News & Analysis as of

Beneficiaries Prescription Drugs

Mintz - Health Care Viewpoints

CMS Publishes Final Rules Implementing Part C and Part D Program Changes

On April 23, 2024, the Centers for Medicare & Medicaid Services (CMS) published final rules setting forth Changes to the Medicare Advantage and the Medicare Prescription Drug Benefit Program for Contract Year 2024--Remaining...more

McAfee & Taft

Employee benefit rules: The gifts that keep on giving

McAfee & Taft on

As employers look back at 2023 and ahead to 2024, there are so many compliance-related items to consider relating to their employee benefit plans.  The rules employers are supposed to be complying with keep growing and...more

King & Spalding

CMS Publishes Frequently Asked Questions Regarding Medicare Advantage Marketing Policies

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CMS released an FAQ document regarding marketing and communications requirements for the Part C and Part D programs. The FAQs seek to clarify rules issued by CMS in the 2023 Medicare Advantage and Prescription Drug Benefit...more

Foley Hoag LLP - Medicaid and the Law

Enforcing Medicaid’s Guarantee of Access to Prescription Drugs

Over the years, we’ve written about the difficulties in challenging the entitlement to Medicaid in the federal courts. In light of a series of Supreme Court decisions dating back to 1990, the pathway for an aggrieved Medicaid...more

Arnall Golden Gregory LLP

October 1, 2020 Hospice Changes: Hospices Must Provide Beneficiaries Addenda Outlining Conditions, Services, and Drugs Not Covered...

In an effort to increase coverage transparency, for hospice elections beginning on or after October 1, 2020, the beneficiary, beneficiary’s representative, non-hospice providers, or Medicare contractors may request a written...more

Mintz - Health Care Viewpoints

CMS Seeks to Lower Costs and Increase Competition with Step Therapy for Medicare Part B Drugs

As a continuation of the recent drug pricing developments tied the Trump Administration’s American Patients First Blueprint, beginning January 1, 2019, Medicare Advantage plans will be able to apply step therapy for...more

Proskauer Rose LLP

ERISA Newsletter - Second Quarter 2018

Proskauer Rose LLP on

As we head into the thick of summer, all eyes are on President Trump's nomination to the U.S. Supreme Court to replace retiring Justice Anthony Kennedy and the impact the new Justice will have on shaping the law for...more

Buchalter

OIG Finalizes New and Expanded Anti-Kickback Safe Harbors, Issues Guidance Regarding Nominal Gifts

Buchalter on

In an uncertain health care environment following the presidential election, the Department of Health & Human Services Office of Inspector General (“OIG”) finalized a new rule expanding existing safe harbors to the federal...more

King & Spalding

OIG Issues Advisory Opinion Regarding Pharmaceutical Manufacturers’ Program to Provide Free Limited Drugs to Beneficiaries When...

King & Spalding on

On August 12, 2015, the Department of Health and Human Services Office of Inspector General (OIG) posted Advisory Opinion No. 15-11, finding that a program to supply a limited amount of free cancer drugs to federal health...more

King & Spalding

GAO Issues Report on Medicaid Prescription Drug Fraud Controls

King & Spalding on

In July 2015, the U.S. Government Accountability Office (GAO) issued a report concerning Medicaid pharmacy-related program integrity efforts. GAO explained that this review was pursued due to the substantial amount of funds...more

Arnall Golden Gregory LLP

GAO Recommends Congress Reduce Incentives for Prescribing 340B Drugs

The United States Government Accountability Office (GAO) recently released a report entitled “Medicare Part B Drugs: Action Needed to Reduce Financial Incentives to Prescribe 340B Drugs at Participating Hospitals” (“the...more

Mintz - Health Care Viewpoints

2014 Final Call Letter: CMS Raises Medicare Advantage Rates but Foreshadows Other Significant Program Changes

After receiving many comments on its Draft Call Letter, CMS published its Contract Year 2014 Final Call Letter on April 1, 2013. The Final Call Letter addresses a wide variety of issues that will affect all parties involved...more

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