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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

February 17, 2022 · Clinical Team
The U.S. Food and Drug Administration (FDA) issued a warning on January 12, 2022, regarding a potential risk of dental problems with orally-dissolving buprenorphine medications. Buprenorphine is a mixed opiate agonist-antagonist used to treat opioid use disorder (OUD) and pain. Read more...
February 14, 2022 · Medicare Insights Team
On Thursday, February 17, 2022, the Centers for Medicare and Medicaid Services (CMS) will host a Workers’ Compensation Medicare Set-Asides (WCMSA) webinar. During the webinar, CMS will review what’s new with WCMSAs and address questions related to the inclusion of treatments and the application of state rules, re-reviews/amended reviews and more. We also believe CMS will review the recent WCMSA Reference Guide update of Section 4.3 regarding Non-Submit MSAs/EBMSAs. Read more...
February 10, 2022 · Clinical Team
In October 2021, the U.S. Food and Drug Administration (FDA) approved a higher-dose naloxone hydrochloride (HCl) injection - ZIMHI™ (5 mg/0.5 mL) - to treat opioid analgesic overdose. ZIMHI is designed to be administered in the muscle (intramuscular) or under the skin (subcutaneous) using a single-dose, prefilled syringe that delivers 5 mg of naloxone HCl solution. Read more...
January 04, 2022 · Medicare Insights Team
One year after it was signed into law, the Provide Accurate Information Directly ("PAID") Act went live on December 11, 2021. The Act requires the Centers for Medicare & Medicaid Services (CMS) to expand its process to identify whether a claimant is currently or has– in the last three years– been enrolled in Medicare Part C and/or Medicare Part D coverage. With this information, insurers can better identify a claimant’s Medicare plans and avoid unnecessary litigation. Read more...
December 09, 2021 · Medicare Insights Team
The U.S. Food and Drug Administration (FDA) approved a new medication to prevent episodic migraine (fewer than fifteen headache days per month) on September 28, 2021. This approval allows AbbVie, Inc. to market Qulipta - a once daily oral calcitonin gene-related peptide (CGRP) receptor antagonist - for migraine prevention. Qulipta is not indicated for the acute treatment of migraines like other oral CGRP receptor antagonists on the market, such as Ubrelvy™ (ubrogepant) and Nurtec® ODT (rimegepant). Qulipta is the second oral CGRP receptor antagonist to be approved for prevention of episodic migraine. Read more...
November 18, 2021 · Clinical Team
In April 2021, Sanofi Consumer Healthcare released a new, over-the counter (OTC) medication called Zantac 360°. Read more...
October 11, 2021 · New WCMSA Reference Guide
The Centers for Medicare and Medicaid Services (CMS) released Version 3.4 of the Workers’ Compensation Medicare Set-Aside Arrangement (WCMSA) Reference Guide on 10/5/2021. Read more...
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...
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