Ankur J. Goel
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Ankur J. Goel represents health industry clients in significant compliance, False Claims Act, litigation and regulatory matters. Ankur works with a range of health industry clients. He represents health plans on issues arising under Medicare Advantage, Part D, and health insurance exchanges, as well as health care providers on a variety of complex enforcement, compliance, regulatory and litigation matters. Read Ankur Goel's full bio.
CMS Issues Broad-Ranging Medicare Advantage and Part D Proposed Rule
By Ankur J. Goel, Emily Curran, Grayson I. Dimick and Casey Li on Feb 21, 2023
Posted In Employee Benefits, Health and Welfare Plans
The Centers for Medicare & Medicaid Services (CMS) recently issued a proposed rule regarding Contract Year 2024 Policy and Technical Changes to the Medicare Advantage (MA) and Medicare Prescription Drug Benefit Programs. This proposed rule includes a range of proposals addressing popular topics, including marketing and prior authorization, along with other significant changes to utilization...
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Proposed Rule on MA and Part D Would Reinstate Historical Requirements, Make Changes to Prescription Drug Payment Structure
By Kate McDonald, Mara McDermott, Ankur J. Goel, Emily Curran, Taylor Hood and Haile Dagne on Mar 3, 2022
Posted In Employee Benefits, Health and Welfare Plans
On January 6, 2022, the Centers for Medicare and Medicaid Services (CMS) released a proposed rule regarding Contract Year 2023 Policy and Technical Changes to the Medicare Advantage and Medicare Prescription Drug Benefit Programs, marking the Biden administration’s first proposed rule on these topics. The proposed rule includes proposed changes to the manner in which...
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Podcast | After the Curve: Focus on Health Insurance and Coverage
By Ankur J. Goel and Kate McDonald on Dec 15, 2020
Posted In Employee Benefits, Health and Welfare Plans
COVID-19 has catalyzed significant changes in the patterns of healthcare delivery, with the potential for long lasting effects on payors as a result. In this episode of the After the Curve podcast, we discuss how the COVID-19 pandemic may shift the healthcare coverage and payment landscape as well as how it may boost integration among...
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Fifth Circuit Issues ACA Ruling, But Severability Question Remains
By Ankur J. Goel, Eric Zimmerman, Michael B. Kimberly and Matthew A. Waring on Dec 26, 2019
Posted In Benefit Controversies, Employee Benefits, Health and Welfare Plans
A decision in Texas v. United States was issued by a divided three-judge panel of the US Court of Appeals for the Fifth Circuit on December 18, 2019. This case presented once again the question whether the Affordable Care Act (ACA) is constitutional and sustainable, and questions of severability remain for the near future. Access...
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CMS Releases Broad-Ranging Medicare Advantage and Part D Proposed Rule
By Ankur J. Goel, Kate McDonald and Lauren E. Parisi on Dec 26, 2017
Posted In Employee Benefits, Health and Welfare Plans
CMS released a broad-ranging proposed rule for the Medicare Advantage and Part D Programs on Thursday, November 16, 2017. The proposed rule addresses a broad and diverse range of MA and Part D regulatory requirements, affecting not only Medicare Advantage Organizations and Part D Sponsors, but also health care providers, pharmacies, pharmaceutical manufacturers and others....
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CMS Aims to Stabilize Exchanges but Does Not Address Issuers’ Biggest Questions
By Ankur J. Goel, Jeremy Earl and Seth Schneer on May 16, 2017
Posted In Health and Welfare Plans
CMS recently released a final rule with the goal of stabilizing Exchange markets for 2018. The agency also issued several significant guidance documents where CMS extended the deadlines for 2018 rate and Exchange qualified health plan application submissions, adopted a good faith compliance standard for 2018 and delegated additional plan certification responsibilities to states. While...
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Trump Administration Takes First Steps to Support Exchanges, but Key Questions Remain
By Ankur J. Goel, Jeremy Earl and Seth Schneer on Mar 2, 2017
Posted In Health and Welfare Plans
In an effort to stabilize the Exchanges and encourage issuer participation, the Centers for Medicare & Medicaid Services (CMS) recently extended the federal Exchange application and rate filing deadlines and published a proposed rule affecting the individual health insurance market and the Exchanges. While issuers will likely see these actions as encouraging signs of the...
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How Congress, President-Elect Trump Might Proceed on Promise to Repeal, Replace ACA
By Ankur J. Goel, Jeremy Earl and Kate McDonald on Nov 14, 2016
Posted In Health and Welfare Plans
President-elect Donald Trump has vowed to repeal and replace the Affordable Care Act (ACA). This campaign promise, which echoes a familiar refrain from Republicans since ACA’s passage, is more complex than it may seem. There are pathways to quickly “repealing” key elements of ACA such as the individual mandate and its subsidies, but this could...
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Federal Court Strikes Down ACA Cost Sharing Reduction Payments
By Ankur J. Goel on May 26, 2016
Posted In Employee Benefits, Health and Welfare Plans
Last week, a federal district court ruled that US Congress did not appropriate funds for the cost-sharing reduction subsidies in the Affordable Care Act. The court stayed the decision pending an anticipated appeal to the US Court of Appeals for the District of Columbia Circuit. Read the full article.
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King v. Burwell Decision Upholds Subsidies in Federal Exchanges
By Ankur J. Goel, Eric Zimmerman, H. Guy Collier and Jeremy Earl on Jul 2, 2015
Posted In Benefit Controversies, Employee Benefits, Fiduciary and Investment Issues, Health and Welfare Plans, Labor
On June 25, 2015, the Supreme Court of the United States ruled in King v. Burwell that the Affordable Care Act (ACA) requires premium tax credits to be made available in states that use a federal exchange. The case challenged an Internal Revenue Service (IRS) regulation allowing tax credits in federal exchanges. The Supreme Court upheld the...
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