Helaine I. Fingold, Member of the Firm in the Health Care & Life Sciences practice, in the firm’s Baltimore office, was quoted in AIS Health, in “Trump 2.0 Faces Lingering Legal Questions Regarding RADV Audits, Stars, Broker Pay,” by Lauren Flynn Kelly. (Read the full version – subscription required.)

Following is an excerpt:

As field marketing organizations and Medicare Advantage insurers filed multiple legal challenges to federal rulemaking, 2024 was a particularly litigious year for program stakeholders. Now, with the return of Donald Trump to the White House, the new administration must contend with critical questions about MA plan payments to agents and brokers, the calculation of Part C and Part D Star Ratings and the recoupment of overpayments to MA plans. Two leading managed care attorneys tell AIS Health, a division of MMIT, that the resolution to these questions may depend on the administration’s appetite to defend the rulemaking of the prior administration. …

In Texas, where the court is handling the FMO lawsuits together, one overarching question is whether the new administration “is even going to want to pursue this case,” remarks Helaine Fingold, member of the law firm Epstein Becker Green. The July ruling delayed two key provisions of the 2025 CMS rule until the issues can be fully briefed and the court issues a decision. “It’s a little bit of a strange posture because at this point the court hasn’t ruled on the case, [it’s] just granted this preliminary injunction, so it’s not clear procedurally how this will play out, even if the administration didn’t want to continue to defend on this.”

Although the new administration could pull back the regulation and issue a revised one, that would likely be a longer process than just proceeding with the court case and having the court render a decision, suggests Fingold. “If the administration came in and didn’t want to actively support those [provisions], they could certainly file something in agreement that those provisions are wrong .... And it does seem like those are areas the incoming administration is not going to want to push on or try and fight for.”

Services

Jump to Page

Privacy Preference Center

When you visit any website, it may store or retrieve information on your browser, mostly in the form of cookies. This information might be about you, your preferences or your device and is mostly used to make the site work as you expect it to. The information does not usually directly identify you, but it can give you a more personalized web experience. Because we respect your right to privacy, you can choose not to allow some types of cookies. Click on the different category headings to find out more and change our default settings. However, blocking some types of cookies may impact your experience of the site and the services we are able to offer.

Strictly Necessary Cookies

These cookies are necessary for the website to function and cannot be switched off in our systems. They are usually only set in response to actions made by you which amount to a request for services, such as setting your privacy preferences, logging in or filling in forms. You can set your browser to block or alert you about these cookies, but some parts of the site will not then work. These cookies do not store any personally identifiable information.

Performance Cookies

These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. They help us to know which pages are the most and least popular and see how visitors move around the site. All information these cookies collect is aggregated and therefore anonymous. If you do not allow these cookies we will not know when you have visited our site, and will not be able to monitor its performance.