Health Law Highlights

Fifth Circuit Grants Motion Relating to New CMA Compensation Rule

Summary of article from Troutman Amin, LLP, by John H. Henson:

On July 3, 2024, the US District Court of Northern Texas issued a Memorandum Opinion and Order in the combined cases challenging new CMS rules regarding compensation for Medicare Advantage and Part D plans. The court found the compensation changes to be arbitrary and capricious, granting a partial stay on these rules but allowing the consent requirement for sharing beneficiary data to proceed. The decision highlights the court’s scrutiny of the CMS rulemaking process and indicates a substantial likelihood of the plaintiffs’ success on the merits. However, the consent requirement remains in effect, necessitating prior express written consent for data sharing between third-party marketing organizations. This ruling does not impact the FCC’s 1:1 consent requirement, which remains distinct and unaffected.