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...

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...

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...

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...

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...

Listed below are brief updates on several recent policy developments across the country. Read more...

The Centers for Medicare & Medicaid Services (CMS) recently revised the timeline and abstract noted in the Spring 2020 Unified Agenda. Updated by the Office of Management and Budget, when published, this revision will impact workers’ compensation, liability, and no-fault claims. Read more...

Under the leadership of Tony Martin, Chief Revenue Officer, Optum has named two workers’ comp and auto no-fault industry veterans to lead our enhanced commitment of support for clients’ needs. Read more...