Tara enjoys working with managed care organizations, pharmaceutical services providers such as PBMs, and integrated delivery systems, and companies that invest in them, on matters relating to compliance with federal health care program regulations, federal and state fraud, waste and abuse laws and plan benefits.
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. Tara often advises clients on matters relating to plan bids, medical loss ratio reporting, drug pricing in both Medicare Part B and Part D and direct and indirect remuneration (DIR) reporting. She regularly counsels clients regarding risk adjustment systems and practices needed to support them. Tara also actively engages with CMS on behalf of clients on many matters.
She also works closely with discount medical and pharmacy plan operators (DMPOs) on matters relating to compliance with state laws and provider contracting.
Tara uses her substantive day-to-day compliance experience to assist clients in litigation matters and transactions.
Tara has extensive experience preparing and negotiating complex services agreements for and between MAOs, providers, PBMs, pharmacies, wholesalers, manufacturers, and DMPOs.
More Legal and Business Bylines From Tara E. Dwyer
- Contract Year 2025 Policy and Technical Changes to the Medicare Advantage Program - (Posted On Thursday, June 06, 2024)
- Unpacking CMS’s 2025 DSNP Changes: Considerations for Medicare Advantage Organizations - (Posted On Thursday, May 02, 2024)
- CMS Publishes Final Rules Implementing Part C and Part D Program Changes - (Posted On Tuesday, April 23, 2024)
- PBM Policy and Legislative Update — Winter 2024 - (Posted On Tuesday, April 09, 2024)
- CMS Releases Part Two of Guidance for the Inflation Reduction Act’s Medicare Prescription Payment Plan - (Posted On Tuesday, February 27, 2024)
- CMS Releases Draft Part One Guidance on the Maximum Monthly Cap on Cost-Sharing Payments Program to Part D Plans - (Posted On Thursday, September 07, 2023)
- New York Establishes First Pharmacy Benefits Bureau in the Nation as Registration and Annual Reporting Deadlines for Pharmacy Benefit Managers Approach - (Posted On Wednesday, May 25, 2022)
- Health Law Diagnosed — Transactions Part 2: The Role of Health Regulatory Diligence and How to Prepare for a Sell-Side Transaction [PODCAST] - (Posted On Friday, March 25, 2022)
- Supreme Court Holds that ERISA Does Not Preempt Arkansas PBM Law: The Impact on Employer Sponsored Group Health Plans - (Posted On Thursday, December 31, 2020)
- Post-Election 2020 - Health Care Preview - (Posted On Monday, November 23, 2020)