The ACA and the New Administration: CMS Proposed Rule Impacting Marketplace Eligibility and Other Notable Actions

Ms. Campbell is co-chair of the firm’s Health Services group. She advises clients on all aspects of the Affordable Care Act (ACA), including the insurance market reforms, qualified health plan standards, exchange rules, consumer assistance programs for the federal marketplace, and ACA section 1557 nondiscrimination rules. Ms. Campbell also works with clients on the Federal Mental Health Parity and Addiction Equity Act (MHPAEA), state insurance law, and Medicare and Medicaid. She represents health insurance companies, employers, consultants, and trade associations on federal and state laws regulating health coverage. Ms. Campbell also provides advice on advocacy with federal and state agencies, compliance programs, government enforcement, and regulatory initiatives.

Ms. Carey brings extensive experience advising healthcare clients on a wide range of regulatory, transactional, and reimbursement issues. She partners with a wide range of clients, from independent providers and ambulatory surgery centers to academic medical centers and private equity investors, to navigate the evolving healthcare landscape. Ms. Carey’s practice is particularly focused on the development and operation of ambulatory surgery centers, certificate of need applications, and value-based care arrangements. She also advises clients in emerging areas such as artificial intelligence in healthcare, palliative care, and the creation of new physician residency and anesthesia assistant programs. Ms. Carey’s deep knowledge of the corporate practice of medicine, Stark Law, Anti-Kickback Statute, EMTALA, HIPAA, and state-specific fee-splitting laws enables her to structure transactions that are both compliant and commercially strategic. Her transactional work is informed by a nuanced understanding of payer-provider dynamics, sharpened by her previous roles at Anthem and other managed care organizations.