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.
viewpoints
Post-Election 2020 - Health Care Preview
November 23, 2020 | Blog | By Alexander Hecht, Anthony DeMaio, Tara E. Dwyer
With the presidential transition underway, we now look forward to what the Biden administration will seek to accomplish, particularly in the realm of health care policy.
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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
February 25, 2020 | Blog | By Tara E. Dwyer, Lauren Moldawer
As a continuation of our series on the Contract Year 2021 and 2022 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, Medicaid Program (the “Proposed Rule”) released by the Centers for Medicare & Medicaid Services (“CMS”) earlier this month, this blog focuses on CMS’s codification of its recent guidance on supplemental benefits, including guidance on Special Supplemental Benefits for the Chronically Ill (“SSBCI”). It also discusses CMS’s proposed changes to the medical loss ratio (“MLR”) to account for changes in supplemental benefits.
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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
February 13, 2020 | Blog | By Tara E. Dwyer, Lauren Moldawer
In CMS’s recently released proposed rule (the Medicare and Medicaid Programs: Contract Year 2021 and 2022 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, Medicaid Program, Medicare Cost Plan Program and Programs of All-Inclusive Care for the Elderly) (the “Proposed Rule”) and supplemental HPMS memos, CMS is proposing several significant changes to its star rating system and to its methodology for reviewing plan past performance. This blog post highlights the key details of the proposed changes to the star rating system and past performance methodology and their potential impact on Medicare Advantage and Part D plans.
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CMS Proposes Significant Changes to Medicare Advantage and Part D for 2021 and Beyond
February 7, 2020 | Blog | By Tara E. Dwyer
This week, the U.S. Department for Health and Human Services (HHS) Centers for Medicare and Medicaid Services (CMS) released a proposed rule (the Medicare and Medicaid Programs: Contract Year 2021 and 2022 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, Medicaid Program, Medicare Cost Plan Program and Programs of All-Inclusive Care for the Elderly), the 2021 Medicare Advantage and Part D Advance Notice of Methodological Changes for Medicare Advantage Capitation Rates and Part C and Part D Payment Policies (Part II), and multiple Health Plan Management System (HPMS) memos and notices covering topics including Medicare Advantage (MA) benefits, Medicare Part D bidding, and suspension of its Past Performance Review Methodology.
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Health Care: A Clearer Vision in 2020? Don’t Bet On It
January 15, 2020 | Blog | By Tara E. Dwyer
As we noted in our previous blog post, there are several legislative priorities in the health care space that could see action this year. There are also a variety of activities beginning this year that could set the stage for later action. Here’s what we’re tracking for a 2020 health care legislative package.
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Administration Finally Releases Proposed Drug Importation Policies for Stakeholder and Public Comments
December 27, 2019 | Blog | By Joanne Hawana , Tara E. Dwyer
At the end of July 2019, the U.S. Department of Health and Human Services (HHS) and the Food and Drug Administration (FDA) jointly published the Safe Importation Action Plan, which outlined the Trump Administration’s two-part plan to allow foreign prescription drugs to be imported into the United States in an effort to reduce drug prices. We wrote about the release of the Safe Importation Action Plan here, and the detailed proposals made public by the Administration on December 18, 2019, follow the framework that the agencies sketched out earlier this year. Specifically, HHS and FDA have proposed two different pathways: one that is being implemented via notice-and-comment rulemaking, and one that is being implemented via an FDA guidance document. HHS Secretary Alex Azar touted the two pathways together in a same-day FDA press release as “historic actions…[that] represent the bold nature of President Trump’s agenda for lowering drug costs.”
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CMS Finalizes Rule Requiring Disclosure of Drug Prices in TV Ads
May 9, 2019 | Blog | By Tara E. Dwyer
Yesterday, May 8, 2019, the Centers for Medicaid & Medicaid Services (“CMS”) released its final rule requiring drug manufacturers to disclose a drug’s wholesale acquisition cost (“WAC”) in direct-to-consumer television advertisements. The rule, which will become final 60 days after the official publication of the rule (which will be tomorrow, May 10, 2019) was proposal last fall. CMS is largely adopting the rule as published last fall with minor technical changes for clarification
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HHS Proposes to Remove Drug Rebate Protections
February 1, 2019 | Blog | By Theresa Carnegie, Tara E. Dwyer
On January 31, 2019, the U.S. Department of Health & Human Services (HHS) issued a proposed rule that would amend the discount safe harbor under the Anti-Kickback Statute (AKS) to eliminate protection for certain drug discounts paid by manufacturers to plan sponsors or their pharmacy benefit managers (PBMs) under Medicare Part D, and Medicaid managed care organizations (MCOs). Additionally, the proposed rule would create two new safe harbors to protect: (i) certain point-of-sale discounts on prescription pharmaceutical products; and (ii) certain fixed fee service arrangements between manufacturers and PBMs.
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President Trump Delivers Much Anticipated Drug Pricing Speech
May 14, 2018 | Blog | By Theresa Carnegie, Tara E. Dwyer
On Friday, after weeks of delay, the President finally delivered his Drug Pricing Speech and released the HHS Blueprint detailing the Trump Administration's plan to lower drug prices and reduce out-of-pocket costs.
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CMS Releases 2019 MA and Part D Final Rules and Call Letter
April 4, 2018 | Blog | By Tara E. Dwyer
Earlier this week, CMS released both the Contract Year 2019 Final Rules for Medicare Advantage and Part D (Final Rules) and the 2019 Call Letter. CMS also released fact sheets for the Final Rule and the Call Letter.
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News & Press
Mintz Facilitates $3.7 Billion Deal For The Cigna Group
January 31, 2024
The Cigna Health Group signed a deal selling its Medicare businesses to Health Care Service Corporation (HCSC) for $3.7 billion. A Mintz team led by Tara Dwyer and Lauren Moldawer acted as regulatory counsel to The Cigna Group on the sale. In the deal, which is expected to close in the first quarter of 2025, HCSC will acquire Cigna’s Medicare lines including Medicare Advantage, Medicare supplement, and Medicare drug plans, as well as CareAllies, a unit that works with physician groups and other healthcare providers.
Lawsuits, Tax Fuel Doubt As Medicare Preps Drug Pricing Talks
August 25, 2023
Member Tara Dwyer spoke to Bloomberg Law and discussed potential roadblocks delaying Medicare's plans for negotiating lower drug prices.
Mintz is pleased to announce that 120 firm attorneys have been recognized as leaders by Best Lawyers® in the 2024 edition of The Best Lawyers in America©.
'Many Legal Challenges' Loom As HHS Inks $4.7B Audit Rule
January 30, 2023
Mintz Member Tara Dwyer was quoted in Law360 examining the release of a Health and Human Services rule which prompted backlash and predictions of litigation.
Mintz Member Tara Dwyer was quoted in a Bloomberg Government article on the passage of the bipartisan infrastructure package and reconciliation bill, which would be paid for in part by delaying a controversial rebate rule – a rule which pharmacy benefit managers and insurers are in stiff opposition to.
Supreme Court Holds that ERISA Does Not Preempt Arkansas PBM Law: The Impact on Employer Sponsored Health Plans
February 5, 2021
Mintz Member and Chair of the firm’s Employee Benefits & Executive Compensation Practice Alden J. Bianchi and Member Tara E. Dwyer co-authored an article published by Bloomberg Tax & Accounting’s Compensation Planning Journal examining the U.S. Supreme Court’s recent decision in Rutledge v. Pharmaceutical Care Management Association, holding that the Employee Retirement Income Security Act of 1974 (ERISA) does not preempt an Arkansas statute that regulates reimbursement levels paid by Pharmacy Benefit Managers (PBMs) to local pharmacies, and its impact on employer-sponsored group health plans.
Drug Intermediaries Threaten Lawsuits to Preserve Cut of Prices
November 23, 2020
In an article published by Bloomberg Law, Mintz Member Tara E. Dwyer was quoted on the Trump administration’s proposed final rule, which is currently under review by the Office of Management and Budget, that would end legal shields for drug rebates.
Mintz Practice Groups and Attorneys Garner Top Rankings in 2020 Edition of The Legal 500 United States
June 12, 2020
In the latest guide, Mintz garnered rankings as a top national firm in eight practice areas, and 32 firm attorneys were individually recognized.
Proposed changes to Medicare Advantage audits could put insurers on the hook for billions
October 29, 2018
This feature article discusses a potentially significant change proposed to Medicare Advantage audits by the Centers for Medicare & Medicaid Services (CMS). Health Law Member Tara Dwyer is among the industry sources quoted in the story providing commentary.
Mintz Promotes Six Attorneys to Member
May 23, 2018
Mintz is pleased to announce that eight attorneys have been named Washington, D.C. Super Lawyers for 2018 and three others have been named Washington, D.C. Rising Stars. The annual publication identifies lawyers who have attained a high degree of peer recognition and professional achievement.
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.
Eight Mintz attorneys have been named Washington, D.C. Super Lawyers for 2017 and four have been named Washington, D.C. Rising Stars. The list will be published in a special advertising supplement in The Washington Post Magazine and in a stand-alone magazine, Washington D.C. Super Lawyers Magazine.
Seven Mintz attorneys have been named Washington, D.C. Super Lawyers for 2015 and five have been named Washington, D.C. Rising Stars. The list will be published in a special advertising supplement in Washington Post Magazine and in a stand-alone Washington D.C. Super Lawyers Magazine.
Events & Speaking
Panelist
Oct
12
2022
Legal, Regulatory, and Compliance Summit on Medicare Advantage
American Conference Institute
Nashville, TN
Speaker
Speaker
May
8
2018
3rd Annual Mintz /ML Strategies Pharmacy & Pharmaceutical Industry Summit
Mintz and ML Strategies
Boston, MA
Speaker
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Recognition & Awards
Best Lawyers in America: Health Care (2024)
Included on the Washington DC Super Lawyers Rising Stars: Health Care list (2016 - 2021)
Recognized by The Legal 500 United States for Healthcare: Service Providers (2019-2020)
Order of the Coif
ABA-BNA Award for Excellence in the Study of Health Law
Recent Insights
CMS Publishes Final Rules Implementing Part C and Part D Program Changes
April 23, 2024| Blog|
