- Health Law
- Fraud & Abuse, Compliance & Regulatory Counseling
- Medicare, Medicaid & Commercial Payor Coverage & Payment
- Mergers, Acquisitions & Other Transactions
- State & Federal Audits, Investigations & Litigation
- Health Care
|Contact Info||Telephone: 202.585.3504|
|University ||Villanova University, B.A., 2004|
|Law School||Seton Hall University, J.D., 2007|
|Admitted||2007, New Jersey and New York; District of Columbia|
Tara focuses on advising private and public health care services entities, including managed care organizations, pharmaceutical services providers such as PBMs, and integrated delivery systems, on mergers and acquisitions, joint ventures, and complex service arrangements. She works closely with Medicare Advantage Organizations (MAOs) and Medicare Part D Plan Sponsors, including Employer Group Waiver Plans (EGWPs), and first tier and downstream entities to address regulatory and compliance matters that arise as a result of participating in Medicare Parts C and D. She regularly counsels clients regarding risk adjustment systems and practices needed to support them. Tara has experience preparing and negotiating a variety of contracts needed to establish and support Medicare Advantage Plans, Part D Plans, and health plans intending to participate in state exchanges.
Tara has also advised multiple clients regarding issues related to participating in CMS demonstration projects. Most recently she has worked with clients on matters relating to the State Demonstrations to Integrate Care for Dual Eligible Individuals. Such projects have included advising clients on contracting and compliance issues and assisting clients to engage both CMS and the applicable state agencies to address potential demonstration barriers.
Other aspects of Tara's practice focus on state and federal regulatory laws unique to the health care industry, and the application of such laws to the structuring business arrangements. She regularly advises clients on such issues as federal and state anti-kickback and self-referral laws.
During law school, Tara was an associate editor for the Seton Hall Law Review, and a research assistant for Professor John V. Jacobi.
• Co-author, CMS Proposes Major Changes to Medicare Parts C and D, Health Law Advisory (01.21.2014)
• Co-author, Caution: Risk Adjustment Hurdles Facing Plans and Providers Under the Affordable Care Act, BNA's Health Insurance Report (07.17.2013)
• Co-author, 2014 Final Call Letter: CMS Raises Medicare Advantage Rates but Foreshadows Other Significant Program Changes, Health Law Advisory (04.16.2013)
• Co-author, Fiscal Year 2013 Work Plan Highlights OIG's Medicare Parts C and D Priorities, Health Law Advisory (10.09.2012)
• Co-author, Medicare in the 21st Century: Achieving Quality and Efficiency Through Payment and Service Delivery Reforms, BNA's Medicare Report (04.23.2010)
• Speaker, What Do the Proposed Changes to Medicare Parts C and D Mean for Your Business?, Mintz Levin, Webinar (01.29.2014)
Recognitions & Awards
•Order of the Coif
•ABA-BNA Award for Excellence in the Study of Health Law
•2007 Seton Hall University Outstanding Real Property Graduate
Documents by this lawyer on Martindale.com
CMS Issues Rewards and Incentive Guidance to MA Plans
Tara E. Swenson,Bridgette A. Wiley, February 19, 2015
On December 4, 2014, CMS issued additional guidance regarding rewards and incentives programs (“RI Programs”). This guidance elaborates on whether an RI Program can target members with specific diseases, whether rewards can be tied to health outcomes, how to value rewards and...
The Contraception Coverage Controversy Continues...
Tara E. Swenson,Bridgette A. Wiley, November 5, 2014
As we have been discussing, the Affordable Care Act (“ACA”) requires all health plans to cover preventive health services for women, including all Food and Drug Administration (“FDA”)-approved contraceptives, at no cost (i.e. no deductibles, coinsurance, or co-payments). The...
CMS Continues to Struggle with How to Provide High Quality Care to Dual Eligibles
Tara E. Dwyer, September 23, 2014
Last week CMS announced that it would not execute its option to terminate its 2015 contracts with Medicare Advantage Plans and Part D plans that had scored three stars or less for three consecutive years. At the same time, CMS announced that it was seeking information from insurers and others in...
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