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Sharing information with the industry is an important part of our mission. Our subject matter experts translate today’s news into comprehensive informational pieces to help you better understand the impact of a recent industry update, trend, or issue.

December 07, 2023 · Public Policy & Regulatory Affairs Team
The Policy Guys are back at it, yet again. In this episode, the Guys mix metaphors and swap dad jokes with Michael Flower, Optum Associate General Counsel and resident guru on Medicare set-asides to help explain the latest CMS rule changes, specifically the requirements for claimants, as well as the penalties and fines for claims that fail to meet those requirements. Read more...
December 06, 2023 · Clinical Team
FDA warns that the antiseizure medications levetiracetam and clobazam may cause life-threatening adverse reaction. Read more...
December 06, 2023 · Public Policy & Regulatory Affairs Team
Brief updates include updated California’s workers’ comp treatment guidelines; and the Maryland workers’ comp fee guideline committee continues to discuss, in an open meeting process, the development of the state’s first pharmacy fee schedule. Read more...
December 01, 2023 · Medicare Insights Team
The Centers for Medicare and Medicaid Services (CMS) posted an FAQ on the civil money penalties and on November 13, hosted a webinar on future requirements for mandatory Medicare Set Aside (MSA) insurer reporting . Read more...
November 29, 2023 · Clinical Team
In January, Optum clinical programs will adopt revised morphine equivalent dose (MED) conversion factors for the opioid analgesics hydromorphone, methadone, and tramadol to correlate with CDC Guidelines. However, these modifications are predicted to have little effect on Optum risk identification and clinical review programs. Read more...
November 17, 2023 · Clinical Team
Opvee® (nalmefene) nasal spray now available for emergency treatment of opioid overdoses, but currently non-formulary on all standard formularies until review by Optum P&T Committee. One unit of Opvee will likely be allotted per year by CMS. For WCMSAs, exposure for opioid antagonists like Opvee is unlikely to be significant. Read more...
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