Überblick
Kate McDonald represents clients across the healthcare industry on complex regulatory matters and high-stakes mergers and acquisitions, affiliations and other investments. She has particular expertise in federal and state laws applicable to health insurers and HMOs, including the downstream implications of these rules for the provider organizations and vendors that work with them, as well as the reimbursement landscape of federal healthcare programs.
With extensive experience navigating the Medicare Advantage, Medicare Part D, and Medicaid managed care programs, Kate is regularly called on by health plans, provider organizations, technology start-ups, private equity funds, retailers and other clients to benchmark risks, solve regulatory challenges and structure transactions, particularly those that involve federal and state healthcare programs. As payors and providers continue to realign in today’s market, Kate has a nuanced understanding of the unique obstacles and opportunities facing companies at the intersection of these two worlds. She helps innovative companies navigate state risk-bearing regulations, drafts and negotiates agreements with complex reimbursement structures and regulatory implications, and advises healthcare companies and private equity funds on investments in highly-regulated segments of the healthcare market.
Kate is a contributing author to Regulation of Medicare Part D Plans (Thomson Reuters, 2019 edition) and Thomson Reuters Health Law Handbook (2017 edition). She speaks regularly at healthcare industry events, including the Wall Street Journal Health Forum, American Health Lawyers Association Institute for Health Plan Counsel, Blue Cross Blue Shield National Summit, Health Care Compliance Association Managed Care Compliance Conference, and Medicaid Managed Care Congress. Kate has been recognized in the Legal 500 United States (2019) and was the first recipient of the McDermott Will & Emery Client Service Award (2019).
Referenzmandate
- Represented CVS Health Corp. in connection with its approximately $70 billion acquisition of Aetna Inc., leading a multidisciplinary team of McDermott attorneys advising on health regulatory, tax, real estate, IP, IT and other matters.
- Provided corporate, health and tax representation for CVS Health Corp. in connection with the divestiture of Aetna Inc.’s standalone Medicare Part D prescription drug plans to a subsidiary of WellCare Health Plans, Inc.
- Successfully represented Medicare Advantage organizations and Part D plans in connection with administrative appeals of Quality Star Ratings and application denials.
- Counseled Part D plans and pharmacy benefit managers on related party arrangements, Any Willing Pharmacy rules and prescription drug pricing reform.
- Evaluated proposed business arrangements between health insurers, providers and pharmacies for potential risks under the federal Anti-Kickback Statute, Beneficiary Inducement Civil Money Penalties Law and False Claims Act.
- Provided strategic advice regarding demonstration programs sponsored by the Center for Medicare & Medicaid Innovation.
- Drafted and negotiated provider, vendor and pharmacy benefit management agreements for health plans.
- Led a multidisciplinary regulatory due diligence team in connection with a $400 million acquisition of an independent medical group.
- Performed health regulatory due diligence on a provider organization specializing in high-touch in-home care for chronically ill patients.
- Represented numerous healthcare organizations, venture capital funds and private equity investors in connection with proposed investments in and acquisitions of health insurers and HMOs.
Auszeichnungen
- Legal 500 United States, 2019 – 2020
- McDermott Will & Emery Client Service Award, 2019
- American Health Lawyers Association, Pro Bono Champion, 2014
Mitgliedschaften
- American Health Lawyers Association, Payers Plans and Managed Care Practice Group; Vice Chair, Medicare Advantage and Part D Affinity Group
- National Women’s Law Center, Leadership Advisory Committee
- DC Bar, Health Law Section
Qualifikation
Education
Georgetown University Law Center, JD, cum laude, 2010
University of North Carolina at Chapel Hill, BA, with highest honors, 2007
Admissions
District of Columbia
