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  • Michael S. Kolber
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Michael S. Kolber

Kolber_Michael_New-2018-Bio-Template-730-x-730

Partner

Manatt Health
Contact
  • mkolber@manatt.com
  • Phone: 212.790.4568
  • Download vCard
  • New York
Bar Admissions
  • New York
Education
  • Harvard Law School, J.D., magna cum laude, 2009
    Supervising Editor, Harvard Law Review

    Yale University, B.A. with distinction in History, 2002

Services
  • False Claims Act
  • Government and Regulatory
  • Government Litigation and Administrative Law
  • Health Care Litigation
  • Health Care Transactions
Industries
  • Manatt Health

Show Full Bio

  • Profile
  • Experience
  • Speaking Engagements
  • Honors & Awards
  • Memberships
  • Publications
Profile

Profile

With a health law background in both government and private practice, Michael Kolber represents and advises health insurers, pharmaceutical manufacturers, health care providers, state and federal agencies, technology vendors, and others on implementation of health coverage issues, especially the Affordable Care Act (ACA), Medicare and Medicaid managed care, value-based purchasing, and employee benefits. He provides legal and policy advice with a particular focus on mental health parity; medical loss ratio reporting; pharmacy benefit management; risk adjustment in Medicare, Medicaid and commercial managed care; and health care nondiscrimination rules. He provides regulatory advice and advocacy, counsels clients on corporate transactions, and litigates in federal court and before administrative tribunals. Michael’s work often occurs at the intersection of public policy, regulatory advice and litigation.

Health care reform. Prior to joining Manatt, Michael was the lead legal adviser to the U.S. Department of Health and Human Services (HHS) on several key features of the ACA, including essential health benefits, health insurance exchanges and risk adjustment. Now, health insurers, actuarial consultants, state exchanges, technology vendors, health care providers and pharmaceutical manufacturers turn to Michael to advise them on complex regulatory questions, advocate on their behalf in front of key federal decision makers, and argue these issues when they arise in litigation. A frequent speaker and author on health care reform, Michael coauthored Bloomberg BNA’s treatise on the subject.

Employee benefits. Michael counsels health insurers, third-party administrators, benefits consultants and others on the interaction among ERISA, the ACA and other employee benefits laws. He has also performed analyses for states on how state efforts at provider payment and delivery system reform relate to self-insured employer health plans.

Federal health programs. Michael advises clients on many aspects of federal health care programs, including Medicare and Medicaid managed care, value-based contracting, prescription drug price reporting, price transparency, the Freedom of Information Act, and fraud and abuse laws.

Prior to joining Manatt, Michael was an attorney in the Centers for Medicare & Medicaid Services Division of the HHS Office of the General Counsel. He served as a law clerk to the Hon. Amalya L. Kearse of the U.S. Court of Appeals for the Second Circuit.

Experience

Experience

  • American Hospital Ass’n v. Azar, 983 F.3d 528 (D.C. Cir. 2020) (represented amicus Healthcare Financial Management Association in challenge of federal hospital price transparency regulation).
  • Ass’n of Community Cancer Centers v. Azar, No. CCB-20-3531, 2020 WL 7640818 (D. Md. Dec. 23, 2020) (represented plaintiff Global Colon Cancer Association in successful challenge to Medicare Part B “most favored nation” drug pricing demonstration).
  • Schmitt v. Kaiser Foundation Health Plan of Washington, No. 18-35846 (9th Cir. Aug. 27, 2020) (represented amici Association of California Life and Health Insurance Companies and California Association of Health Plans in health plan Affordable Care Act section 1557 disability discrimination litigation).
  • Morris v. California Physicians’ Service dba Blue Shield of California, No. 17-55878, 918 F.3d 1011 (9th Cir. 2019) (favorable first-impression appellate decision interpreting Affordable Care Act medical loss ratio reporting requirements for health insurers).
  • Texas v. Rettig, No. 18-10545 (5th Cir. Nov. 27, 2019) (filed amicus brief on behalf of Medicaid Health Plans of America regarding Medicaid managed care capitation rate actuarial soundness regulation).
  • AvMed, Inc. v. Centers for Medicare & Medicaid Services, No. C-17-444 (HHS Departmental Appeals Board Nov. 16, 2017) (obtained reduction in civil money penalty imposed on Medicare Advantage organization).
  • USAble Mutual Ins. Co. v. Hargan, No. 4:17-cv-00644 (E.D. Ark. Oct. 12, 2017) (challenge to Department of Health and Human Services regulation imposing minimum medical loss ratio requirement on Medicare Part D prescription drug plans).
  • Morris v. Blue Shield of California, No. CV16-05914, 2017 WL 1653938 (C.D. Cal. May 1, 2017) (successful defense of Blue Shield of California in $35 million class action regarding medical loss ratio rebates).
  • Berger v. Price, No. 5:17-cv-00025-FL (E.D.N.C. July 20, 2017) (successful defense of North Carolina Medicaid agency against suit by state legislative leaders to block Medicaid expansion).
  • Represented Brown University, in the formation of Brown Physicians, Inc.
Speaking Engagements

Speaking Engagements

Speaker, “Overview of Key Points and Considerations of the No Surprises Act,” 2022 Summer Forum, Workgroup for Electronic Data Interchange (WEDI), August 2, 2022, Chicago, IL.

Speaker, “Implementing the No Surprises Act,” Advocacy Insights Webinar Series, American Medical Association, January 20, 2022.

Speaker, “Hot Topic: Implementing the ‘No Surprises Act,’” State Advocacy Summit, American Medical Association, January 14, 2022, Amelia Island, FL.

Panelist, “Whose job is it anyway? Balancing Federal and State Surprise Billing Law Oversight and Enforcement,” Texas Covered Health Care Conference, Texas Association of Health Plans, November 10, 2021.

Speaker, “Surprise Billing: Federal versus the States – A Myriad of Oversight & Enforcement,” AHIP 2021 Annual State Issues Retreat, September 14, 2021.

Speaker, “Current Legal Issues in Medicaid,” AHIP’s National Conference on Medicare, Medicaid & Dual Eligibles, September 21, 2021.

Panelist, “Federal Update and Political Environment on Health Care Policy,” American Health Law Association Health Plan Law and Compliance Institute, November 5, 2020.

Panelist, “Regulatory State of the Union for Managed Care,” American Conference Institute 11th Annual Advanced Forum on Managed Care Disputes and Litigation, July 22, 2020.

Panelist, “Update on Federal Commercial Health Insurance Regulation,” American Health Lawyers Association Health Plan Law and Compliance Institute, November 13, 2019.

Speaker, “New Developments in Medicare Advantage Risk Adjustment,” American Health Lawyers Association Health Plan Affinity Group Open Member Call, February 7, 2019.

American Bar Association, Tort Trial and Insurance Practice Section, Midwinter Insurance and Employee Benefits Conference, “Association Health Plans: Legal Update & Analysis,” January 19, 2019.

Speaker, “Healthcare Costs: What’s a Fiduciary to Do?” American Bar Association Webinar, Sept. 6, 2018.

Speaker, “Explaining the Stewart v. Azar Decision and Implications for States,” Robert Wood Johnson Foundation State Health and Value Strategies, Webinar, July 24, 2018.

Speaker, "Litigation, Regulatory and Compliance Challenges Under Medical Loss Ratio Rules," American Health Lawyers Association Institute for Health Plan Counsel, Chicago, IL, November 14, 2017.

Panelist, “The Transformation of Private Health Insurance: The Affordable Care Act Five Years In,” American Health Lawyers Association (AHLA) In-House Counsel Program & Annual Meeting, Washington, D.C., June 29-July 1, 2015.

Speaker, “The Latest on Public Exchanges,” Society of Actuaries, Atlanta, GA, June 16, 2015.

Speaker, “Implications of King v. Burwell on the future of the ACA,” Southeastern Regulators Association Conference, Charleston, SC, April 30, 2015.

Speaker, “What’s Next for Health Plans: Opportunities and Challenges in 2015 and Beyond,” World Healthcare Congress, Washington, D.C., March 23, 2015.

Panelist, “Will ACA Reign Supreme in 2015?,” Bloomberg Intelligence State of Health Care Summit, New York, NY, February 13, 2015.

“2017 Innovation Waivers: The Future Is Right Around the Corner,” State Coverage Initiatives and State Health Reform Assistance Network webinar, December 4, 2014.

“Client briefing on King v. Burwell,” Bloomberg BNA webinar, November 2014.

Speaker, "Health Insurance Exchanges," American Academy of Orthopaedic Surgeons Annual Meeting, Washington, D.C., May 2, 2014.

Speaker, "Off to a Rocky Start: The Ongoing Implementation of Health Insurance Exchanges and Their Future Impact," Yale Healthcare Conference, New Haven, CT, April 11, 2014. 

Panelist, "The Dash to 2014: The Scramble to Implement Health Reform in Individual and Group Health Coverage," American Health Lawyers Association (AHLA) Annual Meeting, San Diego, CA, June 30-July 3, 2013.

Guest Lecturer, "Risk Adjustment, Reinsurance, and Risk Corridors," New York University Law School, New York, NY, 2013.

Guest Lecturer, "Adverse Selection and Risk Adjustment," George Washington University Law School, Washington, D.C., 2011.

 

Honors & Awards

Honors & Awards

“Rising Star” Recognition (Top Healthcare Attorney Under 40), Law360, 2017

Excellence in Legal Services Award, U.S. Department of Health and Human Services Office of the General Counsel, 2012

Best Paper in Administrative Law, Harvard Law School, 2009

First Place Short Paper, H. Thomas Austern Memorial Writing Competition, Food and Drug Law Institute, 2008

 

Memberships

Memberships

Admitted to practice in the U.S. District Courts for the Southern District of New York and the District of Columbia and in the U.S. Court of Appeals for the Ninth Circuit

Member, American Health Lawyers Association

Member, Association of the Bar of the City of New York, Health Law Committee

Publications

Publications

Co-author, “What Health Plans Should Know About Federal Changes for Dual Eligibles,” Manatt Health, December 2022.

Author, “Major Issues for Compliant Health Care Billing Practices Under the No Surprises Act,” American Health Law Association, May 6, 2022.

Quoted, “Insurers stretched provider bonuses, quality investment to avoid rebates, CMS says,” Modern Healthcare, February 1, 2022.

Quoted, “Buckle Up: Wild Ride Awaits Health, Life Sci Policy In 2022,” Law360, January 3, 2022.

Quoted, “Stakeholders Still Square Off, Lawsuits Continue Over Surprise Billing Rules,” InsideHealthPolicy, December 8, 2021.

Quoted, “Employers, Insurers Get Upper Hand in Surprise Billing Rule,” Bloomberg Law, July 6, 2021.

Quoted, “Key surprise billing ban details still murky for providers, insurers,” Modern Healthcare, July 2, 2021.

Quoted, “Plaintiffs’ Lawyer Finds Silver Lining In ACA Ruling; Next Steps Unclear,” InsideHealthPolicy, June 29, 2021.

Quoted, “Experts Consider Impacts of SCOTUS Affordable Care Act Decision,” HealthPayerIntelligence, June 21, 2021.

Quoted, “Where Does Healthcare Go After California V. Texas?,” HealthLeaders, June 18, 2021.

Quoted, “Experts: ACA likely safe from large-scale legal attacks after latest Supreme Court win,” FierceHealthcare, June 17, 2021.

Author, “Could next year be the beginning of the end of traditional employer-sponsored health insurance?” The Hill, August 20, 2019.

Author, “Work Requirements Litigation,” Robert Wood Johnson Foundation’s State Health and Value Strategies program, April 5, 2019.

Co-author, “Understanding the Rules: Federal Legal Considerations for State-Based Approaches to Expand Coverage in California,” California Health Care Foundation, February 2018.

Co-author, “The Future of Essential Health Benefits,” Health Affairs blog, February 14, 2017.

“King v. Burwell: What a Subsidy Shutdown Could Mean for…Consumers, Insurers, Health Care Providers and States,” Series of four articles prepared for The Commonwealth Fund blog, February 24-27, 2015.

Co-author, “How Consumers Might Game the 90-Day Grace Period and What Can Be Done About It,” Health Affairs blog, November 17, 2014.

Co-author, “Reference Pricing And Network Adequacy Standards: Conflict Or Concord?” Health Affairs, September 18, 2014.

Co-author, “Provider Payment Reform in New Hampshire: Legal Considerations for Policymakers,” Prepared for the New Hampshire Insurance Department, 2014.

Author, "Administrative Inefficiency in Coordination of Benefits," The Council for Affordable Quality Healthcare (CAQH) White Paper Series, 2014.

Co-author, "Affordable Care Act Implementation: Regulations, Models and Implications," Bloomberg BNA's Health Law & Business Series, 2013.

Author, "Opacity and Cost-Effectiveness Analysis in Medicare Coverage Decisions: Health Policy Encounters Administrative Law," Food & Drug Law Journal, 2009.

Author, "The Mysteries of the Congressional Review Act," Harvard Law Review, 2009.

Author, "Rulemaking Without Rules: An Empirical Study of Direct Final Rulemaking," Albany Law Review, 2009.

 

Michael in the News

  • 02.07.23

    Manatt Represents Medicaid Health Plans of America in the Supreme ...

    On January 6, 2023, Manatt attorneys filed an amicus brief on behalf of the Medicaid Health Plans of America in the U.S. Supreme Court in support o...

  • 01.03.23

    Manatt Advances 19 Legal and Consulting Professionals Across ...

    Manatt, Phelps & Phillips, LLP, a multidisciplinary, integrated professional services firm, announced today the advancement of 19 professionals, ...

  • 02.01.22

    Kolber Quoted in Modern Healthcare on Insurers Prioritizing Provider ...

    Manatt Health Partner Michael Kolber was quoted by Modern Healthcare about a rule recommended by the Centers for Medicare and Medicaid Services ...

  • 01.03.22

    Kolber and Rochman Quoted by Law360 on No Surprises Act Implementation

    Manatt Health Partner Michael Kolber and Litigation Partner Harvey Rochman were quoted in a Law360 article about how the No Surprises Act, ...

Show More

Michael's Articles

  • 12.15.22

    What Health Plans Should Know About Federal Changes for Dual Eligibles

    Approximately 12 million people in the United States are dually eligible for Medicare and Medicaid. Because dual-eligible individuals and health ...



  • 05.06.22

    Major Issues for Compliant Health Care Billing Practices Under the No ...

    Manatt Health Partner Michael Kolber authored an article for American Health Law Association on the implementation challenges surrounding ...



  • 08.20.19

    Could Next Year Be The Beginning Of The End Of Traditional ...

    “The same type of transformation that turned traditional pension plans into employee-directed 401(k)s may be coming for employer-sponsored ...



  • 04.16.19

    Work Requirements Litigation

    “On March 27, for the second time, a federal judge vacated the Centers for Medicare & Medicaid Services (CMS) approval of Kentucky’s ...



Show More


Michael's Newsletters

  • 02.13.23

    What Changes if the COVID-19 Public Health Emergency Ends May 11

    The Biden Administration has announced that May 11, 2023, will be the final day of the COVID-19 public health emergency (PHE) declaration, which ...

  • 02.09.23

    CMS Finalizes Medicare Advantage Risk Adjustment Rule

    On January 30, the Centers for Medicare & Medicaid Services (CMS) released a long-awaited final rule addressing how it will calculate and collect ...

  • 01.04.23

    What Health Plans Should Know About Federal Changes for Dual Eligibles

    Designed to better coordinate care between Medicare and Medicaid programs, a D-SNP enrolls only dual-eligible individuals.

  • 09.07.22

    No Surprises Act Final Rule Addresses Dispute Resolution Provisions ...

    On August 19, the Biden Administration released a final rule on the No Surprises Act that primarily addresses regulatory provisions invalidated by ...

Show More


Michael's Events and Webinars

  • 04.11.23

    Navigating the Rapidly Changing Medicare Advantage Regulatory ...

    Medicare Advantage (MA) plans now cover about half of Medicare beneficiaries, and with that enrollment growth has come increased scrutiny from ...



  • 09.28.22

    What Will the Midterm Elections Mean for Health Care?

    Americans are strongly focused on the upcoming midterm elections. An NBC News survey shows that 68% of Republicans and 66% of Democrats are ...



  • 09.22.22

    Implications Across the Health Care System of the New Federal Drug ...

    The Inflation Reduction Act of 2022 (IRA) includes the most dramatic change to U.S. drug price regulation in history. The new law allows the federal ...



  • 08.02.22

    Kolber to Speak at WEDI 2022 Summer Forum

    Manatt Health Partner Michael Kolber will present “Overview of Key Points and Considerations of the No Surprises Act,” at the opening ...



Show More
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