Ankur J. Goel

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.

Firm/Organization: McDermott Will & Emery

Blogs: Employee Benefits Blog, FCA Update, Of Digital Interest

Latest Articles

Of Digital Interest

CMS Proposes New Telehealth Guidelines and RADV Extrapolation for MAOs

By Ankur J. Goel, Kate McDonald, Mary Moll Alexandre & Seth Schneer on November 2, 2018

On October 26, 2018, CMS released a Notice of Proposed Rulemaking addressing expanded telehealth coverage in Medicare Advantage, extrapolation of RADV audit results, and updates to the Medicare Advantage and Part D Quality Star Ratings program, among other topics. If finalized, the regulations set forth in the Proposed Rule would impact not only Medicare Advantage and Part D plan sponsors but also a broad range of providers and health care companies, particularly those involved in…

Employee Benefits Blog

CMS Releases Broad-Ranging Medicare Advantage and Part D Proposed Rule

By Ankur J. Goel, Kate McDonald & Lauren E. Parisi on December 26, 2017

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. Continue Reading.…

Employee Benefits Blog

CMS Aims to Stabilize Exchanges but Does Not Address Issuers’ Biggest Questions

By Seth Schneer, Jeremy Earl & Ankur J. Goel on May 16, 2017

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 these steps may provide some comfort for issuers, the agency did not address the most significant areas of issuer concern…

Employee Benefits Blog

Trump Administration Takes First Steps to Support Exchanges, but Key Questions Remain

By Seth Schneer, Jeremy Earl & Ankur J. Goel on March 2, 2017

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 Trump administration’s willingness to support the Exchanges, these actions do not resolve the political uncertainty regarding the Affordable Care Act’s…

Employee Benefits Blog

How Congress, President-Elect Trump Might Proceed on Promise to Repeal, Replace ACA

By Ankur J. Goel, Jeremy Earl & Kate McDonald on November 14, 2016

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 result in significant market disruption in the absence of a replacement. Republicans will now be in charge of putting together…

Employee Benefits Blog

Federal Court Strikes Down ACA Cost Sharing Reduction Payments

By Ankur J. Goel on May 26, 2016

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. …

Employee Benefits Blog

King v. Burwell Decision Upholds Subsidies in Federal Exchanges

By Jeremy Earl, H. Guy Collier, Eric Zimmerman & Ankur J. Goel on July 2, 2015

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 regulation as consistent with the statute. Our On the Subject provides a discussion on the issue. Click here to read…

FCA Update

Fraud Enforcement Trends for 2015: Over the Horizon

By Tony Maida, Laura McLane, Michael W. Peregrine, T. Reed Stephens, Jason B. Caron, Eric B. Gordon, MD, Daniel H. Melvin, Joan Polacheck & Ankur J. Goel on February 18, 2015

Health care fraud enforcement continues to be a priority for the federal government and is poised to expand even more. As a result, health care providers and suppliers should anticipate greater oversight activities from auditors and investigators. Ensuring that your compliance program is up-to-date and up-to-task in proactively identifying problems and making timely decisions about corrective actions and potential disclosures is key to protecting the organization. BIGGER BUDGETS FOR LAW ENFORCEMENT AND PROGRAM INTEGRITY In…

Employee Benefits Blog

U.S. Appeals Courts Issue Conflicting Decisions on Whether ACA Permits Tax Subsidies of Health Care Coverage Purchased Through Federal Exchanges

By Ankur J. Goel, Eric Zimmerman, H. Guy Collier, J. Peter Rich & Anthony A. Bongiorno on July 29, 2014

The U.S. Court of Appeals for the District of Columbia struck down the Internal Revenue Service (IRS) rule providing for federal tax credits for health insurance purchased through federal exchanges, while the U.S. Court of Appeals for the Fourth Circuit upheld the same IRS rule. If en banc review in the appeals courts does not resolve the circuit split, the matter likely will go to the Supreme Court of the United States for review. Tax…

Employee Benefits Blog

2015 Notice of Benefit and Payment Parameters

By Ankur J. Goel, Jeremy Earl & Anthony A. Bongiorno on April 3, 2014

The Centers for Medicare & Medicaid Services’ Final Notice of Benefit and Payment Parameters for 2015 contains numerous alterations to premium stabilization programs, cost-sharing requirements and employee counting provisions to account for lower-than-anticipated enrollment through the Exchanges and the Obama Administration’s decision to permit individuals to “keep their current plan” through 2016. All of these changes and the fluid regulatory environment create significant challenges for issuers, who must operationalize these changes, some of which are…

Ankur J. Goel

CMS Proposes New Telehealth Guidelines and RADV Extrapolation for MAOs

CMS Releases Broad-Ranging Medicare Advantage and Part D Proposed Rule

CMS Aims to Stabilize Exchanges but Does Not Address Issuers’ Biggest Questions

Trump Administration Takes First Steps to Support Exchanges, but Key Questions Remain

How Congress, President-Elect Trump Might Proceed on Promise to Repeal, Replace ACA

Federal Court Strikes Down ACA Cost Sharing Reduction Payments

King v. Burwell Decision Upholds Subsidies in Federal Exchanges

Fraud Enforcement Trends for 2015: Over the Horizon

U.S. Appeals Courts Issue Conflicting Decisions on Whether ACA Permits Tax Subsidies of Health Care Coverage Purchased Through Federal Exchanges

2015 Notice of Benefit and Payment Parameters

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