Late in 2018, our federal government announced that in 2019 that it intends to regulate how and when to take Medicare’s future interests into account.
Although we hear a great deal about Medicare becoming increasingly more aggressive with primary payers (responsible employers, corporations, insurers, self insured entities, and third party administrators), the federal government is also becoming just as unforgiving with beneficiaries’ attorneys. Pursuant to the Medicare Secondary Payer provisions of the Social Security Act, 42 U.S.C. § 1395y(b)(2), when Medicare … Read moreFeds pursuing Medicare conditional payment reimbursement from beneficiaries’ attorneys, as well as primary payers
Cross-posted from our Optum Insights blog. Two advisory committees of the U.S. Food and Drug Administration (FDA) recently voted to approve esketamine nasal spray for the treatment of adults with treatment-resistant depression (TRD), which is typically defined as failing trials of at least two antidepressant treatments for major depressive disorder. Esketamine is chemically related to … Read moreFDA advisory committees recommend approval of esketamine nasal spray for treatment-resistant depression
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.