Jeremy Earl on Medicare Part D

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

CMS Guidance and Waivers for MA and Part D Plans’ Response to COVID-19

Over the past week, the Centers for Medicare & Medicaid Services (CMS) has made a number of announcements related to Medicare coverage in connection with the Coronavirus (COVID-19) outbreak. Several of those announcements...more

3/22/2020 / Centers for Medicare & Medicaid Services (CMS) , Coronavirus/COVID-19 , Cost-Sharing , Medicare , Medicare Advantage , Medicare Part D , New Guidance , Public Health Emergency , State of Emergency , Waivers

CMS Seeks to Provide Flexibility and Facilitate Innovation in Medicare Advantage and Part D

The Centers for Medicare and Medicaid Services (CMS) recently released several significant Medicare Advantage (MA) and Part D guidance documents outlining new Center for Medicare and Medicaid Innovation (CMMI) programs and...more

2/8/2019 / Advance Notice , Bipartisan Budget Act , Call Letter , Centers for Medicare & Medicaid Services (CMS) , CMMI , GAO , Medicare Advantage , Medicare Part D , Opioid , Prescription Drugs , Risk Adjustment Formula , Social Security Act

Administration Offers Up New Proposals to Cut Drug Costs

On November 26, CMS released a notice of proposed rulemaking, “Modernizing Part D and Medicare Advantage to Lower Drug Prices and Reduce Out-of-Pocket Expenses,” which includes provisions that aim to reduce overall drug...more

12/3/2018 / Centers for Medicare & Medicaid Services (CMS) , Drug Pricing , Life Sciences , Medicaid , Medicare Advantage , Medicare Part B , Medicare Part D , Pharmaceutical Industry

Flurry of Medicare Advantage and Part D Changes Includes Significant Policy Shifts

Last week, CMS released new regulations and guidance for Medicare Advantage Organizations (MAOs) and Part D Sponsors. These documents—along with the Bipartisan Budget Act of 2018 that was passed in January—reflect significant...more

4/13/2018 / Centers for Medicare & Medicaid Services (CMS) , Medicare , Medicare Advantage Organizations (MAOs) , Medicare Part D

CMS Indicates Select Controversial Part D Proposals Will Not Be Finalized

Acknowledging concerns regarding some proposals in the January 2014 proposed rule for the Medicare Advantage and Part D Programs, the Centers for Medicare & Medicaid Services states it does “not plan to finalize” certain...more

3/17/2014 / Centers for Medicare & Medicaid Services (CMS) , Healthcare , Medicare , Medicare Part D

CMS Proposes Significant Changes to Medicare Part D Program’s Administration

The Centers for Medicare & Medicaid Services proposes significant changes to several key Medicare Part D Program components, such as the “any willing pharmacy” contracting requirement, that will affect all industry...more

1/24/2014 / Centers for Medicare & Medicaid Services (CMS) , Healthcare , Healthcare Reform , Medicaid , Medicare , Medicare Part D , Pharmacies

CMS Proposed Rule Reflects Increased Sophistication in Administration of MA/Part D Programs

Addressing issues ranging from participation in Part D Plan pharmacy networks to compliance training for so-called first-tier, downstream and related entities, the Proposed Rule covers numerous topics with varying degrees of...more

1/22/2014 / Centers for Medicare & Medicaid Services (CMS) , Healthcare , Medicare , Medicare Part D

CMS Releases 2014 Advance Notice and Proposed MA and Part D Program MLR Regulations

On February 15, 2013, the Centers for Medicare & Medicaid Services released for comment two key documents affecting the Medicare Advantage (MA) and Part D Programs: (1) the Advance Notice of Methodological Changes for...more

2/25/2013 / Centers for Medicare & Medicaid Services (CMS) , Fee-for-Service , Medicaid , Medical Loss Ratio , Medicare , Medicare Advantage , Medicare Part D , MLR Rebate

Jeremy Earl

McDermott Will & Emery

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