Elisa Y. Muller, Of Counsel

Biography

Elisa focuses her practice on assisting clients with regulatory and contractual issues affecting managed care, pharmacy benefit management (PBM), and various pharmacy settings, including retail, specialty, mail order, and long-term care. She assesses risks and legal implications of client's activities subject to a variety of government regulations, including the False Claims Act, Affordable Care Act, Controlled Substances Act, federal and state Anti-Kickback statutes, CMS Part D Regulations, Department of Insurance regulations, and HIPAA.

Her representative legal experience includes:

  • Contracting:
    • Negotiating and drafting service, purchase, and licensing agreements
    • PBM-network provider agreements, including chain pharmacies, PSAOs, independents, mail order pharmacies, and specialty pharmacies
    • Review and negotiate employer or health plan PBM RFPs
    • Rebate agreements, including on behalf of PBMs and specialty pharmacies
  • Develop template agreements for client use and negotiation
  • Provide tailored and strategic support to clients for novel products and services based on applicable regulations and industry needs and direction
  • Privacy:
    • Advise PBM on HIPAA and HITECH
    • Advise on state health privacy laws (where applicable)
  • Regulatory:
    • Advise PBM on various state regulatory matters, including MAC, anti-clawback, and pharmacy audits and appeals
    • Federal and state fraud, waste, and abuse compliance
    • Advise on cash card related regulatory issues, including marketing and copays
  • Discount/cash cards:
    • Draft and negotiate terms related to cash cards in various PBM-pharmacy network agreements
    • Draft and negotiate terms for PBM-cash card client agreement

Prior to joining the firm, Elisa served as an associate general counsel for a PBM. She is also a licensed pharmacist.

Legal Services

Education and Honors

  • John Marshall Law School (J.D., 2006)
  • University of Illinois at Chicago College of Pharmacy (Pharm.D., 2003)
  • University of Illinois at Urbana-Champaign (B.S., 1999)

Bar Admissions

  • Illinois

Court Admissions

  • U.S. Patent and Trademark Office