Bridgette advises clients in the health insurance industry, including managed care organizations, PBMs, and integrated delivery systems, ACOs, and providers on a variety of regulatory, fraud and abuse, and business planning matters. Her practice centers on compliance with federal health care program regulatory requirements, with a focus on reimbursement issues and value-based contracting.
Bridgette regularly counsels clients regarding risk-adjusted reimbursement programs and the practices that support them, including Medicare Advantage Organizations (MAOs) and ACOs participating in the Medicare Shared Savings Program (MSSP). Bridgette has experience conducting and defending investigations regarding fraud and abuse issues, including billing compliance related to Medicare, Medicaid, and TRICARE. She also works closely with discount medical plans (DMPOs) and other clients in the health care industry on matters relating to compliance with state regulations.
Bridgette is interested in value-based healthcare. She works closely with payors, providers, and ACOs, on a variety of innovative collaborations and has experience negotiating and papering these relationships.
With a background in health care operations, Bridgette is able to provide clients with practical insight that includes a focus on the business implications of health care regulatory and compliance, internal investigations, and fraud and abuse analyses of proposed new procedures. Bridgette applies her experience in health system administration and ethics in health care to her health law practice. Prior to practicing law, she worked as a health care ethicist at the Department of Veterans Affairs National Center for Ethics in Health Care (NCEHC) and held other health system operations positions within VHA.
Most recently, Bridgette began hosting Health Law Diagnosed, Mintz’s health law podcast and she is a frequent author on Mintz’s Health Law Viewpoints.
Experience
- Counsels clients regarding Medicare Advantage risk adjustment compliance, including responses to OIG and CMS RADV audits.
- Assists with communication and advocacy with federal health care program regulators, including CMS and the HHS OIG.
- Drafts and negotiates complex services agreements between health plans and PBMs.
- Monitors changes and developments in state laws that impact the PBM industry and other related stakeholders.
- Conducts internal investigations into potential fraud and abuse matters and manage multiple key stakeholders.
- Develops and implements compliance reviews to recommend and identify compliance best practices.
- Assisted with the defense and settlement of a five-year False Claims Act investigation conducted by multiple U.S. Attorney’s Offices and DOJ’s Civil Division on behalf of a national health care provider. We successfully convinced the Office of Inspector General for the Department of Health and Human Services not to pursue a Corporate Integrity Agreement.
- Represented a national health care provider in a False Claims Act investigation conducted by the U.S. Attorney’s Office for the Southern District of New York. The government ultimately declined to intervene, and the relator chose to voluntarily dismiss the case.
- Assisted with the defense of a diagnostics company in a national criminal and civil investigation involving multiple US Attorneys’ Offices and state Attorneys' General Offices. The investigation involved alleged kickback issues and billing violations.
viewpoints
Health Law Diagnosed – EnforceMintz: Analyzing Health Care False Claims Act Cases
April 18, 2023 | Podcast | By Bridgette Keller, Karen Lovitch , Brian Dunphy, Eoin Beirne
Bridgette Keller speaks with Karen Lovitch, Brian Dunphy, and Eoin Beirne about the Mintz Health Care Enforcement Defense Practice’s recent edition of the EnforceMintz newsletter, Analyzing Health Care False Claims Act Cases, and key health care enforcement trends.
Mintz Health Law: What We Are Grateful For
January 11, 2023 | Podcast | By Bridgette Keller
Bridgette Keller speaks with the Mintz Health Law team about what they are grateful for as they look back on a year of client service, mentorship, and working together as a team.
PBM Regulatory Roundup (Fall 2022): State Medicaid Enforcement Efforts Continue As Legislative Activity Slows Down
November 14, 2022 | Blog | By Bridgette Keller, Hassan Shaikh
Though the flurry of state PBM-focused legislation slowed down with the summer recess, there has still been plenty of noteworthy PBM news. This roundup focuses on state Medicaid enforcement activities involving Centene and provides a brief overview of recent legislative activity.
Health Law Diagnosed – The Regulatory Landscape of Value-Based Primary Care: Top 5 Matters for Aledade’s Regulatory Counsel
November 4, 2022 | Podcast | By Bridgette Keller
Bridgette Keller speaks with Bre Hitchen, Regulatory & Operations Counsel at Aledade, Inc., about the most important topics on Bre’s mind as she works to support Aledade’s business teams with regulatory counsel and compliance advice.
MintzRx Newsletter — Your Prescription for the Pharmaceutical Supply Chain
October 3, 2022 | Article | By Theresa Carnegie, Tara E. Dwyer, Xavier Hardy, Stephnie John, Bridgette Keller, Lauren Moldawer, Pat Ouellette, Hassan Shaikh
MintzRx is a regular newsletter providing you with everything you need to know to stay abreast of the legal, regulatory, and industry developments across the pharmaceutical supply chain.
Senate Democrats Pass Long-Awaited Drug Pricing Reforms in Budget Reconciliation Bill
August 10, 2022 | Blog | By Bridgette Keller, Stephnie John
On August 7, 2022, after extensive deliberation, Senate Democrats passed their long-awaited reconciliation bill, the Inflation Reduction Act of 2022 (the Reconciliation Bill). In addition to climate and tax provisions, the Reconciliation Bill includes a revised drug pricing reform package that Democrats had approved last month. In this post, we review what passing the long-awaited drug pricing reforms means for Medicare recipients and for drug prices in the United States.
PBM Regulatory Roundup (Summer 2022): States Continue PBM Oversight Activities
August 2, 2022 | Blog | By Bridgette Keller, Hassan Shaikh, Derek Flynn, Shaina Sikka
2022 continues to see a surge in state-led PBM enforcement efforts. This roundup provides a brief summary of Louisiana’s complaint against United Healthcare and OptumRx related to its Medicaid program and recent state legislative actions.
Health Law Diagnosed – Medical-Legal Partnerships: Leveraging a Cross-Disciplinary Approach to Improve Health Outcomes
July 18, 2022 | Podcast | By Bridgette Keller, Jean D. Mancheno
Bridgette Keller speaks with Kerlann Flowers, Legal Director and Senior Attorney for Hofstra University School of Law’s Medical-Legal Partnership (MLP), and Mintz Associate Jean Krebs about the MLP’s work and how collaboration between medical providers and lawyers can improve outcomes.
PBMs Continue to Draw Federal Scrutiny: PBM Transparency Act of 2022
June 30, 2022 | Blog | By Bridgette Keller, Hassan Shaikh, Sergey Smirnov, Jewel Duberry-Douglas
As we noted in our last PBM Regulatory Roundup, there has been a wave of state regulation focused on PBM practices in the wake of Rutledge and Webhi. However, PBMs are also facing federal reform efforts. The Pharmacy Benefit Manager (PBM) Transparency Act of 2022 (the Act) was recently proposed in the U.S. Senate and intends to incentivize “fair and transparent” PBM practices, prohibit spread pricing and claw backs of payments to pharmacies, and empower the Federal Trade Commission (FTC) and state attorneys general in enforcement actions to stop “unfair and deceptive” PBM business practices.
At the same time, government watchdogs are also taking action: on June 7, 2022, the FTC announced that it would launch an inquiry into vertically integrated PBMs, and the Office of the Inspector General (OIG) for the Department of Health and Human Services expects to release a report in 2022 following completion of its analysis of Medicaid Managed Care Organization (MCO) PBM pricing.
Health Law Diagnosed – Digital Health During the PHE and Beyond: Leveraging Telehealth to Address Disparities in Access to Care
June 14, 2022 | Podcast | By Bridgette Keller, Cassandra Paolillo
Telehealth has the potential to counteract historical disparities in access to health care. Listen to hear how Andy Ward, Director of the South Boston Collaborative Center, and Kate Steinle, Chief Clinical Officer of Folx Health, are leveraging telehealth to serve their communities.
News & Press
Twenty-nine Mintz Attorneys Named to 2023 New York Metro Super Lawyers List
September 22, 2023
NEW YORK – Mintz is pleased to announce that 18 attorneys have been named New York Metro Super Lawyers and 11 attorneys have been named New York Metro Rising Stars by Super Lawyers for 2023.
Twenty-six Mintz Attorneys Recognized as 2022 New York Super Lawyers and Rising Stars
September 29, 2022
17 Mintz attorneys have been named New York Metro Super Lawyers and nine Mintz attorneys have been named New York Metro Rising Stars by Super Lawyers for 2022.
Events & Speaking
Legal, Ethical, and Practical Issues for Vaccine Credentials and Verification for Workplaces
Lawline
Online Event
Recognition & Awards
Included on the New York Super Lawyers Rising Star: Health Care list (2020-2023)
ABA-BNA Award for Excellence in the Study of Health Law
Involvement
- Member, American Health Lawyers Association (AHLA)
- Member, American Bar Association (ABA)
- Member, American College of Healthcare Executives (ACHE)