Health Insurance Industry Partners (PBMs, TPAs, DMPOs and URAs)
Legal counsel delivering value and experience for pharmacy benefit managers, third-party administrators, utilization review agents and discount medical plan organizations
Capabilities at a glance
- A dedicated team of experienced attorneys who lead the industry in representing health coverage payor entities and their partners, including pharmacy benefit managers (PBM), third-party administrators (TPA), utilization review agents (URA) and discount medical plan organizations (DMPO).
- Legal support built on understanding each client’s needs, the business of health care in general and evolving legal requirements in all 50 states.
- Serving as comprehensive regulatory counsel, we help keep you up to speed on licensing, reporting and compliance requirements across the country.
Practical legal and strategic guidance suited to your business needs
In addition to representing health insurance companies and self-funded plans, our firm’s Health Law attorneys represent entities hired by or under contract with health coverage payors to provide valuable services related to claims processing and health care utilization. This includes PBMs, TPAs, URAs and DMPOs. Providing such guidance efficiently requires not only understanding each client’s unique business needs, but also understanding the business of health care generally. Specific to PBMs, TPAs, URAs and DMPOs, our experience includes licensing, reporting and compliance requirements in all 50 states, managing business transactions such as formations, mergers and acquisitions (M&A), and designing and implementing clinical integration programs.
Extensive experience and knowledge of PBMs, TPAs, URAs and DMPOs
What sets our Health Insurance Industry Partners team apart is our knowledge of the entirety of the legal landscape affecting PBMs, TPAs, URAs and DMPOs. This area is rapidly evolving, and our team engages in ongoing analysis and evaluation of state and federal laws affecting these entities. We have the depth and breadth of industry knowledge along with years of experience resolving the day-to-day legal and strategic business issues confronting our clients. Over decades, we have built relationships with regulators that allow us to successfully advocate for our clients’ interests; this often enables us to influence proposed statutes and regulations before they go into effect. Our clients receive this level of experience and knowledge in a practical, proactive and cost-effective manner.
