J.D., Cornell Law School
B.A., cum laude, University of Vermont
Senior Editor, Cornell International Law Journal
Bar and Court Admissions
District of Columbia Bar
Supreme Court of the United States
U.S. Court of Appeals for the Ninth Circuit
U.S. Court of Federal Claims
U.S. District Courts for the District of Columbia and District of Maryland
Kathryn’s practice is at the intersection of three industry groups: health care, insurance, and government contracts. For three decades she has represented health care insurers and affiliates in their work with federal health care programs (including Medicare, Medicaid, the Federal Employees Health Benefits Program, and TRICARE). From government contractors of administrative services to insurers and managed care organizations with underwriting risks, all must navigate complex regulations and government oversight. Kathryn has devoted a significant part of her practice to representing these clients in procurement matters, litigation, and regulatory disputes arising under Medicare law, the Federal Employees Health Benefits Act, and the Affordable Care Act (ACA); defending Medicare contractors in complex False Claims Act investigations and qui tam suits; and negotiating complex pharmacy benefit management (PBM) contracts.
Kathryn is co-chair of the firm’s Health Care Group and also chair and founder of the firm’s specialty practice for property and casualty (P&C) insurers with Medicare obligations. Her unique practice mix has positioned her as a recognized thought leader on Medicare secondary payer issues for these insurers, including how to meet their “Section 111” reporting and reimbursement obligations. Read more here.
- For insurers:
- Counsels on health care policy, legislation, and regulatory matters.
- Advises on the application of federal health care law to the businesses of P&C insurers and specialty lines.
- Counsels and writes frequently on a wide range of Medicare secondary payer (MSP) issues:
- Obligations of “group health plans” and “non-group health plans” (also known as “NGHPs,” which include liability, no-fault, and workers’ compensation carriers) to reimburse Medicare for “conditional payments;”
- Voluntary Medicare set-aside (MSA) arrangements and other structured settlements;
- MSP claims audits;
- Internal legal reviews and related voluntary self-disclosures and remediation plans;
- Mistaken payments and the working aged rule;
- MSP statute of limitations;
- Mandatory reporting obligations of P&C insurers (or non-group health plans) under Section 111 of the Medicare, Medicaid, and SCHIP Extension Act of 2007 (MMSEA); Section 111 penalties; and
- Classification of professional liability and accident & health insurance under Section 111.
- Often cited articles include:
- "Dispelling Medicare Myths in Tort Settlements", DRI's For The Defense (May 2013).
- "Broad Application of Medicare’s Mandatory Insurer Reporting Requirements to Non-U.S. Property & Casualty Carriers Flouts Supreme Court Limitations on Extraterritorial Reach of U.S. Law", Insurance Coverage Law Report (July 2014).
- Wiley Rein's Section 111 Bulletins (2009 to present).
- Defends health care and P&C insurers in administrative proceedings and related appeals challenging MSP reimbursement demands.
- Defends insurers in MSP False Claims Act litigation.
- Audits MSP compliance programs for P&C insurers and works hand-in-hand with their Medicare compliance vendors.
- Advises on Medicare Advantage (MA) and Medicare Part D program compliance and associated contract administration matters for MA organizations (MAOs) and Prescription Drug Plans (PDPs).
- For health care government contractors:
- Counsels on health care policy, legislation, and regulatory matters.
- As lead counsel, routinely defends cases brought by Medicare providers and suppliers against Medicare contractors in federal court; all have ended in dismissal.
- Defends government contractors in investigations, suits, and third-party actions under the False Claims Act, having achieved government declination or resolution prior to intervention in more than a dozen cases.
- Litigates bid protests before the U.S. Government Accountability Office (GAO) and the Court of Federal Claims, including the successful defense of the first Medicare Administrative Contractor (MAC) award in DME Jurisdiction D in 2006 and subsequent Cycle Two MAC protests.
- Successfully arbitrated a state health insurance exchange/IT dispute between prime and subcontractor resulting in a $11 million award, defeating related claims in federal district court and resolving an umbrella state/prime contract performance dispute.
- Advises on cybersecurity and data rights and privacy issues for Medicare contractors.
- Counsels on compliance with the Anti-Kickback laws and the Federal Acquisition Regulation (FAR) Mandatory Disclosure Rule.
- Defends cost audits before federal agencies and litigates final audit decisions before Boards of Contract Appeals.
- Prepares contracts, subcontracts, affiliate agreements, contractor certifications, and administrative claims.
- Advises Medicare contractors on contractor performance issues, suspension and debarment matters, and contractor reporting obligations.
- Assesses cost allowability and allocability issues under the FAR.
- For a broad array of commercial entities:
- Leads internal investigations for compliance officers and general counsel.
- Negotiates PBM contracts (retail, mail order, and specialty drugs) and counsels on related pharmacy benefit issues, including rebate contracting. Read more here.
- Conducts health care due diligence for mergers and acquisitions.
- Implements and reviews corporate compliance programs.
- American Bar Association (ABA)
- Vice-Chair (2004-2005) and Member, Accounting, Cost & Pricing Committee, Section of Public Contract Law
- Procurement Fraud and Health Care Contracting Committees, Section of Public Contract Law
- Section of Health Law
- American Health Lawyers Association (AHLA)
- America’s Health Insurance Plans (AHIP)
- Board of Trustees, The Barker Adoption Foundation
- Received 2013 Burton Award for Distinguished Legal Writing for "Supreme Court Affirms Opportunities and Uncertainties for Health Care Contractors"
- Received 2016 Richard B. Barker Award for leadership contributions to The Barker Adoption Foundation
- Wiley Rein Pro Bono Champion (2014, 2016, and 2017)
- Past Member, Firm Management Committee and Vice-Chair, Pro Bono Committee
News & Insights
- March 28, 2018 | PRESS RELEASEHHS Office for Civil Rights Director Roger Severino Leads Discussion on Health Care Regulation and Cybersecurity at Wiley Rein LLP
- November 7, 2017 | PRESS RELEASE
- September 18, 2017 | ALERTKathryn Bucher, Margaret D. Thomas
- June 21, 2017 | ALERT
- May 22, 2017 | ALERTKathryn Bucher
- August 24, 2016 | ALERTSummer 2016 Round Up of Section 111 and Medicare Secondary Payer Developments for Liability InsurersKathryn Bucher
- November 24, 2015 | ALERTKathryn Bucher
- March 6, 2015 | ALERTCMS Final Rule Establishing Right of Appeal for Medicare Secondary Payer Determinations Raises Important Issues for Liability Insurers
- February 13, 2015 | ALERTRound Up of Notable Medicare Reporting and Reimbursement Developments for Property and Casualty Insurers
- September 18, 2014 | ALERTNew Section 111 Guidance Amends Decades-Old CMS Practice of Identifying Medicare Beneficiaries by Full Social Security Numbers
- September 8, 2014 | ALERTSummer Round Up On Notable Medicare Reporting And Reimbursement Developments For Property And Casualty Insurers
- July 16, 2014 | ALERTRichard McConnell and Kathryn Bucher Author Insurance Coverage Law Report Article on Limitations to Extraterritorial Application of Medicare Section 111 Reporting Requirements to Non-U.S. Property and Casualty CarriersKathryn Bucher
- July 2014 | ARTICLEBroad Application of Medicare’s Mandatory Insurer Reporting Requirements to Non-U.S. Property & Casualty Carriers Flouts Supreme Court Limitations on Extraterritorial Reach of U.S. LawInsurance Coverage Law ReportKathryn Bucher
- December 20, 2013 | ALERTCMS Holds First Town Hall in Five Months for Non-Group Health Plans; Seeks Public Comment on Section 111 Reporting Penalties
- August 1, 2013 | ALERTMedicare To Issue Mandatory Insurer Reporting Guidance On Amended Complaints, Specialty Line Reporting Exceptions, And SMART Act RegulationsKathryn Bucher
- June 28, 2013 | ALERTThe Real Scoop on the Purported Insurer Duty "to Protect Medicare's Interest" and Pay for Future MedicalsKathryn Bucher
- May 2013 | ARTICLEDRI's For The DefenseKathryn Bucher
- May 20, 2013 | ALERTKathryn Bucher
- April 18, 2013 | PRESS RELEASEJim Slattery, Kathryn Bucher, Daniel Graham and Kate McDonald Receive 2013 Burton Award for Distinguished Legal Writing
- April 15, 2013 | ALERTMedicare Narrows Required Reporting By Insurers; Town Hall Reveals Disconnect With Insurers On Key Questions Regarding Pre-1980 ExposuresKathryn Bucher
- January 4, 2013 | ALERTCongress Passes Long-Awaited Reforms To The Medicare Secondary Payer Recovery Process, Including Elimination Of SSN Reporting, But Built-In Regulatory Delays Could Postpone Insurer ReliefKathryn Bucher
- October 25, 2012 | New Orleans, LA | SPEAKING ENGAGEMENTWhen the Players Are All in—Successfully Resolving High Stakes Litigation in the Twenty-First Century (Section 111 Developments)DRI's 2012 Annual MeetingKathryn Bucher, Speaker
- September 25, 2012 | ALERTHouse Committee Moves SMART Act Forward; Medicare Reaffirms Position on Mandatory Insurer Reporting Under Accident & Health and Short-Term Travel PoliciesKathryn Bucher
- Summer 2012 | NEWSLETTERSupreme Court Decision Upholding Affordable Care Act Affirms Contracting Opportunities in Insurance Exchanges and Medicaid
- July 16, 2012 | ARTICLEBloomberg BNA's Health Care Policy ReportKathryn Bucher
- July 6, 2012 | ALERTCMS Releases Revised NGHP User Guide But Fails To Provide Expected Guidance On Important Unresolved Section 111 IssuesKathryn Bucher
- June 21, 2012 | ALERTKathryn Bucher
- June 15, 2012 | ALERTCMS Solicits Comments Defining Obligations To "Protect Medicare's Interests" When Settlement Involves "Future Medicals"Kathryn Bucher
- April 27, 2012 | ALERTGAO and Federal Court Weigh in on Section 111 Infirmities But It's Business as Usual for CMS During Town Hall CallKathryn Bucher
- March 26, 2012 | ALERTSection 111 Town Hall Call Again Addresses MSP Recovery Rights of Medicare Advantage Plans Against Casualty InsurersKathryn Bucher
- February 29, 2012 | ALERTFirst Section 111 Town Hall of 2012 Highlights Need for Further Clarification of Reporting Responsibilities and Frustration Over Improper Claim Denials for Which Insurers Are Taking the HeatKathryn Bucher
- December 20, 2011 | ARTICLEInsurance Law360Kathryn Bucher
- November 28, 2011 | ALERTCMS Dodges Tough Questions Regarding Medicare Benefit Denials and Perpetuates Confusion Over Reportable Amounts During Recent Section 111 Town Hall TeleconferenceKathryn Bucher
- October 25, 2011 | ALERTCMS Town Hall Teleconference and Recent Alert Further Muddy the Waters on Section 111 Reporting and Mass Torts IssuesKathryn Bucher
- October 5, 2011 | ALERTCMS Confirms Another Delay Of Section 111 Reporting For "Certain" Claims Payments But Major Issues Remain UnsettledKathryn Bucher
- September 30, 2011 | ALERTKathryn Bucher
- September 22, 2011 | ALERTKathryn Bucher
- September 7, 2011 | ALERTKathryn Bucher
- September 1, 2011 | ALERTKathryn Bucher
- July 28, 2011 | ARTICLEProperty Casualty 360Kathryn Bucher
- July 19, 2011 | ARTICLELaw360Kathryn Bucher
- July 7, 2011 | ALERTSection 111 Bulletin: Congress Holds Hearing on Improving Medicare Secondary Payer Big Picture While CMS Remains Mired in Section 111 Reporting DetailsKathryn Bucher
- June 30, 2011 | ALERTSection 111 Bulletin: Court Denies Federal Private Right of Action to Medicare Advantage Plan Seeking to Step Into Secondary Payer Shoes of Medicare to Sue Liability InsurerKathryn Bucher
- April 15, 2011 | ALERTSection 111 Bulletin: CMS Solicits Industry Comments During "Mass Torts" Working Group Call and Promises to Fast-Track GuidanceKathryn Bucher
- April 8, 2011 | ALERTSection 111 Bulletin: CMS Town Hall Adds To Confusion Over Section 111 Reporting Obligations Of Accident and Health Insurers; Controversy Emerges Over Insurer's "Duty To Protect Medicare's Interests"Kathryn Bucher
- March 24, 2011 | ALERTHouse Introduces Section 111 Reform Bill—If Enacted, Would Remove SSN Reporting Obligation, Create Safe Harbor Reporting Practices and Require Earlier Notice to Insurers of Final Amount Owed MedicareKathryn Bucher
- March 13, 2011 | Newport Beach, CA | SPEAKING ENGAGEMENTComing to Terms with Healthcare Reform in the Travel Insurance Industry2011 UStiA Annual ConferenceKathryn Bucher, Speaker
- March 11, 2011 | ALERTSection 111 Bulletin: CMS Announces Date of "Mass Torts" Working Group Call and Addresses RRE Questions During Policy and Technical Town Hall TeleconferenceKathryn Bucher
- March 1, 2011 | ALERTSection 111 Bulletin: CMS Releases Long-Awaited Guidance for Foreign Insurers; Reporting Exception for Professional Liability Lines Remains Under ConsiderationKathryn Bucher
- February 14, 2011 | ALERTKathryn Bucher
- December 16, 2010 | ALERTSection 111 Bulletin: CMS Clarifies Delay of TPOC Reporting for Liability Insurers During December 9 Town Hall and Issues New AlertsKathryn Bucher
- November 15, 2010 | ARTICLESection 111 Bulletin: CMS Delays TPOC Reporting Requirements for Liability Insurers By One Year; Other Alerts and November 10 Town Hall Clarify Existing GuidanceKathryn Bucher
- October 22, 2010 | ALERTKathryn Bucher
- August 5, 2010 | ALERTSection 111 Bulletin: CMS Announces "Major and Significant Changes" in Revised User Guide for NGHPs During July 28th Town Hall TeleconferenceKathryn Bucher
- July 7, 2010 | ALERTSection 111 Bulletin: June 30th NGHP Town Hall Teleconference: Confusion and Uncertainties over Deductibles Continue; No Progress on Significant Issues Awaiting ClarificationKathryn Bucher
- June 11, 2010 | ALERTSection 111 Bulletin: June 10th CMS Teleconference Draws Many Questions on New Direct Data Entry Reporting OptionKathryn Bucher
- June 1, 2010 | ALERTSection 111 Bulletin: CMS Announces Five New NGHP Alerts During May 27th Town Hall NGHP TeleconferenceKathryn Bucher
- April 30, 2010 | ALERTSection 111 Bulletin: April 28th Town Hall NGHP Teleconference Reveals No Major Developments in Agency GuidanceKathryn Bucher
- March 17, 2010 | ALERTSection 111 Bulletin: March 16, 2010 Town Hall Teleconference Overview: CMS Takes Stock of Its To-Do ListKathryn Bucher
- March 12, 2010 | ALERTSection 111 Bulletin: Legislative Fix Introduced in Congress to Section 111 Reporting Hurdles; Bill Also Seeks Broader MSP ReformsKathryn Bucher
- March 4, 2010 | ALERTSection 111 Bulletin: A Closer Look at Medicare's Significant Revisions to Mandatory Insurer Reporting Guidance for Property and Casualty InsurersKathryn Bucher
- February 26, 2010 | ALERTSection 111 Bulletin: CMS Significantly Revises Mandatory Insurer Reporting Guidance for NGHP Responsible Reporting EntitiesKathryn Bucher
- February 18, 2010 | ALERTKathryn Bucher
- February 2, 2010 | ALERTKathryn Bucher
- January 6, 2010 | ALERTSection 111 Bulletin: Overview of CMS December 29, 2009 Alert for Foreign Insurers and January 5, 2010 "Town Hall" TeleconferenceKathryn Bucher
- December 16, 2009 | ALERTKathryn Bucher
- December 9, 2009 | ALERTKathryn Bucher
- December 4, 2009 | ARTICLENo Port In A Storm? Crucial Safe Harbor Still In Doubt under New Medicare Section 111 Reporting RequirementsInsurance Coverage Litigation ReporterKathryn Bucher
- November 19, 2009 | ALERTKathryn Bucher
- November 4, 2009 | ALERTKathryn Bucher
- October 30, 2009 | ARTICLESection 111 Bulletin: October 22 Section 111 Town Hall Teleconference: Confusion Continues over 1980 Cutoff Date for MSP Liability and Collection of Social Security NumbersKathryn Bucher
- October 2009 | ARTICLENew Medicare Reporting Requirements for Self-Insured Businesses Kick In: Many Questions Remain UnansweredThe Metropolitan Corporate Counsel Vo. 17, No. 10Kathryn Bucher
- October 7, 2009 | ARTICLESection 111 Bulletin: CMS Teleconferences of September 30 and October 6, 2009 Address Section 111 Registration IssuesKathryn Bucher
- August 10, 2009 | ALERTSection 111 Bulletin: CMS Posts New Version of User Guide and Requests Public Comment on Draft Language Further Defining the Responsible Reporting Entity under MMSEA Section 111Kathryn Bucher
- July 28, 2009 | ALERTSection 111 Bulletin: Long-Term Implications of Medicare Reporting Requirements and Reimbursement Liabilities for Casualty InsurersKathryn Bucher
- July 7, 2009 | ALERTThomas W. Brunner, Kathryn Bucher
- May 29, 2009 | ALERTSection 111 Bulletin: CMS Provides Liability, No-Fault and Workers' Compensation Insurers More Time to Prepare for Mandatory Medicare ReportingKathryn Bucher
- April 20, 2009 | ALERTSection 111 Bulletin: CMS Clarifies Mandatory Medicare Reporting Requirements For Liability, No-Fault, and Workers' Compensation InsurersKathryn Bucher
- March 9, 2009 | ARTICLELiability and Workers' Compensation Carriers Be Warned-Deadlines Loom for New Medicare Reporting Requirements that Carry Steep Civil Money PenaltiesBloomberg Law ReportsKathryn Bucher, Thomas W. Brunner