have received this

e-mail in error, please delete it and notify the sender or contact Health

Information Management .

IMPORTANT NOTICE REGARDING THIS ELECTRONIC MESSAGE:

This message is intended for the use of the person to whom it is addressed and may contain information that is privileged, confidential, and protected from disclosure under applicable law. If you are not the intended recipient, your use of this message for

any purpose is strictly prohibited. If you have received this communication in error, please delete the message and notify the sender so that we may correct our records.

IMPORTANT NOTICE REGARDING THIS ELECTRONIC MESSAGE:

This message is intended for the use of the person to whom it is addressed and may contain information that is privileged, confidential, and protected from disclosure under applicable law. If you are not the intended recipient, your use of this message for

any purpose is strictly prohibited. If you have received this communication in error, please delete the message and notify the sender so that we may correct our records.

IMPORTANT NOTICE REGARDING THIS ELECTRONIC MESSAGE:

This message is intended for the use of the person to whom it is addressed and may contain information that is privileged, confidential, and protected from disclosure under applicable law. If you are not the intended recipient, your use of this message for

any purpose is strictly prohibited. If you have received this communication in error, please delete the message and notify the sender so that we may correct our records.

[Guest guest]

A couple more questions….. Do we have to do this for each patient, or is this something we could petition them for so that the approval can be ‘on file’

? As you know, when the patient needs this treatment it is not something that can wait, so we would just move ahead with appropriate treatment and take the financial risk.

Thanks again!

Deidra

Deidra M. Simano

Transplant Operations Analyst

Department of Transplant Surgery

Dartmouth-Hitchcock Lebanon

Phone: (603) 653.3689 / Fax: (603) 676.4287

Transplant Secretary (603) 653.3931

Dartmouth-Hitchcock.org

From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ]

On Behalf Of on, :LPH Trnsplnt

Sent: Monday, August 20, 2012 3:06 PM

To: TxFinancialCoordinators

Subject: RE: RE: Infusion coverage :Solaris

Of course! I forgot our patient was on it for atypical HUS. I can confirm that writing to your Medicare FI Medical Director is worth the effort. Good Luck!

on

Transplant Financial Coordinator

Legacy Good Samaritan Hospital

Legacy Transplant Services

1040 NW 22nd Ave Ste 480

Portland OR 97210

direct

main office

toll-free

fax

lmorriso@...

ü

Please consider the environment - think before you print!

From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ]

On Behalf Of Deidra M. Simano

Sent: Monday, August 20, 2012 11:59 AM

To: TxFinancialCoordinators

Subject: RE: RE: Infusion coverage :Solaris

I have done that twice and they would not help because it was off label use….

Deidra M. Simano

Transplant Operations Analyst

Department of Transplant Surgery

Dartmouth-Hitchcock Lebanon

Phone: (603) 653.3689 / Fax: (603) 676.4287

Transplant Secretary (603) 653.3931

Dartmouth-Hitchcock.org

From:

TxFinancialCoordinators

[mailto:TxFinancialCoordinators ]

On Behalf Of on, :LPH Trnsplnt

Sent: Monday, August 20, 2012 1:24 PM

To: TxFinancialCoordinators

Subject: RE: RE: Infusion coverage :Solaris

The manufacturer of Solaris has a team devoted to researching the coverage for you, I think. Why not turn this over to them for investigation?

on

Transplant Financial Coordinator

Legacy Good Samaritan Hospital

Legacy Transplant Services

1040 NW 22nd Ave Ste 480

Portland OR 97210

direct

main office

toll-free

fax

lmorriso@...

ü

Please consider the environment - think before you print!

From:

TxFinancialCoordinators

[mailto:TxFinancialCoordinators ]

On Behalf Of Deidra M. Simano

Sent: Monday, August 20, 2012 7:37 AM

To: TxFinancialCoordinators

Subject: RE: Infusion coverage :Solaris

Hi Caryn,

This question has come up at our facility as well. Use of this drug for organ transplant rejection is considered ‘off label’ use. My understanding is that Medicare will not cover

off label use of medications. I tried to search on the web – CMS - and could not find anything conclusive. I am interested in what our peers have to offer.

Deidra M. Simano

Transplant Operations Analyst

Department of Transplant Surgery

Dartmouth-Hitchcock Lebanon

Phone: (603) 653.3689 / Fax: (603) 676.4287

Transplant Secretary (603) 653.3931

Dartmouth-Hitchcock.org

From:

TxFinancialCoordinators

[mailto:TxFinancialCoordinators ]

On Behalf Of Riley, Caryn

Sent: Monday, August 20, 2012 8:14 AM

To: TxFinancialCoordinators

Subject: Infusion coverage :Solaris

Good morning,

My pharmacy would like to know if Soliris (Eculizumab) is covered by Medicare for rejection prevention. I’m told that it is a very expensive drug, does anyone have any insight or know where I could verify? Any help would be

greatly appreciated.

Thanks & happy Monday!

Caryn Riley

Transplant Financial Coordinator

University of Illinois Hospital & Health Sciences System

840 S Wood St Suite 402

Chicago, Illinois 60612

Tel No.

Fax No.

railey1@...

*********************EMAIL DISCLAIMER*********************

This email and any files transmitted with it may be confidential and are

intended solely for the use of the individual or entity to whom they are

addressed. If you are not the intended recipient or the individual

responsible for delivering the e-mail to the intended recipient, any

disclosure, copying, distribution or any action taken or omitted to be

taken in reliance on it, is strictly prohibited. If you have received this

e-mail in error, please delete it and notify the sender or contact Health

Information Management .

IMPORTANT NOTICE REGARDING THIS ELECTRONIC MESSAGE:

This message is intended for the use of the person to whom it is addressed and may contain information that is privileged, confidential, and protected from disclosure under applicable law. If you are not the intended recipient, your use of this message for

any purpose is strictly prohibited. If you have received this communication in error, please delete the message and notify the sender so that we may correct our records.

IMPORTANT NOTICE REGARDING THIS ELECTRONIC MESSAGE:

This message is intended for the use of the person to whom it is addressed and may contain information that is privileged, confidential, and protected from disclosure under applicable law. If you are not the intended recipient, your use of this message for

any purpose is strictly prohibited. If you have received this communication in error, please delete the message and notify the sender so that we may correct our records.

IMPORTANT NOTICE REGARDING THIS ELECTRONIC MESSAGE:

This message is intended for the use of the person to whom it is addressed and may contain information that is privileged, confidential, and protected from disclosure under applicable law. If you are not the intended recipient, your use of this message for

any purpose is strictly prohibited. If you have received this communication in error, please delete the message and notify the sender so that we may correct our records.

[Guest guest]

I’ve only had one unique case reviewed by our FI.  Anyone else with more experience who can comment? on Transplant Financial Coordinator Legacy Good Samaritan Hospital Legacy Transplant Services 1040 NW 22nd Ave Ste 480 Portland OR 97210 direct main office toll-free fax lmorriso@... ü Please consider the environment - think before you print! From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Deidra M. SimanoSent: Monday, August 20, 2012 12:18 PMTo: TxFinancialCoordinators Subject: RE: RE: Infusion coverage :Solaris A couple more questions….. Do we have to do this for each patient, or is this something we could petition them for so that the approval can be ‘on file’ ? As you know, when the patient needs this treatment it is not something that can wait, so we would just move ahead with appropriate treatment and take the financial risk. Thanks again!Deidra Deidra M. SimanoTransplant Operations AnalystDepartment of Transplant SurgeryDartmouth-Hitchcock LebanonPhone: (603) 653.3689 / Fax: (603) 676.4287Transplant Secretary (603) 653.3931Dartmouth-Hitchcock.org From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of on, :LPH TrnsplntSent: Monday, August 20, 2012 3:06 PMTo: TxFinancialCoordinators Subject: RE: RE: Infusion coverage :Solaris Of course! I forgot our patient was on it for atypical HUS. I can confirm that writing to your Medicare FI Medical Director is worth the effort. Good Luck! on Transplant Financial Coordinator Legacy Good Samaritan Hospital Legacy Transplant Services 1040 NW 22nd Ave Ste 480 Portland OR 97210 direct main office toll-free fax lmorriso@... ü Please consider the environment - think before you print! From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Deidra M. SimanoSent: Monday, August 20, 2012 11:59 AMTo: TxFinancialCoordinators Subject: RE: RE: Infusion coverage :Solaris I have done that twice and they would not help because it was off label use…. Deidra M. SimanoTransplant Operations AnalystDepartment of Transplant SurgeryDartmouth-Hitchcock LebanonPhone: (603) 653.3689 / Fax: (603) 676.4287Transplant Secretary (603) 653.3931Dartmouth-Hitchcock.org From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of on, :LPH TrnsplntSent: Monday, August 20, 2012 1:24 PMTo: TxFinancialCoordinators Subject: RE: RE: Infusion coverage :Solaris The manufacturer of Solaris has a team devoted to researching the coverage for you, I think. Why not turn this over to them for investigation? on Transplant Financial Coordinator Legacy Good Samaritan Hospital Legacy Transplant Services 1040 NW 22nd Ave Ste 480 Portland OR 97210 direct main office toll-free fax lmorriso@... ü Please consider the environment - think before you print! From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Deidra M. SimanoSent: Monday, August 20, 2012 7:37 AMTo: TxFinancialCoordinators Subject: RE: Infusion coverage :Solaris Hi Caryn, This question has come up at our facility as well. Use of this drug for organ transplant rejection is considered ‘off label’ use. My understanding is that Medicare will not cover off label use of medications. I tried to search on the web – CMS - and could not find anything conclusive. I am interested in what our peers have to offer. Deidra M. SimanoTransplant Operations AnalystDepartment of Transplant SurgeryDartmouth-Hitchcock LebanonPhone: (603) 653.3689 / Fax: (603) 676.4287Transplant Secretary (603) 653.3931Dartmouth-Hitchcock.org From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Riley, CarynSent: Monday, August 20, 2012 8:14 AMTo: TxFinancialCoordinators Subject: Infusion coverage :Solaris Good morning, My pharmacy would like to know if Soliris (Eculizumab) is covered by Medicare for rejection prevention. I’m told that it is a very expensive drug, does anyone have any insight or know where I could verify? Any help would be greatly appreciated. Thanks & happy Monday! Caryn Riley Transplant Financial Coordinator University of Illinois Hospital & Health Sciences System840 S Wood St Suite 402Chicago, Illinois 60612Tel No. Fax No. railey1@... *********************EMAIL DISCLAIMER*********************This email and any files transmitted with it may be confidential and areintended solely for the use of the individual or entity to whom they areaddressed. If you are not the intended recipient or the individualresponsible for delivering the e-mail to the intended recipient, any disclosure, copying, distribution or any action taken or omitted to be taken in reliance on it, is strictly prohibited. If you have received thise-mail in error, please delete it and notify the sender or contact Health Information Management .IMPORTANT NOTICE REGARDING THIS ELECTRONIC MESSAGE:This message is intended for the use of the person to whom it is addressed and may contain information that is privileged, confidential, and protected from disclosure under applicable law. If you are not the intended recipient, your use of this message for any purpose is strictly prohibited. If you have received this communication in error, please delete the message and notify the sender so that we may correct our records.IMPORTANT NOTICE REGARDING THIS ELECTRONIC MESSAGE:This message is intended for the use of the person to whom it is addressed and may contain information that is privileged, confidential, and protected from disclosure under applicable law. If you are not the intended recipient, your use of this message for any purpose is strictly prohibited. If you have received this communication in error, please delete the message and notify the sender so that we may correct our records.IMPORTANT NOTICE REGARDING THIS ELECTRONIC MESSAGE:This message is intended for the use of the person to whom it is addressed and may contain information that is privileged, confidential, and protected from disclosure under applicable law. If you are not the intended recipient, your use of this message for any purpose is strictly prohibited. If you have received this communication in error, please delete the message and notify the sender so that we may correct our records.

[Guest guest]

Thank you guys so much for all your feedback. I did contact Solaris and request help and like Deidra they were unable to assist me. I appreciate all the

feedback.

Thank you,

Caryn Riley

Transplant Financial Coordinator

University of Illinois Hospital & Health Sciences System

840 S Wood St Suite 402

Chicago, Illinois 60612

Tel No.

Fax No.

railey1@...

From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ]

On Behalf Of on, :LPH Trnsplnt

Sent: Monday, August 20, 2012 2:35 PM

To: TxFinancialCoordinators

Subject: RE: RE: Infusion coverage :Solaris

I’ve only had one unique case reviewed by our FI. Anyone else with more experience who can comment?

on

Transplant Financial Coordinator

Legacy Good Samaritan Hospital

Legacy Transplant Services

1040 NW 22nd Ave Ste 480

Portland OR 97210

direct

main office

toll-free

fax

lmorriso@...

ü

Please consider the environment - think before you print!

From:

TxFinancialCoordinators

[mailto:TxFinancialCoordinators ]

On Behalf Of Deidra M. Simano

Sent: Monday, August 20, 2012 12:18 PM

To: TxFinancialCoordinators

Subject: RE: RE: Infusion coverage :Solaris

A couple more questions….. Do we have to do this for each patient, or is this something we could petition them for so that the approval

can be ‘on file’ ? As you know, when the patient needs this treatment it is not something that can wait, so we would just move ahead with appropriate treatment and take the financial risk.

Thanks again!

Deidra

Deidra M. Simano

Transplant Operations Analyst

Department of Transplant Surgery

Dartmouth-Hitchcock Lebanon

Phone: (603) 653.3689 / Fax: (603) 676.4287

Transplant Secretary (603) 653.3931

Dartmouth-Hitchcock.org

From:

TxFinancialCoordinators

[mailto:TxFinancialCoordinators ]

On Behalf Of on, :LPH Trnsplnt

Sent: Monday, August 20, 2012 3:06 PM

To: TxFinancialCoordinators

Subject: RE: RE: Infusion coverage :Solaris

Of course! I forgot our patient was on it for atypical HUS. I can confirm that writing to your Medicare FI Medical

Director is worth the effort. Good Luck!

on

Transplant Financial Coordinator

Legacy Good Samaritan Hospital

Legacy Transplant Services

1040 NW 22nd Ave Ste 480

Portland OR 97210

direct

main office

toll-free

fax

lmorriso@...

ü

Please consider the environment - think before you print!

From:

TxFinancialCoordinators

[mailto:TxFinancialCoordinators ]

On Behalf Of Deidra M. Simano

Sent: Monday, August 20, 2012 11:59 AM

To: TxFinancialCoordinators

Subject: RE: RE: Infusion coverage :Solaris

I have done that twice and they would not help because it was off label use….

Deidra M. Simano

Transplant Operations Analyst

Department of Transplant Surgery

Dartmouth-Hitchcock Lebanon

Phone: (603) 653.3689 / Fax: (603) 676.4287

Transplant Secretary (603) 653.3931

Dartmouth-Hitchcock.org

From:

TxFinancialCoordinators

[mailto:TxFinancialCoordinators ]

On Behalf Of on, :LPH Trnsplnt

Sent: Monday, August 20, 2012 1:24 PM

To: TxFinancialCoordinators

Subject: RE: RE: Infusion coverage :Solaris

The manufacturer of Solaris has a team devoted to researching the coverage for you, I think. Why not turn this

over to them for investigation?

on

Transplant Financial Coordinator

Legacy Good Samaritan Hospital

Legacy Transplant Services

1040 NW 22nd Ave Ste 480

Portland OR 97210

direct

main office

toll-free

fax

lmorriso@...

ü

Please consider the environment - think before you print!

From:

TxFinancialCoordinators

[mailto:TxFinancialCoordinators ]

On Behalf Of Deidra M. Simano

Sent: Monday, August 20, 2012 7:37 AM

To: TxFinancialCoordinators

Subject: RE: Infusion coverage :Solaris

Hi Caryn,

This question has come up at our facility as well. Use of this drug for organ transplant rejection is considered ‘off label’ use.

My understanding is that Medicare will not cover off label use of medications. I tried to search on the web – CMS - and could not find anything conclusive. I am interested in what our peers have to offer.

Deidra M. Simano

Transplant Operations Analyst

Department of Transplant Surgery

Dartmouth-Hitchcock Lebanon

Phone: (603) 653.3689 / Fax: (603) 676.4287

Transplant Secretary (603) 653.3931

Dartmouth-Hitchcock.org

From:

TxFinancialCoordinators

[mailto:TxFinancialCoordinators ]

On Behalf Of Riley, Caryn

Sent: Monday, August 20, 2012 8:14 AM

To: TxFinancialCoordinators

Subject: Infusion coverage :Solaris

Good morning,

My pharmacy would like to know if Soliris (Eculizumab) is covered by Medicare for rejection prevention. I’m told that it is a very expensive drug, does anyone have any insight

or know where I could verify? Any help would be greatly appreciated.

Thanks & happy Monday!

Caryn Riley

Transplant Financial Coordinator

University of Illinois Hospital & Health Sciences System

840 S Wood St Suite 402

Chicago, Illinois 60612

Tel No.

Fax No.

railey1@...

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