Marc Samuels

Marc leads ADVI Health’s focus on bringing data- and experience-informed strategic guidance and tools to the complete healthcare ecosystem – from life sciences and digital health, to managed services, providers, key trade, patient, and provider associations. Unique to the company’s data-informed advisory business, ADVI has an Innovator License through CMS’ Virtual Research Data Center (VRDC) that allows for research and analyses using 100% Medicare Parts A, B, and D claims (with one month lag) and 100% Medicaid and Medicare Advantage claims (both with 1-2 year lag).

Marc still engages in client work; often related to the evolution of the relationship and roles of the Centers for Medicare and Medicaid Services (CMS) and the US Food and Drug Administration (FDA) as both evolve to manage and excel within a changing healthcare ecosystem and working to find solutions to the coding and reimbursement issues plaguing cell and gene therapies, a large part of the changing ecosystem forcing new ways of addressing high cost, extremely high value therapies within both the public and private payer environment.

Marc has been lucky to play a role in over 200 product and service projects over the last two decades from cell and gene, to rare and ultra-rare to oncology, and digital therapies including nearly every seminal payment and coverage decision made by CMS. He understands what works, and what doesn’t, and has been called one of the best kept secrets for those seeking to work with CMs and payers. He was also recognized as a top lobbyist for Medicare by the Boston Globe and his former firm, HillCo Partners, is consistently ranked as the top advocacy firm in Texas by Texas Monthly and other publications.

Marc spent 10 years in the public healthcare sector, most recently as the Chief of Staff to Texas Medicaid, the state’s largest healthcare program at $24.5 billion (over 25 percent of the Texas state budget). He coordinated Medicaid and Health Care Regulation Policy with other state agencies, the legislature, the Governor’s Office and the federal government. He implemented Texas’ first Medicaid managed care plan law as well as the enactment and operation of S-CHIP. Marc has worked widely across the US healthcare system to improve regulatory and payer policy, promote appropriate clinical outcomes, and highlight the importance of the patient experience. Marc spent the early part of his career in various roles within the Texas state and the U.S. federal governments, including advising both former President George Herbert Walker Bush and then Texas Governor George W. Bush on healthcare issues in the White House Office of Policy Development, the office responsible for policy coordination across the Administration, and the Texas Governor’s Office of Policy, respectively. He was involved in the directive to improve the nation’s drug (and device) approval process while serving the President’s Council on Competitiveness under Vice President Dan Quayle. Marc also worked for the Midwest AIDS Behavioral Research Institute; having published a body of work on the neuropsychological signature to the AIDS virus.

Marc, who has been named one of the most popular lobbyists for Medicare by The Boston Globe, speaks frequently on business strategy and policy matters. His comments and analyses have appeared in STAT News, The Pink Sheet, Fierce Healthcare, the Journal of Oncology Practice, Medical Economics, the Fort Worth Star-Telegram, the Dallas Morning News, and Texas Medicine. He is a contributor to the third edition of the Managed Care Answer Book and the second edition of the HMO and Capitation Answer Book, published by Panel Publishers, New York. He is policy counsel to the National Comprehensive Cancer Network (NCCN), a Visiting Fellow at the Duke Margolis Center for Health Policy where he will focus, among other topic areas, on the evolution of the relationship and roles of the Centers for Medicare and Medicaid Services (CMS) and the US Food and Drug Administration (FDA) as both evolve to manage and excel within a changing healthcare ecosystem and working to find solutions to the coding and reimbursement issues plaguing cell and gene therapies, a large part of the changing ecosystem forcing new ways of addressing high cost, extremely high value therapies within both the public and private payer environment. He is also a board member of the ADAPT and RISE programs at the Rosenman Institute of the University of California San Francisco.

Marc attended the Yale School of Public Health, the University of Texas School of Law, and the University of Michigan, where he focused on neuroscience.