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
- CMS Proposes Significant Changes to Medicare Advantage & Part D for 2021 and Beyond, Part 2: CMS Proposes to Codify Supplemental Benefit Rules and Update MLR - (Posted On Tuesday, February 25, 2020)
- CMS Proposes Significant Changes to Medicare Advantage & Part D for 2021 and Beyond, Part 1: Updates to the Star Rating System and Suspension of the Past Performance Methodology - (Posted On Thursday, February 13, 2020)
- CMS Proposes Significant Changes to Medicare Advantage and Part D for 2021 and Beyond - (Posted On Friday, February 07, 2020)
- Health Care: A Clearer Vision in 2020? Don’t Bet On It - (Posted On Wednesday, January 15, 2020)
- Administration Finally Releases Proposed Drug Importation Policies for Stakeholder and Public Comments - (Posted On Friday, December 27, 2019)
- CMS Finalizes Rule Requiring Disclosure of Drug Prices in TV Ads - (Posted On Thursday, May 09, 2019)
- HHS Proposes to Remove Drug Rebate Protections - (Posted On Friday, February 01, 2019)
- President Trump Delivers Much Anticipated Drug Pricing Speech - (Posted On Monday, May 14, 2018)
- CMS Releases 2019 MA and Part D Final Rules and Call Letter - (Posted On Wednesday, April 04, 2018)
- CMS’s Advance Notice and Call Letter: How Medicare Plans Can Report, Identify, and Address the Opioid Epidemic - (Posted On Thursday, March 01, 2018)