PBM Policy and Legislative Update — Fall 2024
Mintz’s PBM practice is pleased to present its quarterly publication, PBM Policy and Legislative Update. This edition builds upon prior issues and summarizes activity from July through September that affects the PBM industry. It highlights (i) federal legislative activity and oversight, (ii) state legislative activity and oversight, and (iii) other noteworthy events and trends affecting the PBM industry.
We hope you find the PBM Policy and Legislative Update to be a useful resource. If you have any recommendations on additional content that would be helpful to see in future editions, please do not hesitate to reach out to our team to let us know.
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Content Publishers
Rachel A. Alexander, a Member at Mintz, is a seasoned health law attorney and litigator who represents health plans, payors, and managed care entities in all aspects of managed care and payor regulatory, transactional, and litigation matters. She has a specialized focus on pharmacy benefit and drug pricing–related issues. She is regularly called on to help clients navigate pharmacy benefit manager (PBM) contract negotiation, administration, and procurement matters and provide guidance on compliance with federal law.
Tara Swenson Dwyer is a Mintz attorney who advises private and public health care clients on mergers and acquisitions, joint ventures, and complex service arrangements. She works with managed care organizations, pharmaceutical services providers, and integrated delivery systems.
Theresa C. Carnegie is a Mintz attorney who advises health care clients on a wide array of transactional, regulatory, compliance, fraud and abuse matters, and health law issues. She counsels health plans, pharmacy benefit managers, pharmacies, device manufacturers, and distributors.
Bridgette Keller
Madison M. Castle is an Associate at Mintz who focuses her practice on health care regulatory, transactional, and enforcement defense matters. She represents clients across the health care sector, including hospitals, physician organizations, and health care systems.
David R. Gilboa is an Associate at Mintz whose practice encompasses transactional, compliance, privacy, and regulatory matters. He represents a broad spectrum of health care clients, including health care systems, hospitals, digital health companies, clinical laboratories, nursing homes, home care agencies, physician practices, and pharmacies.
Xavier Hardy
Samantha Hawkins is an Associate at Mintz whose practice encompasses a broad range of complex transactions, compliance and regulatory issues, and governance matters for clients across the health care sector, with an emphasis on pharmacy benefit manager (PBM) contract negotiation.
Stephnie is a Mintz Associate. She advises clients across the health care industry on regulatory, transactional, and compliance matters.
Lauren Moldawer
Alison H. Peters is an Associate at Mintz with a broad health law practice that encompasses counseling clients on regulatory, compliance, transactional, and legislative matters. She works with health care and life sciences clients, including pharmaceutical and medical device manufacturers, physician practice groups, hospital systems, clinical laboratories, pharmacy benefit managers (PBMs), private equity firms, trade groups, and executives of health care entities.
Abdie Santiago is an Associate at Mintz who represents life sciences and health care companies in a broad spectrum of regulatory, fraud and abuse, and transactional matters. He assists clients with government drug pricing mandates, Medicare and Medicaid coverage requirements, Anti-Kickback Statute and False Claims Act investigations, and due diligence for health care practice transactions.
Hassan is a Mintz Associate. He advises a broad range of clients across the health care industry—including health care systems, pharmacies, and private equity firms investing in health care companies—in complex industry transactions and compliance and regulatory matters.
Sophia Temis is an Associate at Mintz who focuses her practice on health care transactions and advising health care organizations on a broad spectrum of regulatory and governance matters. She represents physicians, hospitals, ambulatory surgery centers, and other for-profit and nonprofit health care clients.