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

To help our clients achieve the lowest possible Workers’ Compensation Medicare Set-Aside (WCMSA) allocations, Optum continually monitors the average wholesale price (AWP) of the most common medications seen in a WCMSA. The following outlines the most recent price decreases for a few of these medications. Read more...

The recently enacted Provide Accurate Information Directly (PAID) Act will make it easier to determine whether payments for claimed injuries/illness involving workers’ compensation, no-fault and/or liability claims were made by traditional Medicare and/or a Medicare Advantage (Part C) plan (MAP) and/or a prescription Part D plan (PDP) and whether they need to be reimbursed. Read more...

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

On November 12, 2020, the Centers for Medicare and Medicaid Services (CMS) issued a Technical Alert and published version 6.1 of the Non-Group Health Plan (NGHP) Section 111 User Guide. Both note changes that will eventually impact Civil Money Penalties (CMP) involving Section 111 reporting when CMS error tolerance thresholds are exceeded. Read more...

The U.S. Food and Drug Administration (FDA) authorized the use of the Lucira™ COVID-19 All-In-One Test Kit under an Emergency Use Authorization (EUA) on November 17, 2020.  This is the first at-home nasal swab test kit to detect SARS-CoV-2  the virus that causes the coronavirus disease 2019 (COVID-19). Read more...

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

The New York Workers’ Compensation Board (WCB) has temporarily suspended application of drug formulary refill/renewal requirements, moving them from January 1, 2021, to an undetermined date at this time. Read more...