Profil
Eileen Hayes advises health insurers, pharmacy benefit managers (PBMs), dental carriers, and other health care entities on complex insurance regulatory matters, with a particular focus on New York Department of Financial Services (DFS) requirements. She also regularly advises life insurers and property and casualty insurers on regulatory and transactional matters.
Eileen represents clients in high-stakes filings, examinations, investigations, and transactions requiring regulatory approval, including matters involving complex regulatory frameworks affecting health, life, and property and casualty insurers. She develops regulatory strategies and submissions in matters involving direct engagement with DFS and other regulators, drawing on a practical, regulator-informed perspective to help clients pursue business objectives, manage regulatory risk, and navigate sensitive and high-impact regulatory interactions.
Her practice spans a broad range of insurance and health care regulatory issues, including product development, rate and form filings (including SERFF filings), licensure, market conduct and financial examinations, enforcement matters, corporate governance, and transactions requiring regulatory approval, as well as compliance with complex regulatory regimes such as mental health parity. She is particularly experienced in advising on product design and operational and structural issues affecting regulated entities.
In addition to her deep DFS experience, Eileen advises clients on multi-state and national regulatory issues, including the intersection of state insurance requirements and federal law, particularly the ACA and ERISA. She counsels clients on product design, claims administration, and compliance obligations across jurisdictions, including for nonprofit health insurers and other mission-driven organizations, as well as specialized products such as long-term care insurance.
She also played a leadership role in the implementation of the Affordable Care Act (ACA) in New York, advising DFS, the New York State Department of Health, and other state and federal stakeholders on regulatory coordination and compliance.
Eileen represents leading industry trade associations, including the New York Health Plan Association, the Life Insurance Council of New York, the National Association of Dental Plans, the New York Land Title Association, and NAIFA-New York, in connection with regulatory and legislative advocacy. Working closely with Greenberg Traurig’s government affairs team, she works with policymakers and advises members on the development and implementation of new laws, regulations, and guidance, while providing clients with insight into industry trends, priorities, and emerging regulatory developments.
Drawing on over 20 years prior experience working within New York government at DFS, Eileen provides strategic insight into regulatory decision-making and enforcement priorities, seeking to enable clients to anticipate regulatory expectations and position matters for desired outcomes.
Kluczowe Praktyki
Doświadczenie
- Advises and represents health insurers, PBMs, and dental carriers in complex regulatory matters before the New York Department of Financial Services (DFS)—including high-stakes filings, examinations, and enforcement matters—and before other state regulators nationwide.
- Represents health, life, and property insurers and managed care organizations in market conduct examinations, audits, and regulator-facing submissions, developing legal and strategic positions with the goals of addressing examination findings and mitigating enforcement risk.
- Represents pharmacy benefit managers (PBMs) and producers and related entities in connection with licensure, regulatory compliance, and transactions, including change-of-control approvals, and advises on evolving state regulatory frameworks, including issues at the intersection of state regulation and federal law.
- Advises insurers, PBMs, and related entities in transactions requiring regulatory approval, including change-of-control applications, restructurings, and other strategic transactions, and works with clients to structure transactions to meet DFS and other regulatory requirements.
- Guides insurers, PBMs, and plan sponsors on the interaction between state insurance law and federal requirements, including the ACA and ERISA, in connection with product design, claims administration, examinations, and regulatory submissions.
- Advises on product development and administration, including utilization review, medical necessity determinations, and claims adjudication requirements under New York law, with application to multi-state product offerings.
- Represents health insurers in complex compliance initiatives and regulatory submissions, including mental health parity testing and large-scale filings, and advises on associated regulatory expectations, examination risk, and enforcement considerations.
- Represents leading insurance and health care industry trade associations in regulatory and legislative advocacy, working closely with policymakers and advising members on the development and implementation of new laws, regulations, and guidance.
- Counsels clients on evolving regulatory requirements, including DFS cybersecurity obligations and other emerging state regulatory frameworks, and assists with implementation and compliance strategy.
- Provides strategic regulatory advice informed by prior government experience, including assessing how regulators—particularly DFS—are likely to interpret and enforce requirements and positioning filings, transactions, and submissions.
- Assistant Chief, New York State Department of Financial Services (DFS), Health Bureau, 2008-2013
- Attorney, New York State Insurance Department, Health Bureau, 1994-2008
- Supervising Attorney, 2001-2008
- Associate, 1998-2000
- Legal Intern, Gov. Mario Cuomo’s Office, 1994
- Legal Intern, Legal Services for the Elderly, 1994
Wyróżnienia i aktywność zawodowa
- Listed, The Best Lawyers in America, Health Care Law, 2023-2026
- Listed, The Legal 500 United States, 2018-2025
- "Leading Partners," Industry Focus - Healthcare - Health Insurers, 2025
- "Next Generation Partners," Industry Focus - Healthcare - Health Insurers, 2018-2024
- Team Member, BTI Power Rankings, “The 16 Strongest Firms for ‘Go-To Outside Counsel’ Insurance Work,” 2016
Wykształcenie i uprawnienia do wykonywania zawodu
- J.D., cum laude, State University of New York at Buffalo Law School
- B.A., summa cum laude, State University of New York at Albany
- New York