Christine M. Clements

Christine M. Clements is a partner in the Healthcare Team in the firm's Washington, D.C. office with 25 years of experience on managed care law issues. Ms. Clements focuses her practice on federal health care government contract programs, with particular focus on the Medicare Advantage Program, the Medicare Prescription Drug Benefit, the Federal Employees Health Benefits Program, Medicaid managed care, and the Medicare-Medicaid Plans. Ms. Clements advises clients on the issues most important to them, including contract applications and service area expansions, responses to requests for proposals, rate development and bidding, medical loss ratio and other financial and reporting requirements, risk adjustment, Star ratings, sales and marketing, benefit design, employer/union group offerings, provider and vendor contracting and payment, internal audits, fraud and abuse, and compliance programs. Ms. Clements advises health plan clients in government audits and investigations. She also represents clients in administrative appeals including appeals of application denials, assessments of civil money penalties and Star rating/quality bonus payment determinations.

Ms. Clements counsels health plan and other clients on Health Insurance Portability and Accountability Act (HIPAA) privacy and security issues. She advises clients on permitted uses and disclosures under HIPAA and security breaches, negotiates business associate and limited data set agreements, and assists clients with other HIPAA compliance issues.

Ms. Clements also advises clients on state law requirements including insurance and HMO licensure requirement, net worth and other financial requirements, market conduct and other audits, state mandates and extraterritoriality requirements.

Previously Ms. Clements served as chief Medicare counsel at Aetna Inc., where she was responsible for the company's Consumer Segment. As chief Medicare counsel, Ms. Clements was the lead attorney for the company's Medicare Advantage and Medicare Prescription Drug Benefit businesses, Medicare Supplement products, and other retiree plans.

Ms. Clements has written and presented on the Medicare Advantage and Medicare Prescription Drug Benefit programs, the Federal Employees Health Benefits Program, and the HIPAA Privacy Rule, among other topics. 

• American Bar Association
• American Health Lawyers Association