
Theresa has extensive experience advising clients on all aspects of the pharmaceutical supply chain. Her practice involves advising industry stakeholders on a range of business, legal, transactional, and compliance matters. Theresa combines her multilayered industry knowledge with a deep understanding of applicable federal and state legal frameworks, in particular federal and state fraud and abuse laws. She provides clients with strategic counseling and creative business modeling that considers legal restrictions and regulatory risk in light of innovation and business goals.
PBMs and Plans
Theresa applies her comprehensive knowledge of the PBM industry, the legal landscape, and relevant policy initiatives to provide insightful and strategic counsel to plans and PBMs on all aspects of their operations. She regularly assists PBMs and plans in evaluating and structuring innovative strategic alliances, payment structures, and collaborations. She has extensive experience in:
- PBM Service Agreements from both the PBM and plan perspective
- Rebate Contracting, including value-based and outcomes-based rebating arrangements
- Rebate Aggregator and Formulary Service Arrangements
- Pharmacy Network Contracting
- Workers Compensation PBMs
Specialty Pharmacies
Theresa counsels independent and plan/PBM-affiliated specialty pharmacies on regulatory, operational, and contracting matters. She assists specialty pharmacies with:
- Drug Purchase and Service Arrangements
- Fraud and abuse risks in connection with arrangements with pharmaceutical manufacturers
- Payor Relationships
- Wholesaler Arrangements
- Prescription Drug Adherence Programs
- State Pharmacy Law Requirements
- Medicare Part D Regulatory Requirements
Drug Distribution and Procurement
Theresa knows that understanding the interaction among all entities in the pharmaceutical supply chain is critical to providing practical, business oriented advice and services. In addition to plans, PBMs, and pharmacies, she advises a variety of different stakeholders in the pharmaceutical supply chain, including:
- Providers negotiating national drug supply and procurement agreements
- Group Purchasing Organizations
- Reimbursement HUBs
- Co-pay and Coupon Program Administrators
Innovative and Direct-to-Consumer Drug Discount Programs
Theresa advises entrepreneurial health care providers on innovative platforms for the delivery of prescription drugs, pharmacy benefits, and drug discounts, including.
- Prescription Drug Discount Cards
- Direct-to-Consumer Discount Offerings
- Disruptor and alternative model PBM services
Digital Pharmacy Services
Theresa advises telehealth technology developers, telehealth providers, and pharmacies on federal and state regulatory schemes applicable to telehealth participation in the pharmaceutical supply chain and the provision of digital pharmacy services. She counsels clients on fraud and abuse requirements, provides contracting support, and assists with structural considerations such as state corporate practice of medicine (CPOM) requirements.
M&A and Transactional Matters
Theresa regularly represents clients in connection with their investment in the pharmaceutical supply chain. She uses her extensive knowledge of the pharmaceutical supply chain to advise clients investing in the industry on structural considerations, corporate matters, regulatory requirements and compliance risks, and business challenges and opportunities. Theresa assists clients in both M&A transactions and private equity investments and has deep experience in contracting matters, complex due diligence reviews, fraud and abuse risks, licensing, and regulatory and change of ownership (CHOW) filings.
COVID-19 Matters
Most recently, Theresa has advised clients on the impact of COVID-19 on the pharmaceutical supply chain, including its impact on state pharmacy law requirements, Medicare Part D benefit design requirements, and contracting arrangements.
Theresa is a frequent author and speaker on regulatory and policy issues affecting pharmacy benefits and the pharmaceutical supply chain and a regular contributor to the firm’s Health care Viewpoints.
Education
- Duke University (JD)
- Bowdoin College (BA)
Recognition & Awards
- Chambers USA: District of Columbia (Up and Coming) – Healthcare (2014, 2015)
- Nightingale’s Healthcare News: Outstanding Young Healthcare Lawyers (2005)
- Phi Beta Kappa
Languages
- Spanish
Viewpoints
HHS Proposes Sweeping Changes to AKS and Stark Law, Part 3: Personal Services and Management Contracts, Outcomes-Based Payments, and Warranties
October 23, 2019 | Blog | By Karen Lovitch, Theresa Carnegie, Rachel Yount
HHS Proposes Sweeping Changes to AKS and Stark Law, Part 2: Cybersecurity Technology and Electronic Health Records
October 21, 2019 | Blog | By Karen Lovitch, Dianne Bourque, Theresa Carnegie, Rachel Yount
HHS Proposes Sweeping Changes to AKS and Stark Law, Part 1: Value-Based Arrangements
October 15, 2019 | Blog | By Theresa Carnegie, Rachel Yount, Michelle Caton
HHS Proposes Sweeping Changes to Anti-Kickback Statute and Stark Law
October 10, 2019 | Blog | By Karen Lovitch, Theresa Carnegie, Rachel Yount
Senate Finance Committee Passes Drug Pricing Bill
July 30, 2019 | Blog | By Theresa Carnegie, Ellyn Sternfield, Michelle Caton
Trump Administration Withdraws Proposed Rebate Rule
July 11, 2019 | Blog | By Susan Berson, Theresa Carnegie
Government Regulation of Drug Pricing and the Evolving Pharmaceutical Supply Chain
April 12, 2019 | Video | By Theresa Carnegie
HHS Proposes to Remove Drug Rebate Protections
February 1, 2019 | Blog | By Susan Berson, Theresa Carnegie, Tara E. Dwyer
Trump Administration Proposes Requiring Disclosure of Drug Prices in TV Ads
October 17, 2018 | Blog | By Lauren Moldawer, Theresa Carnegie
Significant Drug Pricing Developments in July – Here’s What You Need To Know
July 24, 2018 | Blog | By Theresa Carnegie
News & Press
Five Mintz Attorneys Named 2020 BTI Client Service All-Stars
December 11, 2020
Trump Unveils Disputed, Long-Shot Drug Rules Upending System
November 23, 2020
Mintz Attorney Theresa C. Carnegie and ML Strategies Vice President Rodney L. Whitlock to Speak at Fifth Annual Pharmacy Benefit Oversight & Compliance Conference
November 07, 2016
Events
Examining the Impact of COVID-19 on Pharmacy Benefits and the Pharmaceutical Supply Chain
American Health Law Association Annual Meeting
Online Event

4th Annual Mintz /ML Strategies Pharmacy & Pharmaceutical Industry Summit
Mintz and ML Strategies
Boston, MA
3rd Annual Mintz /ML Strategies Pharmacy & Pharmaceutical Industry Summit
Mintz and ML Strategies
Boston, MA

3rd Annual Mintz /ML Strategies Pharmacy & Pharmaceutical Industry Summit
Mintz and ML Strategies
Boston, MA
