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Our Public Policy & Regulatory Affairs team constantly monitors the latest legislative and regulatory activity that impacts you and the services we provide.

Recent blog posts

March 20, 2024 · Public Policy & Regulatory Affairs Team
Several states update their medical fee schedules, while others propose updates; workers’ comp PTSD and mental health coverage bills pending in many states; expanded cancer coverage likely in Maryland; Florida significantly increases physician reimbursement; Montana clarifies workers’ comp rules; and Texas looks to improve the provider complaint process. Read more...
March 04, 2024 · Public Policy & Regulatory Affairs Team
The California Division of Workers’ Compensation (DWC) proposed significant rule changes in the final phase of integrating its workers’ comp pharmacy reimbursement process into the state’s Medicaid (“Medi-Cal”) pharmacy reimbursement structure. Read more...
February 28, 2024 · Public Policy & Regulatory Affairs Team
California corrects drug formulary, Kentucky introduces several work comp bills, Wisconsin bill would establish a work comp medical fee schedule, New York enhances prior auth portal, several other states introduce work comp firefighter coverage and presumption bills, and New Mexico eyes study on treatment with mushrooms Read more...
February 07, 2024 · Public Policy & Regulatory Affairs Team
California and Ohio update their work comp drug formularies, while New Jersey expands presumptive coverage for first responders and introduces several new work comp and auto no-fault bills. Read more...
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...
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 · 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...
November 15, 2023 · Public Policy & Regulatory Affairs Team
Brief notes include: Updated Washington workers’ comp outpatient formulary and mental health services provider list, updated Michigan workers’ comp health care rules, proposed New Mexico workers’ comp provider fee schedule and billing changes, updated Massachusetts workers’ comp hearing service rules, updated Maine workers’ comp reimbursement rates, and New York workers’ comp looks to update DMEPOS fee schedule. Read more...
October 25, 2023 · Public Policy & Regulatory Affairs Team
Brief updates in California workers’ comp PTSD presumption law amended and several other bill vetoed; Michigan legislation would significantly overhaul auto no-fault medical fee schedule law; Massachusetts to hold meetings on opioids; and Tennessee clarifies medical fee schedule updates. Read more...
October 12, 2023 · Public Policy & Regulatory Affairs Team
You’re invited to the Policy Guys’ end of summer barbeque! Have a brat or burger and listen in as Adam and Kevin discuss physician dispensing of topical medications with Optum Workers’ Comp Chief Clinical Officer Tron Emptage, proposed new rules for Medicare Secondary Payer conditional payments with Associate General Counsel Michael Flower, and the latest state policies on PTSD with Associate Medical Director Dr. Kathleen Fink. Read more...
October 04, 2023 · Public Policy & Regulatory Affairs Team
Brief updates include Colorado furthering limits on physician dispensing in work comp, California work comp bill requiring in-state licensure for UR physicians on hold, Arizona Fee Schedule features new DMEPOS requirements, Tennessee activates Certified Physician Program and New York PTSD bill keeps moving. Read more...
September 13, 2023 · Public Policy & Regulatory Affairs Team
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