McDermott offers unmatched experience addressing the legal obstacles facing health plans, managed care arrangements and accountable care organizations (ACOs) across the United States and internationally. Our lawyers help clients establish and participate in numerous types of managed care arrangements and integrated delivery systems for health insurers, hospitals, academic medical centers, other institutional inpatient and outpatient facilities, medical groups and independent practice associations, physicians, medical discount programs and employers, as well as for investment bankers, venture capitalists and individual entrepreneurs. Our Firm also works closely with health insurers and their pharmacy benefit managers (PBMs) on prescription drug plans and pricing issues.
The explosive growth of health plan mega-mergers shows no signs of abating, mirroring the trend toward consolidation among large health care providers. Our transactional lawyers conduct full due diligence and represent clients in negotiations involving health plan, managed care and health maintenance organization mergers, acquisitions and joint ventures between such entities and health care providers. We also work with accountable care organizations on their organizational and contractual arrangements, and provide guidance as to applicable requirements under the Medicare Shared Savings Program. We advise trade associations on communications to their membership on legal developments, draft comments on proposed regulations and subregulatory guidance, and offer strategic counseling in dealing with state and federal agencies that regulate health insurance.
Clients turn to McDermott for our depth of knowledge of the issues and our skill in addressing the most complex needs facing the industry. This includes providing counsel for administrative services only arrangements, requirements under the ACA such as tax issues and risk management, antitrust and trade regulation, bankruptcy and workout plans, consumer-directed health plans, prescription drug pricing, conversions and tax-exempt issues, corporate integrity agreements and compliance programs, ERISA, the Federal Employees Health Benefits Program, HIPAA privacy and security, tiered-benefit arrangements and disease management programs, medical discount programs, the Medicare Advantage Program and Medicare Part D, and federal and state licensure of plans and insurers.
Drawing on our multidisciplinary team with an impressive depth of national and international regulatory experience, McDermott’s health lawyers offer innovative solutions and creative counsel to help health plans navigate the changing health care landscape.