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 Releases Advance Notice and Call Letter for Medicare Advantage and Part D - (Posted On Tuesday, February 06, 2018)
- In Proposed Regulations CMS Requests Information on Changes to Part D Negotiated Prices - (Posted On Tuesday, January 16, 2018)
- Azar’s Nomination Hearing Highlights Medicare Negotiation of Part B Drug Prices - (Posted On Wednesday, January 10, 2018)
- Proposed Medicare Advantage and Part D Regulations for CY 2019 – CMS Takes Aim at Drug Prices - (Posted On Monday, November 27, 2017)
- CMS Releases CY 2019 Proposed Rule for Medicare Advantage and Part D - (Posted On Monday, November 20, 2017)
- CMS Completes Final Medicare Part D Reconciliation for 2016 - (Posted On Wednesday, October 11, 2017)
- CMS Releases the Final Medicare Part D DIR Reporting Requirements for 2016 - (Posted On Monday, June 26, 2017)
- CMS Releases the Proposed Part D DIR Reporting Requirements for 2016 - (Posted On Thursday, May 18, 2017)
- California Advances PBM Licensing and “Transparency” Law - (Posted On Tuesday, April 25, 2017)
- C-THRU’s Proposed Changes to Negotiated Prices – Demonstration of Part D Program’s Complexities and Misunderstandings - (Posted On Thursday, March 30, 2017)