Skip to main content

Lauren M. Moldawer

Associate

[email protected]

+1.202.434.7486

Share:

Lauren's practice focuses on advising pharmacies, PBMs, managed care organizations and other payors on a variety of transactional, regulatory, and fraud and abuse matters.

Drawing from her experience working for the Federal Coordinated Health Care Office (the “Duals Office”) within the Centers for Medicare & Medicaid Services (CMS), she is able to provide practical advice to clients on regulatory and compliance issues relating to Medicare Advantage, Medicare Part D and Medicaid. She has advised clients on Medicare Advantage and Medicare Part D applications, audit appeals, contract negotiations, and payment issues.

Lauren also focuses much of her practice on counseling clients on various matters relating to federal and state regulatory issues, including compliance with the anti-kickback statute, corporate practice of medicine and fee-splitting prohibitions, telemedicine, and prescribing and licensing requirements. She has advised entities on compliance with the 340B Drug Pricing Program requirements. She also assists in representing clients in connection with mergers and acquisitions, provider contracts, network development programs, and general contracting.

Prior to her tenure with CMS, she was a research consultant with a health care consulting company in the DC area, working primarily with state Medicaid agencies and Medicaid managed care plans. During law school, Lauren was a member of the George Washington Journal of Energy & Environmental Law and competed in the Van Vleck Moot Court Competition.

Education

  • George Washington University (JD, with honors)
  • Georgetown University (BS, cum laude)

Recent Insights

News & Press

Viewpoints

The Future of the Medicare Part B Payment Demo under a Republican-held Congress

November 29, 2016 | Blog | By Theresa Carnegie, Lauren Moldawer

There has been much controversy over the Medicare Part B payment demonstration proposed by the Center for Medicare and Medicaid Innovation (CMMI) in March 2016.
Read more

Will Republicans Embrace CMMI’s Authority?

November 18, 2016 | Blog | By Lauren Moldawer

The Affordable Care Act (ACA) and the Medicare and CHIP Reauthorization Act (MACRA) provided the Centers for Medicare & Medicaid Services (CMS) and the newly created Center for Medicare and Medicaid Innovation (CMMI) tremendous authority.  With Republicans set to take control of both the White House and Congress, the future of that authority is very much in question.
Read more

2017 MA and Part D Audit Protocols and Data Requests are Open for Comment

November 14, 2016 | Blog | By Lauren Moldawer, Tara E. Dwyer

CMS issued its Audit Protocols and Data Requests for Medicare Advantage and Part D plans on November 4, 2016 (the “Protocols”). The Protocols have been updated based on the over 500 comments CMS received in response to the draft released in June.
Read more

CMS Delays Enforcement of Part D Prescriber Enrollment Requirements

November 8, 2016 | Blog | By Lauren Moldawer

Last week, CMS released a Fact Sheet announcing that it is further delaying enforcement of the Medicare Part D Prescriber Enrollment Requirements, with full enforcement to begin on January 1, 2019.
Read more

CMS releases Final Rule Overhauling Long-Term Care Facility Requirements

October 10, 2016 | Blog | By Lauren Moldawer, Cassandra Paolillo

The Centers for Medicare & Medicaid Services (CMS) recently released its final rule overhauling long-term care (LTC) facility participation requirements for Medicare and Medicaid (“Final Rule”).
Read more

2018 Notice of Benefits and Payment: Proposed Updates to the HHS Risk Adjustment Model

September 8, 2016 | Blog | By Lauren Moldawer, Tara E. Dwyer

Last week, the Centers for Medicare & Medicaid Services (“CMS”) released its 2018 Notice of Benefit and Payment setting out payment parameters for the Health Insurance Marketplace for upcoming years.
Read more
Last week, the OIG issued a favorable opinion to a hospice provider seeking to make supplemental payments to skilled nursing facilities. Under the proposed arrangement, the hospice provider would make a supplemental payment to the nursing facility for dual-eligible individuals electing the hospice benefit that would be in addition to and separate from what the managed care organization (“MCO”) pays the nursing facility.
Read more
Earlier this month, the Court of Appeals for the D.C. Circuit issued its decision in Central United Life Insurance Co., v. Burwell, striking down a Department of Health and Human Services (HHS) rule prohibiting the sale and marketing of “fixed indemnity” plans to consumers who did not otherwise have minimum essential coverage.
Read more

Delays in 340B Mega-Guidance and a Recap of the Latest 340B Updates

June 7, 2016 | Blog | By Lauren Moldawer, Ellyn Sternfield

Thus far, 2016 has been a relatively quiet year for the 340B program at the federal level. Neither Congress nor the Health Resource and Service Administration (HRSA) has shown an appetite to take on the issues plaguing the program.
Read more

Alternative Payment Models (APMs) Under MACRA Proposed Rule

May 6, 2016 | Blog | By Thomas Crane, Lauren Moldawer

Continuing our blog series on CMS’s massive proposed rule for the implementation of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), we dedicate this post to examining the Advance Payment Model (APM) provisions of the proposed rule.
Read more

News & Press

Press Release Thumbnail
Mintz is advising a consortium of investors led by TPG Capital and Welsh, Carson, Anderson & Stowe in their acquisition of Curo Health Services, one of the nation’s leading hospice providers. The definitive agreement was announced on April 23, 2018. The deal is valued at approximately $1.4 billion.
Press Release Thumbnail
Mintz is advising a consortium of investors led by TPG Capital and Welsh, Carson, Anderson & Stowe in their acquisition of Kindred Healthcare, Inc. The definitive agreement totals approximately $4.1 billion in cash including the assumption or repayment of net debt.
Lauren Moldawer, a Mintz Health Law Associate based in Washington, DC, authored this AHLA article providing a comprehensive look at the operations and particulars of Medicaid programs across the United States.