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March 20, 2024 · Public Policy & Regulatory Affairs Team
Several states update their medical fee schedules, while others propose updates; workers’ comp PTSD and mental health coverage bills pending in many states; expanded cancer coverage likely in Maryland; Florida significantly increases physician reimbursement; Montana clarifies workers’ comp rules; and Texas looks to improve the provider complaint process. Read more...
March 11, 2024 · Medicare Insights Team
CMS will update MIR steps RREs must take in reporting Medicare workers compensation TPOCs claims and notifying CMS of WCMSA arrangements. Read more...
March 04, 2024 · Public Policy & Regulatory Affairs Team
The California Division of Workers’ Compensation (DWC) proposed significant rule changes in the final phase of integrating its workers’ comp pharmacy reimbursement process into the state’s Medicaid (“Medi-Cal”) pharmacy reimbursement structure. Read more...
February 28, 2024 · Public Policy & Regulatory Affairs Team
California corrects drug formulary, Kentucky introduces several work comp bills, Wisconsin bill would establish a work comp medical fee schedule, New York enhances prior auth portal, several other states introduce work comp firefighter coverage and presumption bills, and New Mexico eyes study on treatment with mushrooms Read more...
February 07, 2024 · Public Policy & Regulatory Affairs Team
California and Ohio update their work comp drug formularies, while New Jersey expands presumptive coverage for first responders and introduces several new work comp and auto no-fault bills. Read more...
January 29, 2024 · Medicare Insights Team
Recent CMS webinar clarifies final rule on civil money penalties for Non-Group Health Plans, describing the triggers for reporting and the auditing process, emphasizing that RREs are required to report claims and that the penalties apply only to prospective claims, and distinguishing between informal and formal notices. Read more...
January 17, 2024 · Clinical Team
The U.S. Food and Drug Administration (FDA) reported that Dr. Reddy’s voluntarily recalled one lot of tizanidine 4 mg tablets at the consumer level as a precautionary measure. Tizanidine is a skeletal muscle relaxant commonly prescribed for the treatment of muscle spasticity. Read more...
January 17, 2024 · Public Policy & Regulatory Affairs Team
Workers’ comp mental injury/illness bills filed in several states and another New Jersey bill seeks to shorten work comp medical fee dispute timeframe, while another would increase PIP coverage requirements Read more...
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