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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... |
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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... |
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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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December 06, 2023 · Clinical Team
FDA warns that the antiseizure medications levetiracetam and clobazam may cause life-threatening adverse reaction. Read more... |
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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... |
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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... |
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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... |
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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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