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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
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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 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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October 12, 2023 · Clinical Team
The 3Q 2023 Brand-Generic Pipeline update Read more... |
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October 11, 2023 · Medicare Insights Team
On October 10, 2023, CMS finalized its Civil Monetary Penalty (CMP) rule for imposing penalties against Responsible Reporting Entities (RREs), which includes Group Health Plans (GHPs) and Non-Group Health Plans (NGHPs). Read more... |
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September 20, 2023 · Clinical Team
Zavzpret – indicated for the acute treatment of migraine with or without aura in adults – is now available as a 10 mg nasal spray device. Read more... |
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September 15, 2023 · Clinical Team
According to the U.S. Food and Drug Administration (FDA), Duexis — a single-tablet combination product containing ibuprofen, a nonsteroidal anti‐inflammatory drug (NSAID), and famotidine, a histamine H2–receptor blocker — will no longer be manufactured. Read more... |
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