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Latest featured insights

Optum CEO Matt Wolfe on Technology, Talent & Mission

Article

Optum CEO Matt Wolfe on technology, talent and mission

Optum President and CEO Matt Wolfe reveals how AI, modernized platforms and mission-driven reform are reshaping the workers’ comp and auto no-fault landscape.

How Optum helps payers navigate new drug impact

White paper

How Optum helps payers navigate new drug impact

New medications are approved every year. Combining clinical insight, claims data, and strategic guidance, Optum helps payers manage their utilization.

The Future of Workers’ Comp & Auto: A 10-Year Outlook

White paper

The future of workers’ comp and auto: A 10-year outlook

Major shifts are coming for insurers from demographic, AI and mobility risks. Here are ways to stay prepared.

Surgical Bundle Drives Improvements in Worker Recovery

Article

Surgical bundle drives dramatic improvements in worker recovery

The innovative Optum–MinWorx surgical program dramatically reduces total claim costs and claim duration.

 

Clinical services

Surgical Bundle Drives Improvements in Worker Recovery

Article

Surgical bundle drives dramatic improvements in worker recovery

The innovative Optum–MinWorx surgical program dramatically reduces total claim costs and claim duration.

FDA requires opioid analgesic labeling changes | Clinical Connection

Clinical update

FDA requires opioid analgesic labeling changes

In July 2025, the FDA issued a safety alert regarding risks associated with long-term use of opioid analgesics.

New Migraine Med Available: Symbravo | Clinical Connection

Clinical update

New migraine medication Symbravo approved by FDA

In January 2025, Axsome Therapeutics announced FDA approval of Symbravo for treatment of acute migraine.

Caring for Workers Affected by Climate Change

White paper

Caring for workers affected by climate change

Climate change poses significant health risks for workers; our programs work together to address their needs.

 

Corporate partnership

The Future of Workers’ Comp & Auto: A 10-Year Outlook

White paper

The future of workers’ comp and auto: A 10-year outlook

Major shifts are coming for insurers from demographic, AI and mobility risks. Here are ways to stay prepared.

Driving Quality & Innovation with Accountable Intelligence

White paper

Driving quality and innovation with accountable intelligence

Sameer Diddee, CTO, explains how responsible AI is optimizing internal processes and client solutions.

Leading and collaborating to build better programs

White paper

Leading and collaborating to build better programs

Our leaders collaborate on path-breaking solutions that deliver better care and client-focused service.

Much More Than Pharmacy Benefits: Optum Whole-Person Care

Article

Much more than pharmacy benefits

With our whole-person approach to injured person care, we can lower costs and support interconnected needs.

 

Cost containment

Strategies for Improving Your Bill Review Savings

White paper

Partnership and strategies to improve your bill review savings

Optum Clinical & Coding Logic supplements bill review to uncover additional opportunities for savings.

Evaluating PBM Pricing Models: Key Factors to Consider

Article

Factors to consider when evaluating PBM pricing models

When it comes to selecting a PBM, it’s important to fully understand the main PBM pricing models.

Evaluating PBM Vendor Pricing: How to Get the Best Value

Article

Questions to ask when comparing PBM pricing models

By asking the right questions, payers can find the right fit and the most savings for their organization.

How PBM Cost Savings Help Auto Insurers Attract Policyholders

Article

How PBM cost savings help auto insurers attract policyholders

Auto insurers face increasingly severe claims, but with a sound strategy, carriers can stay profitable.

 

Policy/regulatory guidance

Policy Matters Brief – January 14, 2026

Policy-regulatory update

Policy Matters Brief – January 14, 2026

Recent state policy updates in AZ, CT, CA, ME, MA, NY, OR, TN, and TX

Policy Matters Brief – December 19, 2025

Policy-regulatory update

Policy Matters Brief – December 19, 2025

Recent state policy updates in AZ, CA, CO, IL, OR, PA, and WA

Policy Matters Brief – November 18, 2025

Policy-regulatory update

Policy Matters Brief – November 18, 2025

Recent state policy updates in CA, CO, NV, NM, and NY

Policy Matters Brief – October 22, 2025

Policy-regulatory update

Policy Matters Brief –October 22, 2025

Recent state policy updates in AK, CA, CO, FL, MI, NV, NH, NJ, OR, and RI.

 

Program features

How Optum helps payers navigate new drug impact

White paper

How Optum helps payers navigate new drug impact

New medications are approved every year. Combining clinical insight, claims data, and strategic guidance, Optum helps payers manage their utilization.

Our Commitment to Compassionate Service for Injured Workers

White paper

Living out our commitment to compassionate service

Our customer service professionals embody our commitment to personalized, compassionate service.

VitalPoint’s Surgery Plan Feature Saves Time

White paper

Surgery Plan feature saves precious time for adjusters

Our Surgery Plan feature lightens the workload for adjusters with claimants preparing for surgery.

Predictive Analytics: Decision-Making for At-Risk Claims

Article

AI models and human expertise combine to predict claim risk

AI-powered tools are valuable in flagging potential claim risk, but human claim oversight is critical.

 

Program management

Optum CEO Matt Wolfe on Technology, Talent & Mission

Article

Optum CEO Matt Wolfe on technology, talent and mission

Optum President and CEO Matt Wolfe reveals how AI, modernized platforms and mission-driven reform are reshaping the workers’ comp and auto no-fault landscape.

Reflections on leadership shaped by integrity

Article

Reflections on leadership shaped by integrity

When hard choices can affect the recovery of injured people, integrity in leadership is even more crucial.

Reinvent the Wheel? No, We're Looking for Ways to Improve it

Article

Reinvent the wheel? No, we’re looking for ways to improve it

AI-driven technologies, streamlined processes, and enhanced security measures drive optimal program value.

5 Medication Management Trends to Watch in Workers’ Comp

Article

5 med management trends to watch in workers' comp

Our annual review of drug utilization revealed trends that will shape workers’ comp care in 2025 and beyond.

 

All insights

Reflections on leadership shaped by integrity

When hard choices can affect the recovery of injured people, integrity in leadership is even more crucial.

Much more than pharmacy benefits

With our whole-person approach to injured person care, we can lower costs and support interconnected needs.

Surgical bundle drives dramatic improvements in worker recovery

The innovative Optum–MinWorx surgical program dramatically reduces total claim costs and claim duration.

Benefits of partnering with a pharmacy benefit manager

A good PBM partner will help to reduce pharmaceutical costs while also improving therapeutic outcomes.

CEO Matt Wolfe sees bright opportunities in technology and talent

Matt Wolfe, CEO, explains why he believes the groundwork has been laid for exciting progress ahead.

How Optum helps payers stay on top of PTSD legislation

Workers’ comp PTSD laws vary among states. The Optum PPRA team helps clients stay informed and compliant.

Why varied expertise is key to successful PBM clinical programs

A PBM team with an array of clinical expertise provides injured persons the varied care they need.

Why client experience is essential in workers’ comp

A commitment to improving the client experience helps service providers stand out from the crowd.

Factors to consider when evaluating PBM pricing models

When it comes to selecting a PBM, it’s important to fully understand the main PBM pricing models.

How PBM cost savings help auto insurers attract policyholders

Auto insurers face increasingly severe claims, but with a sound strategy, carriers can stay profitable.

5 med management trends to watch in workers' comp

Our annual review of drug utilization revealed trends that will shape workers’ comp care in 2025 and beyond.

Using AI predictions to drive improved recovery scenarios

AI-driven risk identification helps our clinicians drive a better therapeutic outcome.

AI models and human expertise combine to predict claim risk

AI-powered tools are valuable in flagging potential claim risk, but human claim oversight is critical.

Questions to ask when comparing PBM pricing models

By asking the right questions, payers can find the right fit and the most savings for their organization.

PBMs help auto insurers mitigate challenges

Through advanced clinical management, our auto no-fault PBM can deliver more savings and better outcomes.

A leader explains his lifetime mission to improve and simplify

As the new CEO, Matt Wolfe continues a mission of transformational improvement in service delivery.

Using the Topicals Toolbox to address topicals prescribing

A handy, interactive toolbox with policy and clinical resources for managing topical utilization.

How many meds are too many meds?

The “right” number of medications depends on an injured individual’s unique medical profile.

Why injured-person centered care is essential

The care needed may extend well past the injury; that’s why Optum uses a holistic, personalized approach.

The auto payers' checklist to manage claims

Organizations that provide pharmacy and ancillary benefits need to understand the intricacies of auto claims.

Reinvent the wheel? No, we’re looking for ways to improve it

AI-driven technologies, streamlined processes, and enhanced security measures drive optimal program value.

Optum and ProCare collaborate to deliver a better client experience

The Optum and ProCare CEOs explain how their collaboration will benefit the client experience.

Best practices for the medical management of high-risk claims

Advice from Optum Medical Director, Robert Hall, MD, on the best methods for managing complex patient needs.

What is the health story and why is it so important?

Exploring an injured worker’s health story builds trust — and helps pharmacists offer better care.

What are the must-have qualities for your PBM partner?

When selecting a business partner, it’s important to prioritize the qualities and values you know are critical.

Formulary management as a strategic safeguard

Formulary management works with the authorization process to support worker safety and reduce complexity.

Optum CEO Matt Wolfe on technology, talent and mission

Optum President and CEO Matt Wolfe reveals how AI, modernized platforms and mission-driven reform are reshaping the workers’ comp and auto no-fault landscape.

Caring for workers affected by climate change

Climate change poses significant health risks for workers; our programs work together to address their needs.

Partnering with an established and stable enterprise

A vendor partner with a stable and respected market presence protects your organization and credibility.

PTSD coverage expands with increased focus on mental health

State legislative efforts to address and expand PTSD coverage in workers’ compensation.

Dispelling rumors about PPOs and other medical networks

Definitions and clear information about the purpose and benefits of PPOs and medical networks.

Early awareness of potential risk through the Optum Risk Score

The Optum proprietary Risk Score alerts insurers to high-risk claims before spend and severity increase.

How Optum helps payers navigate new drug impact

New medications are approved every year. Combining clinical insight, claims data, and strategic guidance, Optum helps payers manage their utilization.

The future of workers’ comp and auto: A 10-year outlook

Major shifts are coming for insurers from demographic, AI and mobility risks. Here are ways to stay prepared.

Understanding traditional and transparent pricing models

Differences between traditional and transparent pricing, and what might work best for your organization.

Living out our commitment to compassionate service

Our customer service professionals embody our commitment to personalized, compassionate service.

Partnership and strategies to improve your bill review savings

Optum Clinical & Coding Logic supplements bill review to uncover additional opportunities for savings.

Leading and collaborating to build better programs

Our leaders collaborate on path-breaking solutions that deliver better care and client-focused service.

Driving quality and innovation with accountable intelligence

Sameer Diddee, CTO, explains how responsible AI is optimizing internal processes and client solutions.

Supporting behavioral health in injury recovery

For injured persons, support for behavioral health can ease burdens and light the path forward.

Top 10 factors in the successful management of high-risk claims

By managing needed care efficiently, insurers can improve quality of life and recoveries for injured persons.

Obesity in the workforce and GLP-1 medications

Our clinical and policy experts can help you navigate the evolving landscape of GLP-1 medications.

A CEO discusses turning challenges into opportunities

By tuning in to market changes and thinking strategically, challenges can become opportunities.

Embracing strategies for improved nutrition

While injuries can create barriers to good nutrition, science-based nutritional strategies can aid recovery.

A career defined by a commitment to clients

Stacey McKee, SVP of Client Experience, explains her commitment to ensuring a positive client experience.

Benefits of proactive adjuster involvement in auto claims

While regulations may discourage engagement in the adjudication process, active involvement delivers benefits.

Surgery Plan feature saves precious time for adjusters

Our Surgery Plan feature lightens the workload for adjusters with claimants preparing for surgery.

A closer look at the effects of comorbidities

An explanation of five ways that comorbid conditions can increase complications, lengthen recoveries, and lead to higher costs.

New migraine medication Zavzpret approved by FDA

In March 2023, the FDA approved Zavzpret™ nasal spray for the acute treatment of migraine in adults.

New nasal spray medication Opvee approved by FDA

Opvee® 2.7 mg nalmefene nasal spray is now available for emergency treatment of opioid overdoses.

Optum Brand-Generic Pipeline Q2 2023

New medications, first-time generics, and brand alternatives approved by the FDA for injury treatment.

Teva initiates voluntary nationwide recall of fentanyl buccal tablets

Teva Pharmaceuticals USA has voluntarily recalled various strengths of fentanyl buccal tablets.

Brand name Duexis and generic alternatives no longer manufactured

The FDA announced that Duexis® and generic famotidine will no longer be manufactured.

Optum Brand-Generic Pipeline Q1 2023

New medications, first-time generics, and brand alternatives approved by the FDA for injury treatment.

FDA announces safety concern with two antiseizure medications

In November 2023, the FDA warned that levetiracetam and clobazam can cause a rare but serious adverse reaction.

American Geriatrics Society updates AGS Beers Criteria

The AGS Beers Criteria® for potentially inappropriate medication use in older adults has been updated.

Narcan OTC naloxone nasal spray approved by FDA

In July 2023, the FDA approved Narcan® 4 mg Nasal Spray for OTC non-prescription use.

Updates to ODG Drug Formulary Appendix A

In April 2023, the ODG Drug Formulary status changed for certain topical analgesic and NSAID medications.

Optum will modify three opioid analgesic conversion factors

In January 2024, Optum clinical programs will adopt revised morphine equivalent dose (MED) conversion factors.

Akorn initiates voluntary nationwide recall of certain drug products

Akorn Operating Company LLC has voluntarily recalled several drug products due to quality concerns.

New Brixadi buprenorphine treatment approved by FDA

In May 2023, the FDA approved Brixadi™ ER injection for the treatment of moderate to severe opioid use disorder.

Optum Brand-Generic Pipeline Q3 2023

New medications, first-time generics, and brand alternatives approved by the FDA for injury treatment.

RiVive (naloxone) nasal spray approved by FDA

In July 2023, the FDA approved Harm Reduction Therapeutics RiVive™ nasal spray 3 mg for OTC use.

More naloxone options for opioid analgesic overdose

In October 2021, the FDA approved a higher-dose naloxone HCl injection, ZIMHI™, for opioid analgesic overdose.

New insomnia treatment Quviviq approved by FDA

In January 2022, the U.S. FDA approved Quviviq™ 25 mg and 50 mg tablets for the treatment of insomnia.

DEA National Prescription Drug Take Back Day is October 29, 2022

Make a plan to drop off unneeded medications on DEA National Prescription Drug Take Back Day.

FDA issues warning for certain Buprenorphine medications

In January 2022, the FDA warned of potential dental risk from orally dissolving buprenorphine.

Gastrointestinal medication Zelnorm withdrawn from the market

Effective June 30, 2022, Zelnorm® 6 mg tablet will no longer be produced and marketed in the U.S.

FDA warning regarding topical pain relief preparations

In March 2024, the FDA issued a warning for consumers to avoid certain OTC analgesic products.

Recall of Duloxetine capsules

In May 2024, the FDA reported that Breckenridge Pharmaceutical, Inc. recalled duloxetine delayed-release capsules.

One lot of tizanidine 4 mg tablets voluntarily recalled

In January 2024, Dr. Reddy’s Laboratories Inc. issued a voluntary recall of tizanidine 4 mg tablets.

New migraine medication Symbravo approved by FDA

In January 2025, Axsome Therapeutics announced FDA approval of Symbravo for treatment of acute migraine.

FDA requires opioid analgesic labeling changes

In July 2025, the FDA issued a safety alert regarding risks associated with long-term use of opioid analgesics.

New pain medication Journavx approved by FDA

In January 2025, the FDA approved Journavx™ (suzetrigine) for the treatment of moderate-to-severe acute pain in adults.

Policy Matters Brief - 2024 - April 10

Recent state policy updates in AL, GA, KS, LA, MD, MN, OH, OK, SC, TX, VA, WV, and WY, as well as more information about PTSD legislation.

Policy Matters Brief - 2024 - February 7

Recent state policy updates in AZ, CA, CO, IN, NJ, OH, OK, TN, VA, and WI.

Policy Matters Brief - 2022 - July 27

Recent state policy updates in CO, CT, FL, IA, KY, LA, MT, NJ, NY, and TN.

Policy Matters Brief - 2022 - March 30

Recent state policy updates in GA, KS, KY, LA, and MI.

Policy Matters Brief - 2022 - December 7

Recent state policy updates in KY as well as proposed updates to HIPAA pharmacy billing standards.

Policy Matters Brief - 2022 - May 11

Recent state policy updates in KY, IL, NY, TN, VA, and WI.

Policy Matters Brief - 2022 - June 22

Recent state policy updates in CA, MN, NY, OK, and TX, as well as notice of the SAWCA annual convention.

Policy Matters Brief - 2022 - August 17

Recent state policy updates in AK, CA, CO, NY, and OR.

Policy Matters Brief - 2022 - March 9

Recent state policy updates in NY, MN, OR, and UT.

Policy Matters Brief - 2022 - February 16

Recent state policy updates in CA, CO, KY, MI, MS, NJ, and OK.

Policy Matters Brief - 2022 - November 16

Recent state policy updates in CA, MS, TN, NJ, and VA, as well as notice of the SAWCA All Committee Conference.

Policy Matters Brief - 2022 - October 26

Recent state policy updates in CA, FL, MI, and NY.

Policy Matters Brief - 2022 - January 19

Recent state policy updates in CA, NC, and VA.

Policy Matters Brief - 2022 - April 20

Recent state policy updates in CT, IN, NJ, NY, UT, and WA.

Policy Matters Brief - 2022 - June 1

Recent state policy updates in CA, MT, and OK.

Policy Matters Brief - 2022 - September 7

Recent state policy updates in CA, TX, KY, OH, as well as notice of the IAIABC Convention.

Policy Matters Brief - 2022 - October 5

Recent state policy updates in CA, CO, MI, and NY.

Policy Matters Brief - 2023 - December 6

Recent state policy updates in AK, CA, MD, and OR.

Policy Matters Brief - 2023 - October 4

Recent state policy updates in AZ, CA, CO, NY, TN, and VA.

Policy Matters Brief - 2023 - June 15

Recent state policy updates in AZ, CA, CO, FL, OR, MI, TN, and VA.

Policy Matters Brief - 2023 - July 26

Recent state policy updates in NJ, NY, and TN, as well as notice of the SAWCA Annual Convention.

Policy Matters Brief - 2023 - March 1

Recent state policy updates in CA, CO, CT, NJ, NY, and ND.

Policy Matters Brief - 2023 - February 8

Recent state policy updates in FL, IL, KY, LA, OH, OR, SC, and WV.

Policy Matters Brief - 2023 - May 4

Recent state policy updates in MI, MT, WA, as well as WCRI updates to workers’ comp pharmacy regulations.

Policy Matters Brief - 2023 – September 13

Recent state policy updates in CA, ME, MI, MS, and WA, as well as notice of the IAIBC Convention.

Policy Matters Brief - 2023 - November 15

Recent state policy updates in MA, ME, MI, NJ, NM, NY, OH, VA, and WA.

Policy Matters Brief - 2023 - May 24

Recent state policy updates in CT, IL, MI, MT, TN, and WA.

Policy Matters Brief - 2025 - January 16

Recent state policy updates in AL, CA, ME, NC, NY, OH, TX, and WA.

Policy Matters Brief - 2025 - March 20

Recent state policy updates in AK, CO, ID, NJ, NY, OR, and VA.

Policy Matters Brief - 2025 - May 8

Recent state policy updates in AL, CA, IN, MT, NM, NY, OH, TN, and WV.

Policy Matters Brief - 2025 - February 27

Recent state policy updates in AL, AZ, CA, MI, OR, and VA.

Policy Matters Brief - 2024 - November 20

Recent state policy updates in AK, CA, NY, and WA.

Policy Matters Alert - 2024 - June 27

New York lawmakers pass legislation impacting the ability of employers and insurers to direct workers’ comp pharmacy care.

Policy Matters Brief - 2024 - September 12

Recent state policy updates in CA, NM, NY, OH, PA, and TX.

Policy Matters Brief – September 23, 2025

Recent state policy updates in AK, CA, CO, FL, MI, NV, NH, NJ, OR, and RI.

Policy Matters Brief - 2025 - April 15

Recent state policy updates in AK, CO, ID, KY, MD, NM, OH, SD, and UT.

Policy Matters Brief - 2025 - May 21

New York WCB offers education on CMS-1500 project prior to 8/1/25 ebilling mandate.

Policy Matters Alert - 2025 - April 4

A ruling from the Pennsylvania Supreme Court changes how OTC medications are prescribed and provided to injured workers.

Policy Matters Brief - 2025 - May 28

California Legislative committee passes presumption and Qualified Medical Evaluator bills.

Policy Matters Brief - 2025 - February 6

Recent state policy updates in CA, CO, FL, IL, NM, NY, OH, OK, OR, and VA.

Policy Matters Brief – August 25, 2025

Recent state policy updates in AK, CA, ME, MA, NJ, OH, OR, and TX.

Policy Matters Alert - 2025 - July 8

New York WCB issues updates to pharmacy direction of care rules for certain medically necessary circumstances.

Policy Matters Brief - 2024 - June 12

Recent state policy updates in CA, FL, KY, MT, NY, NJ, OK, and WA.

Policy Matters Brief - 2024 - May 1

Recent state policy updates in AL, CA, KY, LA, PA, TX, and WI.

Policy Matters Brief - 2024 - October 30

Recent state policy updates in CA, FL, MA, MN, and NM.

Policy Matters Brief - 2024 - July 31

Recent state policy updates in AK, CO, FL, KY, ID, MI, MN, OH, PA, and TX.

Policy Matters Brief - 2024 - December 11

Recent state policy updates in CO, NM, NV, NY, OH, TX, VT, and WA.

Policy Matters Brief - 2024 - July 10

Recent state policy updates in CA, FL, ID, MI, MT, NY, and RI, as well as notice of the annual SAWCA convention.

Policy Matters Brief - 2024 - October 14

Recent state policy updates in CA, CO, MN, NM, and PA.

Policy Matters Alert - 2025 - June 13

On July 1, 2025, California DWC will roll-out a new pharmacy fee schedule for Medi-Cal pharmacy rates.

Policy Matters Brief –October 22, 2025

Recent state policy updates in AK, CA, CO, FL, MI, NV, NH, NJ, OR, and RI.

Policy Matters Brief - 2025 - July 9

Recent state policy updates in CA, MN, NV, OR, RI, WA, and WI.

Policy Matters Brief – November 18, 2025

Recent state policy updates in CA, CO, NV, NM, and NY

Policy Matters Brief - 2023 - August 16

Policy updates in CA, MI, OH, OK, and WA; first annual VA workers’ comp medical fee schedule symposium.

Policy Matters Brief - 2023 - October 25

Policy updates in CA, FL, MA, MI, OR, and TN; notice of the SAWCA 2023 All-Committee Conference.

Policy Matters Brief - 2023 - April 14

Policy updates in FL, KY, OR, SC, UT, and VA; notice of the AAPAN Innovations Retreat and IAIABC Forum.

Policy Matters Brief - 2023 - March 22

Policy updates in AL, CA, MN, MT, and NY; Physician choice legislation introduced in MT and IA.

Policy Matters Brief - 2023 - July 5

Policy updates in AZ, CO, CT, MN, MT, NJ, and NY, as well as notice of the SAWCA Annual Convention.

Policy Matters Brief - 2023 - January 19

Policy updates in CA, FL, IN, MN, NM, NY; Federal Firefighters Fairness Act; health care attachment standards.

Policy Matters Brief - 2022 - February 3

Implementation schedule for NY WCB OnBoard Drug Formulary and DMEPOS fee schedule.

Policy Matters Brief - 2024 - February 28

Policy updates in CA, HI, KY, NM, NY, and WI; new workers’ comp firefighter coverage and presumption bills.

Policy Matters Brief - 2024 - August 22

Policy updates in CA, DE, FL, ID, and TX; readoption of the NCOIL Model Workers’ Comp Drug Formulary Act.

Policy Matters Brief - 2024 - May 22

Policy updates in AK, CO, ID, MT, OK, and VA; NCOIL updates to model law on drug pricing transparency.

Policy Matters Alert - 2024 - May 16

An AP report that the DEA has agreed to move forward with a process to reclassify marijuana under federal law.

Policy Matters Brief - 2024 - January 17

New fee schedules in AK, IL, MA, ME, NE, OH, OR, PA, RI, UT, WA; policy activity in CA, NY, NM, PA, TN, and VA.

Policy Matters Alert - 2024 - June 20

California moves forward with modifications to its proposed workers’ comp pharmacy fee schedule.

Policy Matters Brief - 2024 - March 20

Policy updates in AL, CA, FL, KY, MD, MI, MT, OK, OR, and TX; updates on pending PTSD coverage bills.

Policy Matters Alert - 2024 - March 4

California integrates workers’ comp into the state’s Medicaid pharmacy reimbursement structure.

Policy Matters Alert - 2025 - July 1

New York WCB adopts changes to pharmacy direction of care regulations to take effect July 11, 2025.

Policy Matters Alert - 2025 - February 24

California DWC adopts final rules for its workers’ comp fee schedule and proposes policy changes to UR rules.

Policy Matters Alert - 2025 - February 4

New York WCB announces providers must contract with an electronic trading partner to submit CMS-1500 forms.

Policy Matters Brief – December 19, 2025

Recent state policy updates in AZ, CA, CO, IL, OR, PA, and WA

Policy Matters Brief – January 14, 2026

Recent state policy updates in AZ, CT, CA, ME, MA, NY, OR, TN, and TX

Podcasts

Optum policy experts provide updates on policy changes in CA and CO, PTSD presumptions, and NY eBilling.