Brian Stimson

Apr 24, 2024 | jdsupra.com | Brian Stimson

On April 4, 2024, the Centers for Medicare & Medicaid Services (“CMS”) published its Final Rule1 amending the existing Medicare Advantage (“MA”) agent broker compensation regulations. The Final Rule has significant implications for the compensation relationships between MA Organizations (“MAOs”) and independent agents and brokers.

Jun 6, 2023 | employeebenefitsblog.com | Brian Stimson |Fabiola Díaz Vera

Medicare Advantage Plan Requirements Post-PHE: Ensuring a Smooth Transition Medicare Advantage (MA) plans are facing both regulatory and business risks following the conclusion of the COVID-19 Public Health Emergency (PHE). What are the major MA flexibilities and requirements related to the pandemic, and have they ended along with the PHE? Read more here.

May 15, 2023 | natlawreview.com | Brian Stimson

The end of the COVID-19 Public Health Emergency (PHE) on May 11, 2023, presents both regulatory and business risks for Medicare Advantage (MA) plans as some (but not all) emergency declarations and regulatory flexibilities also come to an end. This article summarizes the major MA requirements and flexibilities related to the COVID-19 pandemic and addresses whether they will end along with the PHE.

May 10, 2023 | jdsupra.com | Brian Stimson |Fabiola Díaz Vera

Flexibility Disposition COVID-19-Related Flexibilities COVID-19 Vaccines COVID-19 vaccinations are currently covered under Medicare Part B and Part D without cost sharing. MA plans must pay for the vaccine and its administration for beneficiaries enrolled in their plans.

May 1, 2023 | jdsupra.com | Emily Curran |Brian Stimson

On April 27, 2023, The Departments of Health and Human Services (HHS), Labor, and the Treasury (the Departments) released a status update on the Federal Independent Dispute Resolution (IDR) Process, which covers the period from April 15, 2022 through March 31, 2023, as well as the initial report on the fourth quarter of 2022. Below are some of the key statistics shared. Status Update Between April 15, 2022 and March 31, 2023, 334,828 disputes were initiated through the Federal IDR portal.