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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.

August 06, 2020 · Optum Workers' Comp and Auto No-fault
Previously proposed Michigan auto no-fault utilization review (UR) rules (which were required by last year’s reform legislation) have moved to the next phase of the formal rule-making process, which is required review by a state legislative committee. Unless there are committee objections, the latest version, amended after comments by the state’s Department of Insurance and Financial Services (DIFS), should be adopted in the near future. Read more...
August 03, 2020 · Clinical Connection team
In late July, the U.S. Food and Drug Administration (FDA) announced they are requiring manufacturers of all opioid analgesics and medications to treat opioid use disorder (OUD) to add recommendations about naloxone to the prescribing information and patient Medication Guides. Read more...
July 28, 2020 · Clinical Connection team
The U.S. Food and Drug Administration (FDA) recently added dexamethasone sodium phosphate to their approved list of medications that may be temporarily compounded during the COVID-19 pandemic. Read more...
July 27, 2020 · Lavonya Chapman, Associate General Counsel, Optum Settlement Solutions
The U.S. Circuit Court of Appeals recently ruled that Medicaid may seek to recover payments it made for an eligible recipient’s treatment from the settlement agreement that released both past and future medical care ― Gallardo v. Dudek, 2020 U.S. App. LEXIS 19928. The 11th Circuit used the U.S. Supreme Court’s decision in Arkansas Dept. of Health and Human Svcs. v. Ahlborn, 547 U.S. 268 (2006) in reaching the Gallardo decision. Read more...
July 22, 2020 · Lavonya Chapman, Associate General Counsel, Optum Settlement Solutions
The Centers for Medicare and Medicaid Services (CMS) recently alerted stakeholders that they updated the requirements for reporting auto no-fault claims in the Non-group Health Plan (NGHP) Section 111 User Guide. This update affects responsible reporting entities (RRE) and associated third-party claims administrators (TPA) who insure or manage No-Fault auto claims and are required to report to CMS under the Medicare Secondary Payer (MSP) Mandatory Reporting Provisions Section 111 of the Medicare, Medicaid, and SCHIP Extension Act (MMSEA) of 2007. Read more...
July 20, 2020 · Policy Matters team
Listed below are brief updates on several recent policy developments across the country. Read more...
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