Ross Margulies

Ross Margulies is a Partner with Manatt Health who helps clients navigate health care’s most complex legal, regulatory and legislative matters. Ross focuses his practice on supporting a diverse range of clients with federal and state legal and regulatory issues across the life sciences and broader health care industries, with a particular emphasis on Medicare and Medicaid law.

Offering coverage and coding advice, compliance counseling, legislative and policy strategy, and market access consulting, Ross works with providers, payers, biopharmaceutical companies, medical device manufacturers, digital health companies and other innovators seeking business-minded solutions that account for legal, regulatory, policy, and legislative considerations. He brings a proactive and attentive approach to client service to help advance clients’ business interests across some of the most urgent and impactful health care policies and innovations. He is a leading authority on the Medicare Part D program, the 340B Drug Pricing Program and the prescription drug provisions of the Inflation Reduction Act, including the Medicare Drug Price Negotiation Program.

Previously, Ross served in roles at the Office of the General Counsel at the U.S. Department of Health and Human Services and at the Health Resources and Services Administration. He also served as a Health Policy Fellow in the office of Vermont Senator Bernie Sanders. In addition to his work at Manatt, Ross provides regular pro bono advice to health care organizations servicing disadvantaged populations and is an Adjunct Professor of Law at Vanderbilt Law School where he teaches Medicare and Medicaid Law.

Ross Margulies
Partner
Washington, D.C.

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Ross Margulies

Ross Margulies is a Partner with Manatt Health who helps clients navigate health care’s most complex legal, regulatory and legislative matters. Ross focuses his practice on supporting a diverse range of clients with federal and state legal and regulatory issues across the life sciences and broader health care industries, with a particular emphasis on Medicare and Medicaid law.

Offering coverage and coding advice, compliance counseling, legislative and policy strategy, and market access consulting, Ross works with providers, payers, biopharmaceutical companies, medical device manufacturers, digital health companies and other innovators seeking business-minded solutions that account for legal, regulatory, policy, and legislative considerations. He brings a proactive and attentive approach to client service to help advance clients’ business interests across some of the most urgent and impactful health care policies and innovations. He is a leading authority on the Medicare Part D program, the 340B Drug Pricing Program and the prescription drug provisions of the Inflation Reduction Act, including the Medicare Drug Price Negotiation Program.

Previously, Ross served in roles at the Office of the General Counsel at the U.S. Department of Health and Human Services and at the Health Resources and Services Administration. He also served as a Health Policy Fellow in the office of Vermont Senator Bernie Sanders. In addition to his work at Manatt, Ross provides regular pro bono advice to health care organizations servicing disadvantaged populations and is an Adjunct Professor of Law at Vanderbilt Law School where he teaches Medicare and Medicaid Law.

Education

The George Washington University Law School, J.D., 2011

The George Washington University School of Medicine and Health Sciences, M.P.H., 2010

McGill University, B.A., 2007

The Hebrew University of Jerusalem, B.A. 2004

Accomplishments

  • Speaker, “One Big Beautiful Session,” Academy of Managed Care Pharmacy (AMCP), October 2025.

  • Speakers -- “Policy Outlook Panel: DC 2025 Endgame: RX Prices, PBMs, ACA Subsidies, NIH & Medicare Cuts,” Nephron Summit, September 2025.

  • Speaker, “Evaluating the Latest Developments in PHS 340B: New Pricing Guidance, ADR, and Contract Pharmacies,” BIG FOUR Pharmaceutical Pricing Boot Camp, June 2025

  • Panelist, “CMS Drug Price Negotiations: Reading the Redacted Room!,” ACCESS 2025, June 2025

  • Speaker, “Looking at IRA CMS Negotiations from the Driver’s Seat,” Eversana Pharma Pricing and Contracting Innovation Conference, March 2025

  • Speaker, “Fundamentals of Medicare Parts A though D and Enrollment,” AHLA Fundamentals of Health Law (November 2024)

  • Speaker, “Drug Pricing and Rebate Essentials and Introduction to Medicaid, Part 2.” American Conference Institute (November 2024)

  • “Medicare Drug Price Negotiation Program - Key Lessons & Recommendations from Those Who Lived IPAY 2026,” Verpora (September 2024) 

  • “Litigation Palooza: Antitrust, 340B, IRA Drug Price Controls & Other Legal Battles,” Nephron Summit (September 2024)

  • “Evaluating the Latest Developments in PHS 340B Pricing and Litigation,” the 18th Annual Big Four Pharmaceutical Pricing Boot Camp (June 2024)

  • “Health Care Reform and the Impact of PBM Legislation,” the Academy of Managed Care Pharmacy (AMCP) Annual Meeting (April 2024)

  • "Patient Definition Following Genesis v. HHS: Implications for 340B Stakeholders," The 340B Coalition Winter Conference (January 2024)

  • "Fundamentals of Medicare Parts A through D," American Health Law Association (AHLA) Fundamentals of Health Law Conference (November 2023)

  • "Analysis of the National Rebate Agreement and the Mechanics of the Rx Drug Rebate System" and "Understanding How Co-Pay Coupons, Accelerators, and Maximizers Impact Medicaid and Medicare Pricing and Rebates," American Conference Institute (ACI) 4th Annual Passport to Proficiency on Rx Drug Pricing & Rebate Fundamentals (November 2023)

  • "Implementing IRA Drug Pricing Provisions: What's Ahead?," Pharmaceutical Care Management Association Annual Meeting (October 2023)

  • "Prescription Digital Therapeutics: How PDTs Integrate Into the Treatment Paradigm," Crossroads: An Artia Solutions Conference (June 2023)

  • "Navigating U.S. Coverage and Reimbursement for Digital Therapeutics," Korea Health Industry Development Institute (KHIDI) USA's DTx Strategy Forum for Korean Digital Healthcare (September 2022)

  • “Understanding the Reimbursement Landscape for Prescription Digital Therapeutics,” BIO International Convention (June 2022)

  • “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 2021)

  • “Biden’s First 100 Days On Healthcare Part I and II,” Biopharma Congress 2020 (December 2020)

  • “Regulatory Issues Roundup,” AMCP Webinar (November 2020) 

  • “Medicare and Medicaid Legal Issues and Developments,” AHLA Virtual Health Plan Law and Compliance Institute (November 2020)

  • “Drug Pricing Reforms: The Impossible, Possible and Probable," AHLA’s Institute for Health Plan Law and Compliance Institute (November 2019)

  • “Deep Dive I: Perspectives on State and Federal Medicaid Policies,“ American Society of Gene & Cell Therapy Policy Summit (November 2019)

  • “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)  

  • "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) 

  • “Assess Potential for Changes to Pharmaceutical Pricing, Discounting, and Reimbursement for the Future,” 2019 CBI 7th Annual Reimbursement and Access (August 2019)

  • "Navigate the Legal Underpinnings of Patent Assistance and Gain Insight on OIG Oversight," PAP2019 (March 2019)

  • "Medicare and Medicaid Reimbursement Issues for New Emerging Technologies: Spotlight on CAR-T and Other Cell and Gene Therapies," AHLA Annual Institute on Medicare and Medicaid Payment Issues Conference (March 2019)

Best Lawyers in America - Ones to Watch, Health Care Law (2024, 2025)

High Honor, 2020-2021 Capital Pro Bono Honor Roll 

ABA-BNA Award For Excellence in the Study of Health Law

Admitted to practice in the District of Columbia, Maryland and Tennessee

Adjunct Professor of Law, Vanderbilt Law School

American Health Lawyers Association, Member

DC Bar Association

Tennessee Bar Association

  • Quoted, “Here’s what’s in the government funding agreement,” CNN, December 18, 2024.

  • Quoted, “To Improve Health Care, Repeal the Inflation Reduction Act,” The Washington Times, October 30, 2024.

  • Featured, “Manatt Adds 3 Partners to Health Care, Life Sciences Practices Amid 'Huge Demand',” The National Law Journal, August 13, 2024.

  • Featured, “Manatt Adds 3 Foley Hoag Healthcare Attys,” Law360, August 13, 2024.

  • As Republicans Rethink Medicaid, Rethink What Is ‘Health Care’, Huffington Post, Ross Margulies and Ruth Ann Norton (June 5, 2017)

  • Assessing and Addressing Legal Barriers to the Clinical Integration of Community Health Centers and other Community Providers, Ross Margulies (July 2011)

  • Tax-Exempt Hospitals and the Patient Protection and Affordable Care Act: Implications for Public Health Policy and Practice, Public Health Reports. Volume 126 (March–April 2011)

  • Rosenbaum S., Margulies R., Shah P. The HHS Departmental Appeals Board: Its Role in Shaping Medicaid Policy and an Overview of Recent Rulings. Kaiser Family Foundation (2010)

  • Lopez N., Margulies R., Rosenbaum S. Analysis of the extent to which State Medicaid Agencies have relayed the recent H1N1 CMS missive to Medicaid providers, Ready or Not? Trust for America’s Health (2009)

  • Rosenbaum S., Cartwright-Smith L., Margulies R., Wood S., Mauery R. An Analysis of the Implications of the Stupak/Pitts Amendment for Coverage of Medically Indicated Abortions. (Nov 16, 2009)

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