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Susan W. Berson

Member / Managing Member, DC Office; Chair, Health Law, Communications, Antitrust & ML Strategies Division

[email protected]

+1.202.661.8715

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Susan’s clients depend on her in-depth industry knowledge and strategic insights. Her in-house experience informs her pragmatic, business-savvy counsel to health care industry clients. She regularly advises pharmaceutical services providers, managed care organizations, post-acute and long term care providers, and those who invest in the industry on the risks and potential benefits of strategic affiliations, complex service agreements, and due diligence in high profile transactions. She also provides counsel on government programs such as Medicare and Medicaid, and compliance and regulatory matters. She has particular insight into the challenges facing managed care organizations, specialty pharmacies, and pharmacy benefit managers. Susan is also part of Mintz’s leadership team.

Susan is the Managing Member of the firm’s DC office, serves on the firm’s Policy Committee, and is Division Head of Mintz's Health Law, Communications, and Antitrust practices as well as ML Strategies, the firm’s government relations affiliate.

Clients look to Susan for her deep understanding of the health care industry and her extensive experience solving their most complex, cutting edge issues. However, a distinguishing feature of why clients turn to Susan is that she is able to provide industry insight and strategic guidance to help them determine the pros and cons of engaging in a transaction, as well as the best structure for that transaction, well before any issues or regulatory requirements are identified. Her broad client base includes:

  • Pharmaceutical services providers such as PBMs, pharmacies, specialty care companies, and integrated delivery systems;
  • Private and public health care service providers, including managed care organizations, such as Medicare Advantage Plan Sponsors, Medicare Part D Plan Sponsors (including Employer Group Waiver Plans), and Medicaid Managed Care plans;
  • Providers of post-acute, home health, and hospice services; and
  • Private equity firms and other investors in the health care sector.

Susan has led many complex due diligence projects of health care companies, in a vast array of areas including managed care, specialty pharmacies, pharmacy benefit managers, post-acute, home health, and hospice, to name a few. She also regularly provides counsel on compliance and regulatory matters, including federal programmatic and certification requirements, risk adjustment programs and practices, benefit design requirements for state and federal programs, fraud and abuse and anti-kickback rules, state regulatory requirements relating to drug pricing and coverage, and government policies, procedures, and reporting requirements. She routinely advises these clients in the context of strategic affiliations and complex service agreements.

Susan has been in the client’s shoes and this drives her holistic view of the industry and her pragmatic business advice in solving legal issues and managing legal expenses. Her in-house experience has given her a unique perspective on the need to devise practical, pragmatic, business-focused solutions to issues in a cost effective and timely manner. From 2006 to 2008, Susan served as general counsel of the Public and Senior Markets Group at UnitedHealth Group, a Fortune 10 company. In this role, she was responsible for the legal and regulatory oversight of UnitedHealth’s government programs, including Medicare and Medicaid, and was also legal counsel for all pharmacy services.

Susan has been recognized by Chambers USA for several years. One Chambers-quoted client called her “brilliant,” noting that she “has a really deep knowledge across the whole spectrum of healthcare, not just one area.”

Education

  • Columbia University (JD)
  • University of Rochester (BA)

Experience

  • Served as regulatory counsel to a consortium of investors led by TPG Capital and Welsh, Carson, Anderson & Stowe in their $4.1 billion acquisition of Kindred Healthcare, Inc. (NYSE:KND). The transaction was recognized by The Deal as the 2018 Private Equity Deal of the Year.
  • Advised a consortium of investors led by TPG Capital and Welsh, Carson, Anderson & Stowe in their $1.4 billion acquisition of Curo Health Services.
  • Advised a global health care company on a variety of issues in connection with its acquisition of several health plans and provider groups, including health care regulatory due diligence, health care regulatory advice regarding transaction structure and strategy, and preparation of regulatory notices and other filings.

Recognition & Awards

  • Chambers USA: District of Columbia – Healthcare (2013 – 2018)
  • Recognized by the The Legal 500 United States for Healthcare: Service Providers (2014 and 2018)
  • International Law Office and Lexology: “Client Choice Award” – Healthcare & Life Sciences, District of Columbia (2015)
  • Harlan Fiske Stone Scholar at Columbia University
  • Phi Beta Kappa

Recent Insights

News & Press

Events

Viewpoints

On Friday, after weeks of delay, the President finally delivered his Drug Pricing Speech and released the HHS Blueprint detailing the Trump Administration's plan to lower drug prices and reduce out-of-pocket costs.
As described in last week’s post, Senator Wyden has introduced the C-THRU Act that seeks to require public disclosure of PBM rebate amounts, establish a minimum rebate percentage that PBMs must pass on to Part D and Exchange Plan clients, and intends to change the definition and/or application of “negotiated prices” under the Part D program. 
For several years now, the public outcry over the issue of drug pricing and reimbursement has increased in frequency and fervor. At least one government agency wants you to know that it has been listening and wants to help provide the information necessary to forge a solution.

Senate Bill Targets Part D DIR Fees

October 11, 2016| Blog

Just last month the “Improving Transparency and Accuracy in Medicare Part D Spending Act” was introduced in the Senate to amend the Social Security Act. The bill seeks to prohibit Part D plans (and their contracted pharmacy benefit managers (PBMs)) from retroactively reducing payments to pharmacies for clean claims.
Here in Washington, it seems everyone has an idea on a drug “fix”:  amendments to the provisions governing Medicare reimbursement, new rebate requirements, changes to price reporting measures, revisions to the 340B Drug Discount Program, etc. Proposals are interesting, but will Congress actually do anything?  If anything is actually going to pass, it has to get through the Senate.
Following our first panel discussing Drug Pricing Challenges and Opportunities, the second panel, which Theresa is moderating involves a subject near and dear to the heart of many of our clients: The New Wave of Value-Based Pricing and Contracting.
We are thrilled that our inaugural Pharmacy Industry Summit is now less than a week away.  The Summit is next Tuesday May 10th, 2016, here in our DC offices.  Since we started planning for the Summit many months ago, this hottest of topics that we chose to cover, drug pricing, has become even hotter.
Last week, the Centers for Medicare & Medicaid Services (CMS) released its 2017 Advance Rate Notice and draft Call Letter (“2017 Draft Call Letter”) for the Medicare Advantage (“MA”) and Part D programs. With the final 2017 Call Letter to be released April 4, 2015, CMS is providing interested stakeholders until this Friday, March 4th to provide comments.
As we start a new year, let’s take a look back at a few hot topics that emerged in the managed care industry in 2015 and will likely be drivers of developments in 2016.
With 2015 coming to a close, we wanted to provide a recap of the major updates impacting the pharmacy industry and what pharmaceutical manufacturers, pharmacy benefit managers (“PBMs”), and pharmacies might expect in 2016. 

News & Press

Mintz partner and Massachusetts lawyer Julie Korostoff is one of 49 attorneys recognized as “Leaders in Their Fields” by the 2018 Chambers USA: America's Leading Lawyers for Business guide. Chambers named Korostoff a “Recognized Practitioner” in Technology.
Mintz is advising a consortium of investors led by TPG Capital and Welsh, Carson, Anderson & Stowe in their acquisition of Curo Health Services, one of the nation’s leading hospice providers. The definitive agreement was announced on April 23, 2018. The deal is valued at approximately $1.4 billion.
Mintz is pleased to welcome back O'Kelly E. McWilliams III, who returns to the firm as a Member in the Employment, Labor & Benefits Section. His clients include multi-national companies, private equity firms, and emerging businesses.
Mintz is advising a consortium of investors led by TPG Capital and Welsh, Carson, Anderson & Stowe in their acquisition of Kindred Healthcare, Inc. The definitive agreement totals approximately $4.1 billion in cash including the assumption or repayment of net debt.
ML Strategies has added veteran policy advisor Constance Garner as Vice President for Disability Policy & Education Policy. Ms. Garner draws on decades of legislative, health care, government agency, and consulting work.

Events

Moderator
Moderator
Speaker
Speaker
Nov
12
2015

4th Annual Pharmacy Benefit Oversight & Compliance Conference

CBI

16770 North Perimeter Drive Scottsdale, AZ

Speaker
Jun
26
2015

CMS Audit Readiness for PBMs and Plans

CBI

Hilton Magnificent Mile, Chicago, IL