Fabiola Díaz Vera

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Fabiola Díaz Vera counsels healthcare organizations on a wide range of federal and state healthcare regulatory issues. She is particularly experienced in matters impacting healthcare insurance companies, including issues related to the Centers for Medicare and Medicaid Services (CMS) requirements for Medicare and Medicaid programs, the Affordable Care Act, fraud and abuse laws and regulations, and the Health Insurance Portability and Accountability Act (HIPAA). She collaborates closely with her clients on implementing operational changes related to recent federal laws including the No Surprises Act (NSA) and the Transparency in Coverage Rule. Read Fabiola Díaz Vera's full bio.

CMS Proposes to Prohibit Overrides in Medicare Advantage

By , , and on Jan 16, 2024
Posted In Employee Benefits, Health and Welfare Plans

On November 6, 2023, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule for the Medicare Advantage and Part D programs. Among other proposals, CMS proposed significant changes to longstanding rules on permissible payment structures for agents and brokers. Specifically, CMS proposes to prohibit “overrides” or administrative fees paid to agents and...

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CMS Announces New GUIDE Model to Support People Living with Dementia and Their Caregivers

By , and on Oct 31, 2023
Posted In Employee Benefits, Health and Welfare Plans

To support people living with dementia and their unpaid caregivers, the US Centers for Medicare & Medicaid Services recently announced the Guiding an Improved Dementia Experience (GUIDE) Model, a new, voluntary and nationwide test model designed specifically for these two rapidly growing demographic groups. The model will offer care coordination and care management for individuals...

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Medicare Advantage Plan Requirements Post-PHE: Ensuring a Smooth Transition

By and on Jun 6, 2023
Posted In Employee Benefits, Health and Welfare Plans

Medicare Advantage (MA) plans are facing both regulatory and business risks following the conclusion of the COVID-19 Public Health Emergency (PHE). What are the major MA flexibilities and requirements related to the pandemic, and have they ended along with the PHE? Read more here.

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