Conference Speakers Announced!
Bipartisan Experts to Discuss Trends in Federal Health Care Policy
Rodney Whitlock, Ph.D.
Partner
McDermott+
Rodney is an accomplished health care advisor with more than two decades on the Hill where he specialized in rural health, the health care safety net and disability policy.
With more than 30 years of experience, Rodney possesses and offers clients the kind of knowledge that is uniquely available to those who have drafted and advanced legislation. He strategically guides clients through dense Medicare and Medicaid issues that have significant business impact.
While working in Congress, Rodney served as former US Representative Charlie Norwood’s (R-GA) health policy director where he managed the Patients’ Bill of Rights (S.1890), among other notable health policy matters. Rodney then went on to serve Senator Chuck Grassley (R-IA) in the Senate. He first joined the Senate Finance Committee Staff as a health policy advisor to Chairman Grassley, and ultimately joined the Senator’s personal office as health policy director. During his time in the Senate, Rodney served as the lead Republican staffer for Medicaid legislation from 2005 to 2010, and continued to serve Senator Grassley on all health-related issues through 2015. During his time in the Senate, Rodney helped staff Republicans in the Senate on such prominent and important legislation as the Deficit Reduction Act of 2005, Tax Relief and Health Care Act of 2006, CHIP Reauthorization Act of 2007 and 2009 and Affordable Care Act of 2010.
For the last 25 years, Rodney has been an adjunct faculty member at the George Washington University Milken Institute School of Public Health’s Department of Health Policy and Management, and the Graduate School of Political Management’s Department of Legislative Affairs. Hundreds of students have taken Rodney’s courses and have gone on to pursue careers in Washington, DC.
Kristi Martin
Former Chief of Staff and Senior Advisor
Center for Medicare
Centers for Medicare & Medicaid Services (CMS)
Kristi Martin provides policy expertise and strategic counsel to advance meaningful health policy that focuses on improving the health and wellbeing of people while delivering practical policy solutions. She draws on more than 20 years of experience working in the public sector, with private sector clients, and in philanthropy. Most recently, Kristi served as the chief of staff and senior advisor to the deputy administrator in the Center for Medicare at the Centers for Medicare & Medicaid Services (CMS). While serving at CMS, she played a significant role advancing regulatory policy in Medicare and implementing the Inflation Reduction Act — the most significant changes to Medicare Part D since its inception. Kristi facilitated and coordinated the implementation of the Medicare Drug Price Negotiation Program, which successfully negotiated the first set of drug prices under the Medicare Drug Price Negotiation Program that will save people with Medicare and the program billions of dollars on prescription drug costs as well as contributed to a wide range of other policy and operational initiatives that have made Medicare better than ever.
Kristi previously was the Vice President for Health Care at Arnold Ventures where she led the philanthropy’s prescription drug pricing portfolio and was the Managing Director of Waxman Strategies’ health practice where she worked alongside Congressman Henry Waxman to drive outcomes in health policy. She has previously served several years in the U.S. Department of Health and Human Services, Office of Personnel Management, and Government Accountability Office. As a senior advisor in the Obama administration’s Office of Health Reform, she had primary oversight responsibility for the coordinated and timely implementation of cross-cutting departmental public health and prevention initiatives under the Affordable Care Act, including addressing the rising cost of drugs and setting up the women’s preventive services initiative.
She received her bachelor’s and master’s degrees in health communication from the University of Kentucky and a Master of Public Administration from George Washington University.
Conference to Address What’s Next in Behavioral Health in the U.S.
Caroline Carney, M.D., Ph.D.
Chief Executive Officer, Magellan Health
Caroline P. Carney, MD, MSc, FAPA, FAPM, CPHQ is a board-certified general psychiatrist, consultation-liaison psychiatrist, and internist who is a senior advisor for Healthsperien. Dr. Carney has nearly thirty years of experience in clinical care, integrated care program development, healthcare policy, managed care, quality improvement, research and medical education. Dr. Carney is the author of over one hundred peer and non-peer reviewed articles, and is sought after to speak at conferences and appear on podcasts regarding integrated care models, the effects of social media on youth, climate change and the effect on mental health, managed care, and other topics of the day.
Dr. Carney began her career in academic medicine where she won awards for teaching and patient care. She oversaw the Med/Psych residency program at the University of Iowa and later developed and ran the psychosocial oncology program for Indiana University’s NCI certified comprehensive cancer center. Her NIMH-funded research focused on the delivery of medical care to persons with mental illness and substance use. She began her managed care career serving as the behavioral health medical director for Wellmark BCBS. Dr. Carney transitioned from academic medicine to work as the Chief Medical Officer for Indiana’s Office of Medicaid Policy and Planning (OMPP). While in this role, she implemented the state’s first value-based contracts with MCOs serving the Medicaid populations and served on the leadership team overseeing the state’s behavioral health transformation. She served on the Governor’s Mental Health Commission, and was on the board of Mental Health America and the Greater Indianapolis YMCA.
After her work at OMPP she was the Chief Medical Officer for MDWise, a regional health plan serving Medicaid and Exchange populations. Her role included oversight of cost of care management, quality, utilization management, provider network, provider relations, medical economics, and behavioral health. During this time she designed and implemented integrated care models that were a precursor to CCBHCs. She later joined Magellan Health, starting as a senior vice president for behavioral health, and eventually becoming Chief Medical Officer, overseeing Magellan RX Management, Magellan Behavioral Health, Magellan Specialty Care, and Magellan Federal and later became the president of the behavioral health company. During this time she was a member of the AHRQ’s national advisory council, co-chaired the National Quality Forum’s Opioid and Behavioral Health task force for two terms, and was a member of the National Quality Forum’s behavioral health quality measures committee in addition to other national committee work. Most recently she co-chaired the Kennedy Forum’s Behavioral Health Quality committee and the Behavioral Health Data committee. Her other work includes advising start-ups and serving on the ABHW board of directors and the Coalition to Empower Our Future.
Dr. Carney is an active clinician and is the Chief Medical Officer for behavioral health at an FQHC in northern Indiana. In this role, she created a stand-alone behavioral health clinic that is integrated into the FQHC and serves a catchment area stretching across northern Indiana and southern Michigan.
Dr. Carney is a graduate of Loras College (BSc) and the University of Iowa College of Medicine (MD, MSc).
Top News
Federal Government Shutdown Update: CMS Staff to Return This Week
The federal government shutdown continues, with no progress in funding negotiations and growing strain on health and nutrition programs. The Centers for Medicare & Medicaid Services (CMS) announced plans to recall roughly 3,000 furloughed employees, nearly half its workforce, this week. The agency will temporarily fund these staff through “user fees” collected from outside researchers, with reimbursement expected once Congress restores federal appropriations. This move will help CMS resume critical operations, including support for Medicare open enrollment, which begins November 1.
Democrats continue to urge swift action to extend the Affordable Care Act’s Advanced Premium Tax Credits (APTCs) ahead of open enrollment on November 1, warning that millions could face steep increases in health care costs if the enhanced credits lapse. Republican leaders argue that the extension should wait until the broader funding dispute is resolved. Members of the House Democratic Women’s Caucus emphasized that women could see an average $1,000 annual increase in health costs without an extension.
Although GOP leadership has shown little interest in negotiating an extension of the enhanced tax credits, some Republican lawmakers have indicated they would support a narrower measure contingent upon a myriad of changes to the tax credits. Potential changes include capping eligibility at a certain income level and requiring recipients to make a minimum premium contribution. However, marketplace experts have cast doubt on the feasibility of implementing and operating such changes before the subsidies expire at the end of the calendar year. GOP-supported alternatives being discussed would instead extend the current form of subsidies for one additional year, with proposed changes implemented the following year.
Atlantic Event: The Next Frontier for Affordable Drugs
The rising cost of prescription drugs continues to strain purchasers, patients, providers, and the broader healthcare system. On Thursday, October 23, The Atlantic hosted The Next Frontier for Accessible Medicines in Washington, D.C., to explore how policymakers and industry leaders can expand access to life-saving treatments by strengthening the generic and biosimilar markets.
One panel featured Alex Keeton, Executive Director of the Biosimilars Council and Policy Team Lead at the Association for Accessible Medicines (AAM), and Matt Erick, Chief Commercial Officer at Biocon Biologics. The discussion highlighted ongoing barriers to biosimilar development, noting that only 10% of drug patents set to expire in the next decade have a biosimilar currently in development.
Senator Ben Ray Luján (D-NM) emphasized the need for congressional action to reduce barriers to interchangeability—allowing biosimilars to be substituted for brand-name biologics without prior authorization. Luján, alongside Senators Maggie Hassan (D-NH) and Mike Lee (R-UT), recently introduced the Biosimilar Red Tape Elimination Act, which would simplify the process of categorizing biosimilars as interchangeable with their brand-name counterparts.
The final panel, featuring Dr. Kelly Anderson of Brigham and Women’s Hospital and Dr. Kim Maxfield of Biocon, examined industry hesitancy to invest in biosimilar development. They also discussed international approaches that could inform U.S. policy, including ways to streamline FDA approval while maintaining rigorous safety standards.
Congressional Action
CBO Report Finds Exclusion of Orphan Drugs from Medicare Negotiations will Cost $8.8 Billion Over 10 Years
The Congressional Budget Office (CBO) released a report estimating that the exclusion of several orphan drugs from the Medicare drug price negotiation program (DPNP) will cost 8.8 billion dollars over 10 years. Initially, CBO estimated the costs of the orphan drug exclusion provision in the One Big Beautiful Bill Act (OBBBA) to cost the federal government an additional 4.9 billion dollars. The new estimate reflects updated information about the eligibility of Johnson & Johnson’s Darzalex, Merck’s Keytruda and Bristol Myers’ Opdivo for price negotiation. Notably, the CBO analysis does not incorporate Centers for Medicare and Medicaid Services’ September guidance on the inclusion of Medicare Advantage spending in determination of drug rankings for future Part B and Part D negotiations.
In response, House Energy and Commerce Committee Ranking Member Frank Pallone (D-NJ-06), House Ways and Means Committee Ranking Member Richard E. Neal (D-MA-01), and Senate Finance Committee Ranking Member Ron Wyden (D-OR) released a joint statement expressing their frustration with the Republicans’ health policies in the OBBBA. Democratic leaders stated the OBBBA’s orphan drug provision gives “… an enormous $8.8 billion sweetheart deal to Big Pharma companies at the expense of seniors.”
Bipartisan Push Aims to Accelerate Generic Market Entry and Lower Drug Prices
Two senators at the center of current government funding talks have reintroduced legislation targeting tactics used by brand-name drugmakers to delay generic competition, a move that could have ripple effects across the broader drug pricing market.
The Ensuring Timely Access to Generics Act, co-sponsored by Senate Appropriations Chair Susan Collins (R-ME) and Sen. Jeanne Shaheen (D-NH), would give the FDA authority to swiftly dismiss “frivolous” citizen petitions that brand manufacturers use to stall generic drug approvals. The reintroduction comes as part of broader negotiations that could shape a bipartisan health care compromise amid the ongoing shutdown and discussions over Affordable Care Act premium tax credits.
Supporters say the bill could accelerate generic entry and reduce prices through competition—though the Congressional Budget Office projects its overall fiscal impact would be modest. CBO found that policies targeting individual barriers, like citizen petitions, would likely speed generic approvals by six months to two years but affect less than 10% of drugs entering the market annually.
Still, Senator Shaheen emphasized the consumer impact: “By increasing competition, our bipartisan legislation would help bring more generic drugs to the market and reduce costs for the families who rely on them.”
While advocates pushed for the measure’s inclusion in last year’s stalled health package, its reemergence suggests generic market reforms may regain momentum in upcoming negotiations.
Senate Aging Committee Proposal Could Reshape the Generic Drug Market
A new bipartisan proposal from the Senate Special Committee on Aging aims to reduce dependence on foreign pharmaceutical manufacturing and strengthen domestic production of generic drugs.
Committee Chair Sen. Rick Scott (R-FL) and Ranking Member Sen. Kirsten Gillibrand (D-NY) are calling on the Trump administration to establish a federal buyer’s market for essential generic drugs, prioritizing products made with U.S.-manufactured active pharmaceutical ingredients (APIs) and key starting materials (KSMs). The plan, outlined in a new committee report, would initially be managed by the Defense Department and later expanded to other federal purchasers, including CMS and the VA.
The proposed system would leverage the government’s position as the largest single purchaser of prescription drugs—accounting for more than 40% of outpatient sales—to drive long-term market changes. By rewarding manufacturers that produce domestically, the buyer’s market could reshape incentives across the supply chain, spurring investment in U.S.-based pharmaceutical production and reducing exposure to foreign supply shocks.
The report frames the issue as both a public health and national security concern, citing data showing that 83% of top U.S. generic drugs lack domestic API sources and that serious adverse events are significantly higher for drugs made overseas.
While the plan would take years to implement, experts say its ripple effects could be far-reaching—potentially influencing drug pricing, supply stability, and the competitive landscape of the global generics market. If enacted, it would represent one of the most ambitious federal efforts in decades to re-anchor the pharmaceutical supply chain within the United States.
While the plan would take years to implement, experts say its ripple effects could be far-reaching—potentially influencing drug pricing, supply stability, and the competitive landscape of the global generics market. If enacted, it would represent one of the most ambitious federal efforts in decades to re-anchor the pharmaceutical supply chain within the United States.
Save the Date
21st Annual Conference
Wednesday, November 5 – Friday, November 7, 2025
The Mayflower Hotel, Washington, D.C.
Visit: Healthcare Roundtable Events – HealthCare Roundtable
