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HTMLCMS Issues Final Call Letter for 2015
Roy M. Albert, Susan W. Berson; Mintz, Levin, Cohn, Ferris, Glovsky and Popeo, P.C.;
Legal Alert/Article
April 11, 2014, previously published on April 9, 2014
Earlier this week, CMS announced in its Final Call Letter that Medicare Advantage rates would rise an average of 0.4 percent in 2015, instead of falling 1.9 percent as proposed in February. CMS’s shift in course may stem from the 1300 comments the agency received in response to...

 

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...

 

HTMLFinal Mental Health Parity Rules Released
Susan W. Berson, Bridgette Wiley; Mintz, Levin, Cohn, Ferris, Glovsky and Popeo, P.C.;
Legal Alert/Article
November 14, 2013, previously published on November 11, 2013
The Departments of Health and Human Services, Labor, and the Treasury jointly issued a long-awaited final rule that implements the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA). The final rule decreases the differences between mental health...

 

HTMLOIG and MA Plan Sponsor Settle Allegations of Altering Records Submitted During Audit
Roy M. Albert, Susan W. Berson; Mintz, Levin, Cohn, Ferris, Glovsky and Popeo, P.C.;
Legal Alert/Article
August 19, 2013, previously published on August 15, 2013
Bravo Health Pennsylvania, Inc. (Bravo), a Medicare Advantage Plan Sponsor and subsidiary of Cigna Corporation, agreed to pay $225,000 to the Government for allegedly misrepresenting or falsifying information furnished to the OIG during an audit. Bravo and the OIG entered into the settlement on...

 

HTMLCMS Issues Final MLR Rule for Medicare Advantage and Part D Programs
Roy M. Albert, Susan W. Berson; Mintz, Levin, Cohn, Ferris, Glovsky and Popeo, P.C.;
Legal Alert/Article
May 24, 2013, previously published on May 21, 2013
Last week, CMS published a final rule implementing the ACA’s medical loss ratio (“MLR”) requirements that will apply to the Medicare Advantage (Part C) and prescription drug (Part D) programs beginning in contract year 2014. CMS already issued a final MLR rule applicable to...