Kate McDonald

Kate’s practice centers on the managed care industry, including Medicare Advantage, Part D, Medicaid managed care, Affordable Care Act Marketplace plans, and the state regulatory regimes that govern risk-bearing and non-risk-bearing entities. She regularly advises health plans, providers, pharmacies, pharmacy benefit managers (PBMs), retailers, digital health companies, and administrative services vendors on the regulatory and contractual frameworks that influence their development of innovative offerings to consumers and commercial partnerships.  

Drawing on deep industry knowledge and practical business judgment, Kate helps clients navigate regulatory complexity while minimizing friction with regulators and commercial partners. She leverages her extensive regulatory experience to provide strategic advice to clients in connection with government investigations and qui tam litigation and to perform due diligence in connection with healthcare transactions.

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• Represented CVS Health in its acquisition of Oak Street Health, a leading multi-payor, value-based primary care company, for approximately $10.6 billion 

• Represented CVS Health Ventures in connection with its $100 million investment in Carbon Health, a primary and urgent care provider 

• Provided corporate, health, and tax representation for CVS Health in connection with the divestiture of Aetna Inc.’s standalone Medicare Part D prescription drug plans to a subsidiary of WellCare Health Plans, Inc. 

• Represented Medicare Advantage organizations and Part D plans in connection with successful administrative appeals of quality star ratings and application denials

• Counseled Part D plans and PBMs on related party arrangements, any willing pharmacy rules, and prescription drug pricing reform 

• Evaluated proposed business arrangements between health insurers, providers, and pharmacies for potential risks under the federal Anti-Kickback Statute, Beneficiary Inducement Civil Money Penalties Law, and False Claims Act 

• Provided strategic advice regarding demonstration programs sponsored by the Center for Medicare & Medicaid Innovation 

• Drafted and negotiated provider, vendor, and PBM agreements for health plans 

• Performed health regulatory due diligence on a provider organization specializing in high-touch in-home care for chronically ill patients 

• Represented healthcare organizations, venture capital funds, and private equity investors in connection with proposed investments in and acquisitions of health insurers and Health Maintenance Organizations (HMOs) 

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• Legal 500 US, Leading Lawyer in Healthcare, 2023 

• The National Law Journal, DC Rising Star, 2023 

• Legal 500 US, Next Generation Partner in Healthcare, 2019-2022 

• McDermott Will & Schulte, Client Service Award, 2019 

• American Health Lawyers Association, Pro Bono Champion, 2014 

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