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Through an integrated medical, pharmacy, claims and legal approach, we deliver insights to help navigate the ever‑changing Medicare Secondary Payer landscape.

Recent blog posts

September 16, 2021 · Medicare Insights Team
Approved by the FDA in August 2021, the first generic of Duexis, ibuprofen-famotidine, is now available and is included in the Workers’ Compensation Medicare Set-Aside Portal (WCMSAP) as of September 2021. Read more...
August 12, 2021 · Medicare Insights Team
Optum continually monitors the average wholesale price (AWP) of the most common medications in WCMSAs to help our clients properly assess their exposure and achieve the lowest possible allocations. Read more...
May 05, 2021 · Medicare Insights Team
The Centers for Medicare and Medicaid Services (CMS) released Version 3.3 of the Workers’ Compensation Medicare Set-Aside Arrangement (WCMSA) Reference Guide, which clarifies how to calculate the seed money (initial deposit) in a structured WCMSA. Read more...
April 28, 2021 · Medicare Insights Team
The generic of Hysingla ER, hydrocodone bitartrate extended-release (ER) tablets, was released in March 2021 and became available for allocation in Workers’ Compensation Medicare Set-Asides (WCMSAs) as of early April 2021. Read more...
April 13, 2021 · Medicare Insights Team
Optum continually monitors the average wholesale price (AWP) of the most common medications in Workers’ Compensation Medicare Set-Asides (WCMSAs) to help our clients properly assess their WCMSA exposure and achieve the lowest possible allocations. Read more...
March 01, 2021 · Medicare Insights Team
Over 800 brand-name medications increased in price in January 2021 ― below we list price boosts for 19 of these medications commonly seen in Workers’ Comp Medicare Set Aside Arrangements (WCMSAs), which average a 6% cost increase. Read more...
February 10, 2021 · Medicare Insights Team
A lower price is now available for a common workers’ compensation medication as its brand alternative hit store shelves in January. Amitiza® is approved by the U.S. Food and Drug Administration (FDA). Read more...
January 06, 2021 · Settlement Solutions Team
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...
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