Skip to main content

Rachel A. Alexander

Member

[email protected]

+1.202.434.7474

Share:

Rachel is a seasoned health law attorney and litigator who concentrates her practice on representing health plans, payors, and managed care entities in all aspects of managed care and payor regulatory, transactional, and litigation matters with a specialized focus on pharmacy benefit and drug pricing–related issues.

Leveraging her extensive knowledge of and experience in health plan operations and health care law, Rachel helps clients navigate pharmacy benefit manager (PBM) contract negotiation, administration, and procurement matters. She also provides guidance on compliance with federal law, with an emphasis on advising health plans on the requirements of Medicare, the Federal Employees Health Benefits (FEHB) Program, Medicaid, and other government health care programs.

In the litigation side of her practice, Rachel represents clients in state and federal court, arbitration, and mediation, directing and managing cases involving commercial and government contract disputes, False Claims Act cases, and other civil enforcement actions. Clients also seek her assistance with internal and government investigations.

Before law school, Rachel spent more than a decade in the health care administration field, working for industry-leading health plans and provider health care systems in roles primarily focused on contract negotiations and administration.

Experience

  • Provides legal guidance on all aspects of pharmacy benefit manager (PBM) contracting, administration, and dispute resolution.
  • Advises on all aspects of health care and government contracting, including drafting and negotiating contracts, subcontracts, and affiliate agreements.
  • Provides counseling on regulatory issues related to managed care, including Medicare Part D/Medicare Advantage, Medicaid, the Federal Employees Health Benefits (FEHB) Program, and the Telephone Consumer Protection Act (TCPA).
  • Advises and defends health care government contractors with regard to government audits, investigations, and actions, including False Claims Act (FCA), Anti-Kickback, and Stark issues.
  • Evaluates and advises on health care corporate compliance programs, assessing whether compliance programs meet evolving legal standards.
  • Advises on all aspects of health care and government contracting, including drafting and negotiating contracts, subcontracts, and affiliate agreements.
  • Provides counseling on regulatory issues related to managed care, including Medicare Part D/Medicare Advantage, Medicaid, the Federal Employees Health Benefits (FEHB) Program, and the Telephone Consumer Protection Act (TCPA).
Read less

viewpoints

CMS 2026 IRA Price Negotiations Results Likely to Create Upstream and Downstream Effects

August 20, 2024 | Blog | By Rachel A. Alexander, Theresa Carnegie, Xavier Hardy, Alison H. Peters, Madison Castle

On August 15, 2024, CMS announced the results of the first round of the negotiated prices between CMS and participating drug manufacturers for the 10 selected drugs under the Inflation Reduction Act’s (IRA) Medicare Drug Price Negotiation Program (MPN or Program). In all, reactions to the MPN results varied: Reuters reported that executives from four of the manufacturers selected in the first round of negotiations stated that they do not expect the negotiated prices to significantly impact their businesses; meanwhile, in its press release announcing the maximum fair prices (MFPs), CMS touted an estimated $1.5 billion in Medicare prescription drug out-of-pocket cost savings for Medicare beneficiaries when the negotiated prices go into effect in 2026. 

Read more

PBM Policy and Legislative Update — Summer 2024

July 31, 2024 | Blog | By Theresa Carnegie, Tara E. Dwyer, Rachel A. Alexander, Bridgette Keller, Madison Castle, David Gilboa, Xavier Hardy, Samantha Hawkins, Stephnie John, Pat Ouellette, Alison H. Peters, Abdie Santiago, Hassan Shaikh, Sophia Temis

Read more

Mintz IRA Update — Third Edition: Q2 2024

July 15, 2024 | Blog | By Rachel A. Alexander, Theresa Carnegie, Madison Castle, Mitchell Clough, Tara E. Dwyer, David Gilboa, Xavier Hardy, Samantha Hawkins, Stephnie John, Bridgette Keller, Lauren Moldawer, Abdie Santiago, Hassan Shaikh

In ‘Third Edition: Q2 2024’ of the Mintz IRA Update, we cover updates to the Medicare Drug Price Negotiation Program being considered by CMS, developments in litigation challenging the program, the consequences and costs of redesigning the Part D program, opposition to the use of march-in rights to lower drug prices, and the growing use of state prescription drug affordability boards.

Read more

PBM Update: Special Edition - FTC 6(b) Interim Staff Report and Activity

July 12, 2024 | Alert | By Rachel A. Alexander, Tara E. Dwyer, Theresa Carnegie, Joseph Miller, Bridgette Keller, Samantha Hawkins, Hassan Shaikh, Payton Thornton

On July 9, 2024, the Federal Trade Commission (FTC) Office of Policy Planning released an Interim Staff Report titled Pharmacy Benefit Managers: The Powerful Middlemen Inflating Drug Costs and Squeezing Main Street Pharmacies. The Interim Staff Report reflects the FTC’s work since it began its 6(b) study of PBMs in June 2022.  Mintz’s Health and Antitrust teams actively monitor federal and state regulatory and legislative developments in the PBM space, including those from the FTC. In this Special Edition of the PBM Policy and Legislative Update, the Mintz Health team partnered with our Antitrust colleagues to analyze the Interim Staff Report including Commissioner Melissa Holyoak’s dissenting statement.  We also highlight upcoming Congressional testimony by CEOs of the three largest PBMs, as well as media reports of a forthcoming FTC action related to PBM insulin rebate practices.

Read more

PBM Policy and Legislative Update — Winter 2024

May 2, 2024 | Blog | By Theresa Carnegie, Tara E. Dwyer, Rachel A. Alexander, Bridgette Keller, Madison Castle, David Gilboa, Xavier Hardy, Abdie Santiago, Hassan Shaikh, Sophia Temis

Mintz is pleased to present its quarterly publication, PBM Policy and Legislative Update. This edition builds upon prior issues and summarizes activity from October through December 2023 that affects the PBM industry and will specifically highlight (i) federal legislative and enforcement updates, (ii) state legislative updates and litigation, (iii) other industry news, and (iv) Inflation Reduction Act (IRA) updates.

 

Read more

Mintz IRA Update — Second Edition: Q1 2024

February 21, 2024 | Blog | By Rachel A. Alexander, Theresa Carnegie, Tara E. Dwyer, Madison Castle, Mitchell Clough, Xavier Hardy, Stephnie John, Bridgette Keller, Abdie Santiago, Hassan Shaikh

In this edition of the Mintz IRA Update, we cover the status of the negotiations underway between CMS and manufacturers pursuant to the Medicare Drug Price Negotiation Program and current legal challenges to the program, other drug pricing–related IRA initiatives, the IRA’s small biotech exemption, implications associated with removing the average manufacturer price cap on Medicaid rebates, and the Biden administration’s proposed draft guidance on patent “march-in” rights.

Read more
Read less

News & Press

News Thumbnail Mintz

Member Rachel Alexander was quoted in a recent Bloomberg Law article about Medicare drug price cuts and what they might mean for ongoing litigation. Rachel addresses the potential implications of the US government’s release Thursday of the first ten drug prices that were negotiated for Medicare.

Press Release Thumbnail Mintz

Mintz proudly announced the election of 13 attorneys to Members and the addition of a record-setting 22 new lateral Members in 2023, with 11 Partners in the newly opened Toronto office. This diverse group strengthens Mintz’s core areas, spanning Commercial and IP Litigation, Life Sciences, Tech, Private Equity, and Energy & Sustainability. The elevated Members and new lateral additions bring invaluable expertise to help clients navigate complex legal landscapes. 

News Thumbnail Mintz

Law360 detailed the arrival of Member Rachel Alexander to Mintz’s health law practice. Rachel represents clients in all aspects of managed care and payor regulatory, transactional, and litigation matters with a specialized focus on pharmacy benefit and drug pricing related issues.

Press Release Thumbnail Mintz

WASHINGTON, DC – Mintz has deepened its health care bench with the addition of new Member, Rachel Alexander.

Read less

Events & Speaking

Involvement

  • Member, Women’s Bar Association of the District of Columbia
  • Co-Chair, Health Law Forum, Women’s Bar Association of the District of Columbia (2013 – 2014)
  • Co-Chair, Insurance Law Forum Women’s Bar Association of the District of Columbia (2012 – 2013)
  • Board of Trustees, Washington Ethical Society (2015 – 2019)
  • Member, Women in Law Empowerment Forum (WILEF)
  • Co-Chair, WILEF DC (2015 – 2017)
  • Global Advisory Board, Women in Law Empowerment Forum (2015 – 2017)
Read less