Susan W. Berson: Lawyer with Mintz, Levin, Cohn, Ferris, Glovsky and Popeo, P.C.

Susan W. Berson

Phone202.661.8715

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Experience & Credentials
 

Practice Areas

  • Fraud & Abuse
  • Compliance & Regulatory Counseling
  • Medicare
  • Medicaid & Commercial Payor Coverage & Payment
  • Mergers
  • Acquisitions & Other Transactions
  • Medical Technology
  • State & Federal Audits
  • Investigations & Litigation
  • Israel Business Group
  • Health Law
  • Health Care
  • Professional Services
 
Contact InfoTelephone: 202.661.8715
Fax: 202-434-7400
Internet: Each Attorney's Internet Address takes the following form: first initial, last name @mintz.com (e.g., rmintz@mintz.com)

http://www.mintz.com/professionals/detail/name/susan-w-berson
 
University University of Rochester, B.A., 1982
 
Law SchoolColumbia University, J.D., 1985
 
Admitted1986, New York; 2000, District of Columbia
 
Biography

Susan is the Managing Member of the firm's DC office, and she also serves on the firm's Policy Committee. Her practice focuses on advising private and public health care service providers, including managed care organizations, such as Medicaid Advantage and Medicaid plans, pharmaceutical services providers such as PBMs, behavioral health companies, specialty care companies, and integrated delivery systems, often in the context of strategic affiliations and complex service agreements.

Susan has advised some of the nation's largest government health programs and has negotiated some of the nation's largest pharmacy service agreements, and also advises on complex mergers, acquisitions, joint ventures, and network development programs. She regularly represents pharmacy benefit manager (PBM) clients and their related mail order/specialty pharmacies in connection with the drafting, negotiation, structuring, and health care regulatory analysis of rebate agreements, drug purchase agreements, distribution agreements (including specialty drug distribution agreements), wholesaler agreements, repackaging arrangements, GPO arrangements and private label arrangements. She also has significant experience assisting venture capital groups and investment banks with investments in the health care industry.

Susan's experience also includes advising Medicare Advantage Organizations (MAOs), Medicare Part D Plan Sponsors, including Employer Group Waiver Plans (EGWPs), Medicaid Managed Care plans and first tier and downstream entities to address regulatory and compliance matters that arise as a result of participating in Medicare Parts C and D. She frequently counsels clients on risk adjustment programs and the practices needed to support them as well as audits of risk adjustment payments. She also develops and negotiates a variety of contracts needed to establish and support Medicare Advantage Plans, Part D Plans, and health plans intending to participate in state exchanges.

Susan returned to Mintz Levin in 2008 after a two-year hiatus, during which she served as general counsel of the Public and Senior Markets Group at UnitedHealth Group, a Fortune 20 company and one of the nation's leading managed care organizations. In this role, she was responsible for the legal and regulatory oversight of UnitedHealth's government programs (including Medicare and Medicaid) and was also the chief legal counsel for all pharmacy services.

Other aspects of Susan's practice focus on a broad spectrum of state and federal regulatory laws unique to the health care industry, and the application of such laws to the structuring and execution of complex business arrangements. She regularly advises clients on such issues as federal and state anti-kickback and self-referral laws; emerging developments in health care legislation, including, most recently, the Affordable Care Act and the Mental Health Parity and Addiction Equity Act; and state regulatory issues, such as corporate practice of medicine and fee-splitting prohibitions.

Susan practiced in New York for many years before moving to Washington, DC.

Newsroom

• Mintz Levin Sponsors U.S. Department of Energy's 2014 National Clean Energy Business Plan Competition, (06.11.2014)

• Fifty-One Mintz Levin Attorneys Featured in Chambers USA 2014 Guide, (05.23.2014)

• Quoted inHealth Care Regulation and Legislation to Watch in 2014,Law360 (01.01.2014)

• Quoted inAs HealthCare.gov Improves, Focus Shifts to Back-End Woes,Law360 (12.03.2013)

• Quoted in5 Highlights of Long-Awaited Mental Health Parity Rules,Law360 (11.15.2013)

• Quoted inmHealth in the Era of Obamacare,Jerusalem Post (10.31.2013)

• Mintz Levin Attorney Susan W. Berson to Present at Israel Advanced Technologies Industries BioMed Conference, (06.06.2013)

• Mintz Levin Sponsors U.S. Department of Energy National Clean Energy Business Plan Competition, (06.06.2013)

• Forty-Eight Mintz Levin Attorneys Featured in Chambers USA 2013 Guide, (05.24.2013)

• Mintz Levin Attorney Susan W. Berson to Present at American Health Lawyers Association's Institute for Health Plan Counsel, (05.07.2013)

• Quoted inA Prosperous Diagnosis,The National Law Journal (02.11.2013)

• Mintz Levin Attorneys Susan W. Berson and Hope S. Foster to Speak at Pharmacy Benefit Oversight and Compliance Congress, (11.12.2012)

• Mintz Levin Attorneys Susan W. Berson and Deborah A. Daccord to Moderate Panels at 2012 Healthcare Deal Making Summit, (09.14.2012)

• Mintz Levin and ML Strategies Sponsor U.S. Department of Energy National Clean Energy Business Plan Competition, (06.12.2012)

• Mintz Levin Attorney Susan W. Berson Named International Law Office Client Choice Award Winner for Healthcare and Life Sciences, (04.17.2012)

• Mintz Levin Marks 30th Anniversary of Washington, D.C. Office, (10.18.2011)

• Mintz Levin Appoints Susan Berson to Chair of Israel Business Practice Group, (05.18.2009)

• Susan Berson Rejoins Mintz Levin to Head Washington, D.C. Office, (07.01.2008)

• Mintz Levin Advises CVS Caremark Corporation on its Acquisition of Longs Drugs Stores, (11.06.2006)

Recognitions & Awards


Chambers USA: District of Columbia - Healthcare (2013 - 2014)
• Harlan Fiske Stone Scholar at Columbia University
• Phi Beta Kappa

Publications

Co-author,CMS Proposes Major Changes to Medicare Part C and Part D,BNA's Medicare Report (03.07.2014)

• Co-author,CMS Proposes Major Rule Changes to Increase Payment Accuracy and Improve Program Integrity in Medicare Part C and Part D,BNA's Health Care Fraud Report (03.05.2014)

• Co-author,CMS Proposes Major Changes to Medicare Parts C and D,Health Law Advisory (01.21.2014)

• Co-author,Managing an Integrating Care for Vulnerable Populations: The Financial Alignment Demonstrations to Support State Efforts to Integrate Care,Payors Plans & Managed Care (12.2012)

• Co-author,Recovery Audit Contractor (RAC) Audits: Are Plan Sponsors Ready?,Compliance Today (11.01.2012)

• Co-author,Text4baby: Texting Health Messages to Pregnant Women and New Moms,mHealth Alert (02.16.2010)

• FCC Extends Boston Scientific's Authority for Implanted Cardiac Devices,mHealth Alert (07.20.2009)

• mHealth Raise New FCC and FDA Issues,mHealth Alert (07.01.2009)

• Co-author,Vermont Passes Sweeping Regulation of Pharmaceutical Marketing Activities,Health Law Advisory (05.28.2009)

Speaking Engagements

Speaker,Getting Paid for your Products in the US and Europe - Medical Device, Pharma and Health IT,MIXiii Israel Innovation Conference, IATI, Tel Aviv, Israel (05.22.2014)

• Speaker,What Do the Proposed Changes to Medicare Parts C and D Mean for Your Business?, Mintz Levin, Webinar (01.29.2014)

• Speaker,Fundamentals of PBM Compliance in the Health Reform Era, CBI, Chicago, IL (11.13.2013)

• Speaker,An Update for Israeli Med-Tech Companies Active in the U.S. Market,Commercializing Innovation under Health Reform, Israel Advanced Technology Industries (IATI), Herzliya (10.08.2013)

• Speaker,Innovation in Era of Health Reform,IATI-BioMed Israel 2013 Conference, Israel Liaison Office (06.12.2013)

• Speaker,Medicare Hot Topics,Institute for Health Plan Counsel, American Health Lawyers Association, Bloomfield, CT (05.08.2013)

• Speaker,Financial Alignment Demonstration for Medicare/Medicaid Dual Eligibles: The Next Frontier?, American Health Lawyers Association, Webinar (03.08.2013)

• Speaker,What You Need to Know to Manage Pharmacy Benefits - A Legal Perspective,Pharmacy Benefit Oversight and Compliance Congress, Las Vegas, NV (11.14.2012)

• Moderator,Commercial Lenders' Perspectives on Healthcare Deal Financing,Healthcare Deal Making Summit, Nashville, TN (09.20.2012)

• Speaker,Commercializing Healthcare Technologies in the U.S.: Challenges and Opportunities, Accelerating U.S.-Israel Neuroscience & Neurotechnology Collaborations, Washington, DC (09.12.2012)

• Speaker,U.S. Health Care Reform - A Special Presentation for Israeli Pharma, Biotech and Medical Device Companies and Their Investors,U.S. Health Care Reform - A Special Presentation for Israeli Pharma, Biotech and Medical Device Comp, Mintz Levin, Israel-America Chamber of Commerce, and Israel Life Science Industry, Webinar (05.05.2010)

• Co-chair,Health Care 2010: Managing Risks in the New Compliance and Enforcement Environment Conference, Practising Law Institute (04.26.2010)

• Speaker,Making History with Health Care Reform: What's Happened and What's Next?, Mintz Levin and ML Strategies, Webinar (04.07.2010)

• Speaker,Legal Sticky Wickets and Constraints: How to Craft Multiple Medical Group or Hospital-Physician Ventures and Improve Performance Opportunities,Paying Doctors Differently: Applying Lessons Learned to Today's Market, Healthcare Financial Management Assocation (03.19.2010)

• Speaker,Healthcare Technology Innovation, LAHAV, the Tel Aviv University, Israel Liaison Office (12.06.2009)

• Speaker,Opening Remarks,Leveraging the Israeli Healthcare Opportunity - A Portfolio View, Mintz Levin's Capital Israel Business Network and Economic Mission of the Embassy of Israel (10.15.2009)

• Speaker,Commercializing Wireless-Life Sciences Technology Successfully, Wireless-Life Sciences Alliance 2009 Convergence Summit, La Jolla, CA (05.14.2009)

• Panelist,The Obama Administration: Immediate Steps in Regulation and Reforms,Healthcare Dealmaking Symposium 2009, The Deal, New York, NY (03.10.2009)

• Speaker,A Glimpse at the Healthcare Horizon: Predicting the Regulatory Landscape for 2009, Mintz Levin, San Diego, CA (02.26.2009)

 
Reported CasesRepresentative Matters: Counseled a full-service pharmacy benefit manager (PBM) and its affiliated companies in a merger with another pharmacy benefit management company, and served as lead counsel on the drafting and negotiation of related transaction documents between the parties, including ancillary services agreements and transition agreements; Counseled a global health care company in connection with its acquisition of health plans and provider groups; work included health regulatory due diligence in more than several health plan acquisitions and health regulatory advice regarding transaction structure and strategy, regulatory notices, and other filings; Counseled a large pharmacy benefit manager (PBM) in its negotiation of a PBM services agreement with a global health insurance company
 
ISLN920977796
 

Documents by this lawyer on Martindale.com

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CMS Issues Final Call Letter for 2015
Roy M. Albert,Susan W. Berson, April 11, 2014
Earlier this week, CMS announced in its Final Call Letter that Medicare Advantage rates would rise an average of 0.4 percent in 2015, instead of falling 1.9 percent as proposed in February. CMS’s shift in course may stem from the 1300 comments the agency received in response to...

Notice to Plans and PBMs: Pay for Contraceptive Services and Maybe We Will Pay You Back
Susan W. Berson,Tara E. Swenson,Bridgette A. Wiley, February 19, 2014
As has been widely covered in the news, regulations and guidance developed under the Affordable Care Act (“ACA”) require that non-grandfathered health plans make preventive care and screenings available to their members at no cost (i.e. no deductibles, coinsurance, or co-payments). The...

Final Mental Health Parity Rules Released
Susan W. Berson,Bridgette Wiley, November 14, 2013
The Departments of Health and Human Services, Labor, and the Treasury jointly issued a long-awaited final rule that implements the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA). The final rule decreases the differences between mental health...
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Office Information

Susan W. Berson

701 Pennsylvania Avenue, N.W.
WashingtonDC 20004-2608




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