Überblick
Jeremy Earl represents a broad range of healthcare organizations with a focus on managed care legal issues. His clients include health insurers, HMOs, healthcare provider organizations, pharmacy benefit managers, and administrative service providers to managed care organizations. Jeremy is a practice area leader for the Managed Care practice.
He represents clients on various types of transactional matters, including joint ventures, complex service agreements, and innovative value-based reimbursement arrangements between health plans and providers or intermediary entities. As the line between health plans and providers continues to blur, Jeremy helps healthcare organizations launch innovative managed care arrangements by providing a deep understanding of the healthcare marketplace and applicable legal and regulatory requirements.
Jeremy also routinely provides complex regulatory counseling and advice on managed care legal issues with a focus on requirements affecting commercial health insurance, the Medicare Advantage and Part D programs and state Medicaid managed care programs. He provides regulatory support to health plan clients on significant regulatory matters and litigation, such as Medicare Advantage risk adjustment compliance and investigations, qui tam actions relating to Medicaid managed care program compliance and class actions relating to health plan coverage policies.
He provides regulatory counseling related to significant managed care transactions, including leading a team as health regulatory counsel to CVS in its $69 billion acquisition of Aetna. Jeremy also regularly represents private equity clients selling, acquiring or investing in managed care companies and other healthcare organizations. He has experience managing the regulatory approval process for managed care transactions, including obtaining insurance department, Medicare Advantage program, and state Medicaid agency regulatory approvals.
Jeremy is a frequent speaker at national healthcare industry conferences and has been quoted in trade and national publications, including HealthPayer Intelligence, Modern Healthcare, Managed Care Executive, Business Insurance and Vox.com.
Referenzmandate
- Jointly advised a group of health insurers on compliance with the Affordable Care Act reforms during the initial years following the law’s passage
- Represented an ACO in drafting and negotiating shared savings agreements that cover the commercial market, the Medicare Advantage program, and the state’s Medicaid managed care program
- Represented a state’s largest health insurer in drafting and negotiating a global shared-risk agreement with the state’s largest health system
- Developed a template global shared-risk agreement for a large health insurer operating in multiple states
- Assisted a state’s largest insurer in moving its primary care physician compensation entirely away from fee-for-service to a value-based model
- Drafted and negotiated a Part D and commercial pharmacy benefit management (PBM) agreement between a state’s largest insurer and a national PBM
Auszeichnungen
- Legal 500 United States, 2018 to 2019
- American Health Lawyers Association Pro Bono Champion for 2012, 2013 and 2014
Mitgliedschaften
- American Health Lawyers Association, Social Media Chair for the Payers, Plans and Managed Care Group
Qualifikation
Education
Duke University School of Law, JD, 2009
University of St. Thomas, BA, summa cum laude, 2006
Admissions
California
District of Columbia
