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New Medicare Advantage Regulations Add Provider and Beneficiary Protections Against Plan Utilization Management Policies

On April 5, 2023, the Centers for Medicare & Medicaid Services (CMS) issued a Final Rule (CMS-4201-F) regarding the Medicare Advantage (MA) and Part D programs. The Final Rule includes changes related to various aspects of...more

Launches Inquiry into Medicare Advantage Marketing Practices

On August 23, 2022, Senate Finance Committee Chair Ron Wyden (D-Ore.) announced he was launching an inquiry into potentially deceptive marketing tactics by organizations offering Medicare Advantage benefits and Part D...more

CMS Finalizes Changes to Organ Procurement Organization Conditions for Coverage

On November 20, 2020, CMS issued a final rule (the Final Rule) strengthening the Organ Procurement Organization (OPO) Conditions for Coverage. The new Conditions of Coverage will subject OPOs to greater scrutiny with the...more

CMS Delays Implementation of Radiation Oncology Payment Model for Six Months in Response to Industry Feedback

On October 21, 2020, CMS announced that it is pushing the implementation of its radiation oncology payment model (RO Model) back from January 1, 2021 to July 1, 2021 in response to industry concerns regarding the...more

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