Sean Higdon

Sean Higdon

McDermott Will & Emery

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Latest Publications


Medicaid Managed Care Update: A Middle Ground for Network Adequacy Standards

This article is part of a series that takes an in-depth look at several proposals that would affect managed care organizations, health care providers and other industry stakeholders participating in, and contracting with...more

7/23/2015 - Accessibility Rules CHIP CMS Comment Period Healthcare Healthcare Providers Hospitals Long-Term Care Managed Care Contracts Medicaid OIG Pharmacies Physicians Proposed Regulation State Medicaid Programs

2015 Notice of Benefit and Payment Parameters

The Centers for Medicare & Medicaid Services (CMS or the agency) kicked off a flurry of springtime regulatory activity for health insurance issuers with publication of the final Notice of Benefit and Payment Parameters for...more

3/24/2014 - Affordable Care Act CMS Employee Benefits Health Insurance Exchanges Healthcare Healthcare Reform

Proposed Overpayment Reporting Requirements for MA and Part D Programs May Increase False Claims Act Liability

The Centers for Medicare & Medicaid Services continues to take an expansive view of the overpayment refund requirement, which in turn can give rise to False Claims Act liability for Medicare Advantage Organizations and Part D...more

1/24/2014 - CMS False Claims Act Medicaid Medicare Medicare Part D Overpayment Reporting Requirements

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