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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

November 05, 2020 · Optum Workers' Comp and Auto No-fault
During the recent National Alliance of Medicare Set-Aside Professionals (NAMSAP), now known as the National Medicare Secondary Payer Network, annual conference, John Jenkins, Health Insurance Specialist, Division of Medicare Secondary Payer Program Operations, Office of Financial Management for the Centers for Medicare and Medicaid Services (CMS) provided information on the appropriate method for calculating seed money for annuities involving a Workers’ Compensation Medicare Set-Aside (WCMSA) within the total settlement amount. Read more...
October 30, 2020 · Clinical Team
Evzio auto-injector and naloxone auto-injector have been discontinued and will no longer be available, according to kaléo Inc. (kaléo). According to information Optum has obtained from kaléo, previously dispensed Evzio and its authorized generic are still safe to use until their expiration dates. In addition, pharmacies may dispense current stock, but future refills will not likely be available. Read more...
October 28, 2020 · Optum Workers' Comp and Auto No-fault
The RED BOOK® September 2020 update indicated Major Pharmaceuticals recently discontinued their formulation of tizanidine 4 mg tablets. Read more...
October 20, 2020 · Optum Workers' Comp and Auto No-fault
The National Alliance of Medicare Set-Aside Professionals (NAMSAP), now known as the National Medicare Secondary Payer Network, continues to hit it out of the park at their annual conference. Read more...
October 14, 2020 · Clinical Team
The U.S. Food and Drug Administration (FDA) reported that the brand-name opioid analgesic, Duragesic (fentanyl transdermal system), manufactured by Janssen Pharmaceuticals, Inc., is being discontinued. According to the FDA’s website, Janssen made a business decision to permanently discontinue all Duragesic transdermal systems and indicated they should be maintained on formularies until the last produced batch expires on July 31, 2021 to maintain continuity of the reimbursement process. No additional information was provided on Janssen’s website related to its business decision. Read more...
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