Mary Anne Hilliard – Children’s National

Purpose-driven leadership often reveals itself not through visibility but through sustained impact. At Children’s National, that impact is felt across patient care, research, compliance, and organizational culture. As executive vice president and chief legal officer, Mary Anne Hilliard brings a rare combination of clinical experience, legal acumen, and mission-centered leadership to one of the nation’s most respected pediatric health systems. Her work sits at the intersection of care delivery, regulatory complexity, and organizational trust, shaping how the institution protects its mission while continuing to innovate for children and families.

Mary Anne Hilliard | Children’s National | Executive vice president and chief legal officer

Children’s National Hospital stands as a cornerstone of pediatric care in the Mid-Atlantic region and beyond. Consistently ranked among the top 10 pediatric hospitals nationwide, it is nationally recognized for excellence in cancer treatment, neurology, orthopedics, and other highly specialized fields. Beyond clinical care, the hospital’s research institute and pediatric surgical innovation center underscore a deep commitment to advancing medical knowledge. With substantial funding from federal agencies such as the National Institutes of Health, Children’s National plays a leading role in shaping the future of pediatric medicine. Its collaboration with the HSC Health Care System further expands access for individuals with complex healthcare needs, integrating specialized facilities and therapies to reduce barriers to essential services.

Against this backdrop, Hilliard’s leadership reflects both continuity and evolution. Her career at Children’s National spans disciplines and decades, rooted in a foundational belief that healthcare is fundamentally about service and teamwork.

Early foundations in care & law

Hilliard’s path to the executive suite did not follow a conventional legal trajectory. She began her career at Children’s National as a nurse, working directly with patients and clinical teams. That early experience shaped her understanding of the hospital not as an abstract institution, but as a living system where decisions ripple outward to affect patients, families, and caregivers. After attending law school, she chose to return to Children’s National, bringing her legal training back to the environment that had first defined her professional purpose.

Her dual background quickly became a differentiator. As both a clinician and a lawyer, Hilliard understood the pressures facing frontline staff as well as the regulatory frameworks governing healthcare delivery. Early in her legal career, she recognized that risk management in healthcare was less about enforcement and more about communication. At a time when transparency was not yet a widely embraced standard, she helped guide Children’s National toward a more open and accountable culture, building reporting systems that encouraged collaboration rather than fear.

“Healthcare is a team sport,” Hilliard says.

That philosophy became a cornerstone of her leadership style. Rather than positioning the legal function as a gatekeeper, Hilliard worked to embed it as a trusted partner across the organization. Her nursing background gave her credibility with clinicians, while her legal expertise allowed her to translate complex regulations into practical guidance. Over time, this approach helped the organization manage risk more effectively while reinforcing trust and shared responsibility.

Building trust through transparency

As Hilliard’s responsibilities expanded, so did her influence on organizational culture. Today, she leads a legal and compliance organization of approximately 40 professionals, supporting a vast and complex health system. Her teams are involved in a wide range of initiatives, from governance and contracting to regulatory compliance, litigation management, and strategic program development. Despite that breadth, the unifying thread remains the mission.

Hilliard has long believed that transparency is essential to both patient safety and organizational resilience. By fostering open communication and robust reporting, she helped Children’s National move beyond reactive risk management toward a proactive, learning-oriented model. Issues are surfaced earlier, addressed collaboratively, and used as opportunities for improvement rather than blame.

This cultural shift has had tangible effects. Leaders across the hospital increasingly view the legal department as a resource rather than an obstacle. Whether supporting clinical innovation, advising on research partnerships, or navigating operational challenges, Hilliard’s team works alongside stakeholders to find solutions that align compliance with care delivery.

Her leadership style emphasizes clarity and consistency. Team members are encouraged to understand not only what the rules are, but why they exist and how they serve the organization’s broader purpose. That perspective is especially critical in healthcare, where regulations are both numerous and constantly evolving.

Navigating regulatory change in healthcare

Few industries experience regulatory change as rapidly or as consequentially as healthcare. Shifts in federal and state policy, often driven by changes in administration, can reshape reimbursement models, compliance requirements, and operational expectations. For Children’s National, staying ahead of these changes is essential to maintaining both excellence in care and financial sustainability.

Hilliard and her team play a central role in that effort. By closely monitoring regulatory developments and interpreting their implications, the legal department helps the organization adapt without losing momentum. This work often happens behind the scenes, but its impact is significant. Timely guidance enables leaders to implement new programs, adjust existing practices, and avoid costly disruptions.

Her approach to regulatory compliance is grounded in partnership. Rather than issuing directives in isolation, Hilliard works with operational leaders to integrate compliance considerations into planning and execution. This collaborative model ensures that regulatory requirements are addressed in ways that support, rather than hinder, patient care and innovation.

Her clinical background again proves valuable here. Having firsthand knowledge of care environments allows her to assess how regulatory changes will affect workflows and staff. That insight helps bridge the gap between policy and practice, ensuring that compliance strategies are realistic and effective.

innovation behind the scenes

One of the most illustrative examples of Hilliard’s impact is the creation of a specialty pharmacy at Children’s National. Designed to allow the hospital to prescribe and dispense medications in the ambulatory setting, the pharmacy represents a significant expansion of services for pediatric patients. For families managing complex conditions, this integration can improve access, coordination, and continuity of care.

The initiative also brought substantial legal and regulatory complexity. As a nonprofit organization participating in the federal 340B Drug Pricing Program, Children’s National must meet stringent compliance requirements. Hilliard’s team played a critical role in structuring the program, ensuring adherence to evolving standards, and addressing potential legal risks.

“The legal work happens quietly, but it is essential to making innovation possible,” she says.

From regulatory approvals to contractual frameworks and compliance monitoring, the legal department’s involvement was foundational. Their work helped position the specialty pharmacy not only as a new service line, but as a sustainable and compliant component of the hospital’s broader pharmacy program. The result is an expanded ability to serve more children while maintaining the integrity of the organization’s nonprofit mission.

Beyond this project, Hilliard’s teams continue to support research initiatives, clinical expansions, and strategic partnerships. Whether engaging with federal research agencies, collaborating with academic institutions, or supporting joint ventures within the healthcare ecosystem, the legal function helps ensure that innovation proceeds responsibly.

Throughout her tenure, Hilliard has remained deeply connected to the mission that first drew her to Children’s National. Her leadership reflects a belief that legal expertise is most powerful when it is informed by empathy and aligned with purpose. By combining her nursing roots with legal leadership, she has helped shape a culture where compliance supports care, transparency builds trust, and teamwork drives impact.

In an environment as complex and high-stakes as pediatric healthcare, that integration is not just valuable. It is essential.