C&M Health Law

C&M Health Law

Analysis, commentary, and the latest developments in health care law and policy

Tag Archives: Medicare Advantage

CMS Signals Future Patient Access Requirements for Medicare Advantage Plans

Posted in Health IT, Medicare
Building on momentum from Administrator Seema Verma’s announcement of the MyHealtheData initiative at HIMSS 2018, CMS has published more clues as to future action to liberate health information for patients. In the CY 2019 call letter to Medicare Advantage organizations and Part D programs, CMS describes the Blue Button 2.0 project and its use of… Continue Reading

Sequestration Extended to 2025 in Federal Budget Deal

Posted in Administrative Law, Litigation, Medicare
On November 2, President Obama signed the Bipartisan Budget Act of 2015. As an offset for near-term increases in federal spending, the new law extends by one year – to 2025 – two-percent sequestration reductions in federal spending for mandatory federal programs including Medicare.  The end result is that Medicare Advantage Organizations (MAOs) can expect… Continue Reading

Crowell’s Long-Term Care Policy Update—Recapping the Discussions and Debates

Posted in Health Care Reform & ACA, Medicaid, Medicare
On April 17th, Crowell & Moring’s Government Affairs and Health Care Groups hosted speakers from Capitol Hill, federal agencies, and national trade groups during a thought-provoking half-day Long Term Care Policy Update forum (“LTC Forum”).  The LTC Forum was spearheaded by James Flood and Scott Douglas, who recently joined the firm from the Government Affairs… Continue Reading

HOOPS 2014: Legal Flashpoints and Developments

Posted in Antitrust, Fraud, Waste & Abuse, HIPAA & Privacy, Litigation, Medicare, Mental Health Parity
This year Crowell & Moring’s Healthcare Ounce of Prevention Seminar, (HOOPS), will focus on important legal and regulatory developments and their impact on the healthcare industry. Join us on October 27th and October 28th in Washington, DC as our healthcare attorneys and outside speakers share their perspectives on the latest developments in areas of interest… Continue Reading

OIG Issues Self-Disclosure Guidance for Contractors

Posted in Fraud, Waste & Abuse, Medicare
The Office of Inspector General, Department of Health and Human Services, has recently issued guidance for those of its contractors seeking to self-disclose reportable conduct under the Federal Acquisition Regulations (“FAR”). Under federal regulations governing relationships between the federal government and its contractors, any contractors with credible evidence of a potential violation of the False… Continue Reading

Hot off the Presses! Latest Edition of Managed Care Lawsuit Watch

Posted in Federal Employees Health Benefits Program (FEHB), Litigation, Managed Care Lawsuit Watch, Medicare
Managed Care Lawsuit Watch is Crowell & Moring’s summary of key litigation affecting managed care. The latest issue covers a broad range of lawsuits, including: Medicare’s preemption of state common law negligence claims; arbitration clauses in provider agreements; the right of a Medicare Advantage plan to assert a lien on a deceased beneficiary’s negligence settlement;… Continue Reading

Marriage Equality and Medicare: Obama Administration Announces Same-Sex Couples Equally Entitled to Medicare Benefits

Posted in Medicare
Continuing the national trend toward marriage equality, the Obama Administration announced that it will allow same-sex married couples to qualify for Medicare benefits just like opposite-sex married couples. Following last June’s landmark Supreme Court decision in U.S. v. Windsor, which held that Section 3 of the Defense of Marriage Act (DOMA) is an unconstitutional deprivation… Continue Reading

Mere Days After Comment Period Closed, CMS Abandons Four Aspects of CY 2015 Medicare Advantage and Part D Rule

Posted in Medicare
In a March 10, 2014 letter to Congress, CMS Administrator Marilyn Tavenner indicated that—based on concerns from Congress and the public—CMS shall not finalize the Proposed Rules’ proposals that would have: Removed the protected class definition for immunosuppressant drugs used in transplant patients, antidepressants, and antipsychotic medicines used to treat schizophrenia and certain related disorders… Continue Reading

Medicare Advantage and Part D MLR Final Rule Issued

Posted in Health Care Reform & ACA, Medicare
On May 20, 2013, the Centers for Medicare and Medicaid Services (CMS) released the final regulations on the Affordable Care Act’s (ACA) medical loss ratio (MLR) requirements for Medicare Advantage and Medicare Prescription Drug Benefit Programs (PDP). The final MLR rule is largely identical to the proposed rule and generally tracks the requirements of the commercial… Continue Reading