Gary Baldwin

Partner

Overview

Gary Baldwin is a partner in Crowell & Moring's San Francisco office, where he practices in the Health Care Group. Gary's practice is focused on health plan regulatory compliance, which includes compliance with the Knox-Keene Act, Affordable Care Act and California's Medi-Cal program requirements. His compliance practice ranges from licensing filings, to financial matters, to potential regulatory enforcement actions.

Prior to joining Crowell & Moring, Gary was the deputy director, Plan and Provider Relations, at the California Department of Managed Health Care (DMHC), where he was the primary advisor to the director on plan and provider issues and provided strategic planning and policy direction on emerging issues and industry trends. He also served as the liaison with Covered California on issues pertaining to the approval of the health plan products offered on the exchange. Prior to his appointment, Gary served as an assistant chief counsel in the Division of Licensing, where he oversaw the review of commercial and Medi-Cal licensing filings, which included applications, material modifications, and amendments to health plan documents, as well as overseeing the DMHC's network staff. With over 13 years' experience as a regulator, Gary became accustomed to creating solutions to regulatory issues that would satisfy various stakeholder interests. 

Career & Education

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    • California
      Deputy Director, Plan & Provider Relations, California Department of Managed Health Care (DMHC);
      Assistant Chief Counsel, Division of Licensing, DMHC
    • California
      Deputy Director, Plan & Provider Relations, California Department of Managed Health Care (DMHC);
      Assistant Chief Counsel, Division of Licensing, DMHC
    • California State University, Sacramento, B.S., chemistry
    • University of California, Davis School of Law, J.D.
    • California State University, Sacramento, B.S., chemistry
    • University of California, Davis School of Law, J.D.
    • California
    • California

Gary's Insights

Client Alert | 6 min read | 03.26.24

California Office of Health Care Affordability Notice Requirement for Material Change Transactions Closing on or After April 1, 2024

Starting next week, on April 1st, health care entities in California closing “material change transactions” will be required to notify California’s new Office of Health Care Affordability (“OHCA”) and potentially undergo an extensive review process prior to closing. The new review process will impact a broad range of providers, payers, delivery systems, and pharmacy benefit managers with either a current California footprint or a plan to expand into the California market. While health care service plans in California are already subject to an extensive transaction approval process by the Department of Managed Health Care, other health care entities in California have not been required to file notices of transactions historically, and so the notice requirement will have a significant impact on how health care entities need to structure and close deals in California, and the timing on which closing is permitted to occur....

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Gary's Insights

Client Alert | 6 min read | 03.26.24

California Office of Health Care Affordability Notice Requirement for Material Change Transactions Closing on or After April 1, 2024

Starting next week, on April 1st, health care entities in California closing “material change transactions” will be required to notify California’s new Office of Health Care Affordability (“OHCA”) and potentially undergo an extensive review process prior to closing. The new review process will impact a broad range of providers, payers, delivery systems, and pharmacy benefit managers with either a current California footprint or a plan to expand into the California market. While health care service plans in California are already subject to an extensive transaction approval process by the Department of Managed Health Care, other health care entities in California have not been required to file notices of transactions historically, and so the notice requirement will have a significant impact on how health care entities need to structure and close deals in California, and the timing on which closing is permitted to occur....