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Medicare Insights

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

May 13, 2024 · Medicare Insights Team
On April 16, 2024, the Center for Medicare and Medicaid Services (CMS) hosted a webinar to discuss Workers Compensation Medicare Set-Asides (WCMSAs) and Civil Money Penalty (CMP) impacts. Our latest blog gives a recap of the webinar and the follow up Q&A session held on April 25. Read more...
May 07, 2024 · Clinical Team
On May 4, 2024, the U.S. Food and Drug Administration (FDA) reported that Breckenridge Pharmaceutical, Inc (Breckenridge) issued a retail level recall of duloxetine delayed-release capsules. Read more...
April 17, 2024 · Medicare Insights Team
The Centers for Medicare and Medicaid Services (CMS) released an updated Workers’ Compensation Medicare Set-Aside (WCMSA) Reference Guide Read more...
March 11, 2024 · Medicare Insights Team
CMS will update MIR steps RREs must take in reporting Medicare workers compensation TPOCs claims and notifying CMS of WCMSA arrangements. Read more...
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...
December 06, 2023 · Clinical Team
FDA warns that the antiseizure medications levetiracetam and clobazam may cause life-threatening adverse reaction. Read more...
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...
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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