Main-blog-page-header

Sharing perspectives leads to greater understanding and fuels innovation. The ​Optum Insights ​blog is where we share our perspective and challenge preconceptions to clear a new path forward



  • Answers to Your Most Common Questions about Predictive Analytics in Workers’ Comp

    by
    • Optum for Workers' Compensation
    | May 16, 2019
    Tag Icon
    Analytics, Workers Comp, Clinical, Predictive Analytics
    Predictive analytics improve clinical outcomes and reduce costs for payers, but only if used properly. Risk & Insurance interviewed OWCA experts to learn how to apply predictive analytics in workers' compensation.


  • Medicare Secondary Payer Recovery Portal enhancements ease payment process

    by
    | May 16, 2019
    Tag Icon
    Medicare Secondary Payer, Medicare Insights
    Enhancements to the Medicare Secondary Payer Recovery Portal (MSPRP) have been announced by CMS that address electronic payment capabilities for identified Non-Group Health Plan (NGHP) conditional payment debt. CMS publicized the enhancements during a March 13, 2019, webinar.


  • What you need to know about naloxone

    by
    | May 16, 2019
    Tag Icon
    Evzio, Naloxone, Opioids, Medicare Insights
    Naloxone is an opioid antagonist that displaces opioids from receptors in the brain, reversing the effects of opioid analgesics, including their life-threatening effects. Naloxone is commercially available by nasal spray (i.e., Narcan® Nasal Spray), solution for injection and an auto-injector (i.e., Evzio®). Currently, naloxone products are only available by prescription. Naloxone is not a controlled substance and has no abuse potential. It has no direct role in the treatment of pain or other industrial conditions; it is used exclusively for the treatment of a known or suspected opioid overdose.


  • Changes influencing Medicare Secondary Payer compliance go into effect April 1, 2019

    by
    | May 16, 2019
    Tag Icon
    Medicare Secondary Payer, Medicare Insights
    In accordance with the SSN Fraud Prevention Act of 2017, the COB&R program will mask the SSN and SSN-portion of the HICN, on all outgoing letters as of April 1, 2019.


  • Brand medication increases and generics for release in 2019

    by
    | May 15, 2019
    Tag Icon
    Medicare Secondary Payer, Generics, Medicare Insights, medicareinsights blog
    As an established Medicare Secondary Payer (MSP) compliance services provider, one of our goals is to keep clients, and the property and casualty insurance industry, informed of changes affecting MSP compliance and Workers’ Compensation Medicare Set Asides (WCMSAs). As part of our best business practices, we continually monitor the RED BOOK® Average Wholesale Price (AWP) changes of the most common medications in WCMSAs as well as generic medications that come to market. This practice assists in identifying price changes that affect WCMSAs.


  • CMS releases NGHP Section 111 User Guide Version 5.5

    by
    | May 15, 2019
    Tag Icon
    Medicare Insights, CMS
    As an established Medicare Secondary Payer (MSP) compliance services provider, one of our goals is to keep clients, and the property and casualty insurance industry, informed of changes affecting MSP compliance. On January 4, 2019, CMS released an updated Non Group Health Plan (NGHP) User Guide, version number 5.5.


  • Version 2.9 of the Workers’ Compensation Medicare Set-Aside Arrangement Reference Guide released

    by
    | May 15, 2019
    Tag Icon
    Medicare Set-Aside, workers compensation, Medicare Insights, WCMSA
    On January 4, 2019, The Centers for Medicare and Medicaid Services (CMS) released an updated Workers Compensation Medicare Set-Aside (WCMSA) Reference Guide, Version 2.9. One of the major updates in Version 2.9 is additional language regarding justification for inclusion of Lyrica® in WCMSAs.



Stay informed by receiving latest updates

Do you have a question about a blog post?