Practice Management

Reaching out for advice.
We have still been offering patients the "option" of initiation of Makena, despite the scientific committee at FDA not supporting this. Wondering what all of those are doing to patients who elect to start this based on counseling, history, shared decision making, when their insurance has denied this? I do not personally, as an MFM, Rx this; however, some of my OB colleagues have done peer-to-peer and coverage for this medication has been denied.

Any support from ACOG or SMFM that can assist with this?

TY


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Brad Dolinsky
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Hi Brad,
In light of the emerging data and SMFM's statement on the use of of 17-alpha hydroxyprogesterone caproate for prevention of recurrent preterm birth, noting "uncertainty regarding benefit", it is unlikely that additional steps will make a difference with payer denials.
All the best,
Fadi

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Fadi BSAT, MD, FAIUM
Chair, SMFM Practice Management Committee
Immediate past Chair, SMFM Coding Committee
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Original Message:
Sent: 12-29-2022 14:52
From: Brad Dolinsky
Subject: MAKENA

Reaching out for advice.
We have still been offering patients the "option" of initiation of Makena, despite the scientific committee at FDA not supporting this. Wondering what all of those are doing to patients who elect to start this based on counseling, history, shared decision making, when their insurance has denied this? I do not personally, as an MFM, Rx this; however, some of my OB colleagues have done peer-to-peer and coverage for this medication has been denied.

Any support from ACOG or SMFM that can assist with this?

TY


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Brad Dolinsky
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