Adam Falk Cautions Medicare Health Plans on New Compliance Risks

This article explains why federal agencies use sub-regulatory guidance, describes how the Centers for Medicare and Medicaid Services (CMS), in particular, has used sub-regulatory guidance in the Medicare Advantage program, identifies key considerations in determining whether CMS sub-regulatory guidance creates legally enforceable obligations upon Medicare health plans, and offers several reasons why efforts to comply with sub-regulatory guidance might have a useful impact on an organization.