Helaine Fingold
Partner
Epstein Becker & Green, P.C.
Helaine I. Fingold is a Partner in the Health Care and Life Sciences practice in the Baltimore office of Epstein Becker Green. She has more than 33 years of broad health law and health regulatory experience, including 20 years in the federal legislative/executive branches. Ms. Fingold advises health care plans and issuers, providers, and other stakeholders on legal and policy issues regarding the Medicare Advantage and Part D programs, including, but not limited to: general program compliance and corrective action; marketing, agent/broker and other TPMO issues; star ratings/quality bonus payments; plan application process, standards and appeals; program/financial audits and other program oversight; and program enforcement/sanctions and appeals. She also advises on Medicare Parts A and B; Medicaid fee-for-service and waiver/managed care programs; Medicare and Medicaid innovation programs; PACE, Qualified Health Plan and commercial plan requirements under the ACA; and federal and state Surprise Billing rules. From 2004 to 2012, Ms. Fingold worked in a range of capacities at the Centers for Medicare & Medicaid Services (CMS), with responsibility for areas of the Medicare Advantage program, including plan application review and approval, network adequacy, plan application denials and appeals, contracting, plan surveillance and oversight, and Medicare Advantage and Part D marketing. Subsequently, Ms. Fingold served in both senior staff and leadership roles with the Center for Consumer Information and Insurance Oversight (CCIIO) in the Exchange Policy and Operations Group through which Ms. Fingold worked on the qualification of qualified health and stand-alone dental plans, plan oversight, essential health benefits, agent/broker issues, and market-wide cost sharing limitations.
