Ross Margulies

Partner - Washington, D.C.

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Clients looking to succeed in the heavily regulated U.S. healthcare marketplace rely on Ross Margulies for his unique ability to advise on complex legal and regulatory issues and frame them within the broader public policy context. An experienced healthcare attorney, Ross brings a proactive approach to client management, helping providers, payers, biopharmaceutical and medical device manufacturers, and other innovators navigate federal and state healthcare regulatory matters, including in the Medicare, Medicaid, and 340B programs.

Since joining Foley Hoag in 2010, Ross has provided his clients with expert strategic counseling on regulatory and administrative processes, and coverage and reimbursement matters. Healthcare providers, payers, pharmacy benefit managers, manufacturers, managed care pharmacies, technology companies, and healthcare startups have relied on Ross to navigate complex issues related to Federal and state healthcare legal and regulatory matters.

Ross has a special expertise in Medicare and Medicaid law, including coverage, reimbursement, and regulatory oversight. He is a co-author of the firm's Medicaid & the Law blog, www.medicaidandthelaw.com, which highlights and explains current legal and policy issues in the Medicaid program. He represents his clients before the United States Congress and the Centers for Medicare & Medicaid Services (CMS) and other components of the Department of Health and Human Services (HHS), the Department of Labor, and the Internal Revenue Service.

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Education:

  • George Washington University Law School, J.D., with honors, 2011
  • George Washington University School of Medicine and Health Sciences, M.P.H., 2011
  • McGill University, B.A., magna cum laude, 2007

Languages:

Hebrew

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In The Media

 

Honors

  • High Honor, 2020 Capital Pro Bono Honor Roll  (April 2021) 
  • ABA-BNA Award For Excellence in the Study of Health Law

Involvement

  • American Health Lawyers Association, Member
  • Health Care Compliance Association, Member
  • DC Bar Association
  • Tennessee Bar Association
  • Panelist, “The Changing Face of the Medicaid Program: A Review of Recent Trends in State Medicaid Waivers,” AHLA Virtual Institute on Medicare and Medicaid Payment Issues (March 26, 2021)
  • Panelist, “Health Care Policy in the Courts,” Webinar (March 25, 2021)
  • Panelist, “Biden’s First 100 Days On Healthcare Part I and II,” Biopharma Congress 2020, Webinar (December 14, 2020)
  • Speaker, “Will the Affordable Care Act Survive California v. Texas? Understanding the Possible Outcomes and Unpacking the Supreme Court Oral Arguments,” Webinar (November 12, 2020) 
  • Speaker, “Regulatory Issues Roundup,” Webinar, AMCP (November 6, 2020)  
  • Panelist,  “Medicare and Medicaid Legal Issues and Developments,” AHLA Virtual Health Plan Law and Compliance Institute, Webinar (November 5, 2020) 
  • Speaker, “The Changing Face of the Medicaid Program: A Review of Recent Trends in State Medicaid Waivers,” Webinar,  [AHLA] American Health Law Association (September 24, 2020) 
  • Speaker, “Electronic Notifications & Interoperability: Satisfying New Conditions of Participation Requirements,” Webinar, (May 20, 2020)  
  • Speaker, “Public Health and Social Services Emergency Fund: Compliance Best Practices; Avoiding Liability Missteps,“ Webinar, (April 30, 2020)  
  • Speaker, “Implications for Managed Care Pharmacy from 2021 and 2022 Medicare Advantage and Part D Proposed Rule,” Webinar, AMCP (March 23, 2020)
  • Speaker, “Drug Pricing Reforms: The Impossible, Possible and Probable," AHLA’s Institute for Health Plan Law and Compliance Institute  (November 2019)
  • Speaker, “Deep Dive I: Perspectives on State and Federal Medicaid Policies,“ American Society of Gene & Cell Therapy [ASGCT] Policy Summit (November 2019) 
  • Speaker, “The Times They Are a-Changin” – A look at Congressional Efforts to Reform the Medicare and Medicaid Prescription Drug Programs, AMCP Nexus 2019 (October 2019)   
  • Speaker, "Keynote Legal Perspective: The Drug Pricing Landscape – A Survey of Current and Future Legal and Regulatory Reforms," 11th Annual Managed Markets and Account Management Strategies Conference (September 2019)  
  • Speaker, “Assess Potential for Changes to Pharmaceutical Pricing, Discounting, and Reimbursement for the Future,” 2019 CBI  7th Annual Reimbursement and Access (August 2019) 
  • Speaker, "A Federal and State Legislative and Regulatory Update for the Home Care Aide Council," Home Care Aide Council Annual Spring Conference (June 2019)
  • “HHS’ Rule To Change AKS Safe Harbor Protection for Rebates in the Drug Supply Chain," Webinar (April 2019)
  • Speaker, "Navigate the Legal Underpinnings of Patent Assistance and Gain Insight on OIG Oversight," PAP2019 (March 2019)
  • Speaker, "Medicare and Medicaid Reimbursement Issues for New Emerging Technologies: Spotlight on CAR-T and Other Cell and Gene Therapies," American Health Lawyers’ Association Annual Institute on Medicare and Medicaid Payment Issues Conference (March 2019)
  • Speaker, “Biotech & Pharmaceutical Patient Access Forum,” 2016 CBI PAP Conference (March 2016)
  • "Can State Medicaid Agencies Restrict Access to Life-Saving Therapies Based on Cost?," Webinar (July 2014)
  • Speaker, "After Obamacare – Opportunities and Challenges for Healthcare Investing," Angel Capital Association 2014 ACA Summit (March 2014)
  • "Will the Six Protected Class Rule Become a Thing of the Past?," Webinar (January 2014)
  • Speaker, "Final Regulations under the Mental Health Parity and Addiction Equity Act: Substance, Legal Implications and Compliance," American Bar Association webinar (December 2013)
  • Speaker, "Assuring Patient Access to Treatments," U.S. Conference on Rare Diseases & Orphan Products: The New Era in Health Care (October 2013)
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Bar Admissions

  • District of Columbia
  • Maryland
  • Tennessee