Jeremy Earl

Jeremy Earl

McDermott Will & Emery

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CMS Proposes to Prohibit Overrides in Medicare Advantage

On November 6, 2023, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule regarding Contract Year (CY) 2025 Policy and Technical Changes to the Medicare Advantage (MA) and Medicare Prescription Drug...more

11/10/2023  /  Centers for Medicare & Medicaid Services (CMS) , Health Care Providers , Managed Care Contracts , Medicare , Medicare Advantage , Medicare Advantage Organizations (MAOs) , Medicare Part D , Proposed Rules

ERISA Preemption Developments in Managed Care

For plans governed by the Employee Retirement Income Security Act of 1974, 29 U.S.C. §§ 1001-1461 (ERISA), the doctrine of federal ERISA preemption over state statutes, regulations or administrative schemes has been a central...more

4/13/2023  /  Employee Benefits , Employee Retirement Income Security Act (ERISA) , ERISA Litigation , Health and Welfare Plans , Managed Care Contracts , Pharmaceutical Industry , Pharmacies , Pharmacy Benefit Manager (PBM) , Preemption , Prescription Drugs , Reimbursements

McDermott Health 2023 Annual Report: Managed Care 2022 Year in Review

The managed care space saw a number of regulatory and legislative developments in 2022 that are shaping the sector as we move further into 2023. Against this backdrop, the healthcare sector itself has continued to transform...more

3/16/2023  /  Acquisitions , CMMI , Employee Retirement Income Security Act (ERISA) , Healthcare Reform , Joint Venture , Legislative Agendas , Managed Care Contracts , Medicare Advantage , Mergers , New Legislation , New Regulations , Regulatory Agenda

[Webinar] Managed Care Spotlight: Recapping 2020 and Looking Ahead to 2021 - January 26th, 12:30 pm - 2:00 pm EST

Over the past year, we saw significant developments in managed care regulation at the federal and state levels, and we anticipate the rapid pace of change to continue in 2021. In this webinar, attendees will hear an analysis...more

1/12/2021  /  Biden Administration , Drug Pricing , Health Care Providers , Health Insurance , Health Plan Sponsors , Managed Care Contracts , Medicare Advantage , Pharmaceutical Industry , Pharmacy Benefit Manager (PBM) , Physicians , Prescription Drugs , Price Transparency , Surprise Medical Bills , Webinars

CMS’s Final Medicaid Rule Creates a Medicaid MLR Framework but Leaves Room for State Variation

In Depth - The final Medicaid managed care rule issued by the Centers for Medicare & Medicaid Services (CMS) on April 25, 2016, (the Final Rule) establishes a new federal medical loss ratio (MLR) standard for Medicaid...more

5/12/2016  /  Centers for Medicare & Medicaid Services (CMS) , Children's Health Insurance Program (CHIP) , Managed Care Contracts , Medicaid , Medical Loss Ratio

Medicaid Managed Care Update: CMS Proposes a National Medicaid MLR Standard

States would have the option to create binding Medicaid MLR requirements modeled after existing commercial market MLR standards. This article is part of a series that takes an in-depth look at several proposals that...more

6/11/2015  /  Centers for Medicare & Medicaid Services (CMS) , Health Care Providers , Managed Care Contracts , Medicaid , Medical Loss Ratio
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