Whitney Phelps

Whitney Phelps

Proskauer Rose LLP

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Medicare Advantage 2024 Rate Announcement – Further Impacts to Risk Adjustment

On Friday, March 31, 2023, the Centers for Medicare & Medicaid Services (CMS) released the Calendar Year (CY) 2024 Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies (Rate Announcement). This Rate...more

4/4/2023  /  Centers for Medicare & Medicaid Services (CMS) , False Claims Act (FCA) , Fee-for-Service , Medicare , Medicare Advantage , Medicare Advantage Organizations (MAOs) , Medicare Part C , Medicare Part D , MedPAC , Social Security Act

The Supreme Court Denies Petition Challenging CMS’s Overpayment Rule

This past week, the Supreme Court of the United States (Supreme Court) denied UnitedHealthcare Insurance Company’s (UnitedHealthcare) petition for a writ of certiorari (Petition) challenging, in part, the Centers for Medicare...more

6/27/2022  /  Centers for Medicare & Medicaid Services (CMS) , Denial of Certiorari , False Claims Act (FCA) , Fee-for-Service , Health Insurance , Healthcare , Medicare Advantage , Overpayment Recovery Time Limits , SCOTUS

CMS Responds to Industry Stakeholder Feedback, Redesigns and Renames the GPDC Model for DCEs as the ACO REACH Model

On February 24, 2022, the Department of Health and Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), announced the Accountable Care Organization Realizing Equity, Access, and Community Health (ACO REACH)...more

3/9/2022  /  ACOs , Centers for Medicare & Medicaid Services (CMS) , Department of Health and Human Services (HHS) , Fee-for-Service , Healthcare , Healthcare Reform , Medicare , REACH , Value-Based Care
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