David Kopans

Dec 12, 2024 | jdsupra.com | David Kopans

On December 10, 2024, the Centers for Medicare and Medicaid Services (CMS) released a Proposed Rule for revisions to the regulations governing the Medicare Advantage (MA) program, Medicare Prescription Benefit (Part D), Medicaid, Medicare cost plans, and the Programs of All-Inclusive Care for the Elderly (PACE). CMS is proposing a broad range of revisions, with the publication of the Proposed Rule consisting of 240 pages. This alert highlights a sampling of the proposals.

Dec 4, 2024 | jdsupra.com | Kathleen Birrane |David Kopans |Peter Rice

On November 27, 2024, the New York State Department of Financial Services (DFS) will be releasing new regulations governing pharmacy benefit managers (PBMs). Beginning with legislation in 2021, New York has been active in developing a comprehensive statutory and regulatory framework governing PBMs. These new regulations build on that framework and establish significant compliance and contracting obligations for any PBM operating under the jurisdiction of DFS.

Oct 15, 2024 | law360.com | Danny Tobey |Kathleen Birrane |David Kopans

By Danny Tobey, Kathleen Birrane and David Kopans (October 15, 2024, 6:59 PM EDT) -- On Sept. 28, California enacted S.B. 1120, which regulates the use of artificial intelligence, algorithms and other software tools in the performance of utilization review and management functions by healthcare service plans or disability insurers and their contractors.... Law360 is on it, so you are, too.

Oct 4, 2024 | jdsupra.com | Kathleen Birrane |David Kopans |Clayton Cosby

On September 28, 2024, California enacted SB 1120, which regulates the use of artificial intelligence (AI), an algorithm, or “other software tool” in utilization review and utilization management (UR/UM) functions by healthcare service plans (HCSPs) or disability insurers (and their contractors).

Oct 3, 2024 | lexology.com | Daniel Tobey |David Kopans |Kathleen Birrane |Clay Cosby

On September 28, 2024, California enacted SB 1120, which regulates the use of artificial intelligence (AI), an algorithm, or “other software tool” in utilization review and utilization management (UR/UM) functions by healthcare service plans (HCSPs) or disability insurers (and their contractors).