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HTMLThe Contraception Coverage Controversy Continues...
Tara E. Swenson, Bridgette A. Wiley; Mintz, Levin, Cohn, Ferris, Glovsky and Popeo, P.C.;
Legal Alert/Article
November 5, 2014, previously published on October 31, 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...

 

HTMLCMS Continues to Struggle with How to Provide High Quality Care to Dual Eligibles
Tara E. Swenson; Mintz, Levin, Cohn, Ferris, Glovsky and Popeo, P.C.;
Legal Alert/Article
September 23, 2014, previously published on September 21, 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...

 

HTMLPrescription Drugs: Refocusing the False Claims Act Microscope on the Rest of the Transaction
Tara E. Swenson; Mintz, Levin, Cohn, Ferris, Glovsky and Popeo, P.C.;
Legal Alert/Article
August 28, 2014, previously published on August 25, 2014
Over the last decade, it has often felt as though the pharmaceutical industry has been the government’s and whistleblowers’ main, and at times only, target for False Claims Act (“FCA”) investigations. While manufacturers are likely not out from underneath the microscope, it...

 

HTMLNotice to Plans and PBMs: Pay for Contraceptive Services and Maybe We Will Pay You Back
Susan W. Berson, Tara E. Swenson, Bridgette A. Wiley; Mintz, Levin, Cohn, Ferris, Glovsky and Popeo, P.C.;
Legal Alert/Article
February 19, 2014, previously published on February 18, 2014
As has been widely covered in the news, regulations and guidance developed under the Affordable Care Act (“ACA”) require that non-grandfathered health plans make preventive care and screenings available to their members at no cost (i.e. no deductibles, coinsurance, or co-payments). The...

 

HTML2014 Final Call Letter: CMS Raises Medicare Advantage Rates but Foreshadows Other Significant Program Changes
Roy M. Albert, Theresa C. Carnegie, Tara E. Swenson; Mintz, Levin, Cohn, Ferris, Glovsky and Popeo, P.C.;
Legal Alert/Article
April 19, 2013, previously published on April 16, 2013
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 in Medicare Advantage (“MA”) and Medicare Part D arrangements,...

 

HTMLDOJ Touts Active Enforcement of the False Claims Act in FY 2012
Karen S. Lovitch, Tara E. Swenson; Mintz, Levin, Cohn, Ferris, Glovsky and Popeo, P.C.;
Legal Alert/Article
December 12, 2012, previously published on December 6, 2012
In a briefing earlier this week, Acting Associate Attorney General Tony West proudly reported that in FY 2012 the Department of Justice (DOJ) set a new single year record of nearly $5 billion in settlements and judgments under the False Claims Act (the “FCA”). This enormous sum exceeded...

 

HTMLFiscal Year 2013 Work Plan Highlights OIG’s Medicare Parts C and D Priorities
Roy M. Albert, Theresa C. Carnegie, Tara E. Swenson; Mintz, Levin, Cohn, Ferris, Glovsky and Popeo, P.C.;
Legal Alert/Article
October 15, 2012, previously published on October 9, 2012
Last week, the OIG published its FY 2013 Work Plan. The Work Plan summarizes new and ongoing reviews and activities that the OIG plans to pursue with respect to HHS programs and operations during FY 2013 and beyond.