Kevin Kroeker is a partner in Crowell & Moring's Los Angeles office, and is a former co-chair of the firm’s Health Care Group. He represents health care organizations on a wide range of state and federal regulatory matters and health care transactions. Kevin has more than 30 years of experience representing a diverse array of health care entities and stakeholders, including managed care plans and insurers, Medicare Advantage Organizations, Medicaid Managed Care plans, hospitals, medical groups and community clinics. Kevin has served on several nonprofit boards and he counsels nonprofit organizations in connection with governance and compliance issues.
Kevin has guided numerous health plans and providers through the regulatory complexities of merger and acquisition transactions. His health care transactional experience also includes representation of managed care organizations and providers in joint ventures, shared savings, and global and partial-risk capitation arrangements. He also represents health insurers and providers in connection with outsourcing agreements and management services agreements.
Kevin counsels health plans and providers concerning compliance with state and federal health care laws and regulations, including the Affordable Care Act. He represents health plans and insurers and provider groups that accept global financial risk in obtaining and modifying HMO, insurance, and other similar licenses.
Kevin counsels non-profit organizations, including federally qualified health centers, in connection with governance and compliance issues. He also represents health care entities in connection with enforcement matters and in internal investigations related to compliance matters.
Representative Engagements
- Regulatory counsel to Health Net, Inc. in its $6 Billion sale to Centene Corporation.
- Regulatory counsel to Blue Shield of California in its $1.2 Billion acquisition of Care1st Health Plan.
- Represented venture-capital-backed national health insurer in obtaining a license to operate as a commercial health plan in California and on the California Exchange.
- Representation of a managed care organization in a strategic agreement with a large hospital system to implement sophisticated care management programs.
- Regulatory counsel to a large health plan in establishing an expansive outsourcing agreement with an international provider of health care-related administrative services.
- Represented a large medical group in obtaining a license to operate as a global risk provider organization in California.
- Represented a large physician practice management company in acquisitions of physician practices in several states.
- Served as outside general counsel to a non-profit Medicare Advantage plan during its search for a permanent general counsel.
- Regulatory counsel in connection with a large national health insurer's acquisition of a California based Medicare Advantage Plan and provider organization in an $800 million transaction.
- Regulatory counsel in representing a large national health insurer related to several acquisitions of large physician practices and physician practice management companies.
- Represented health insurer in development of accountable care shared savings programs for its commercial and Medicare programs.
- Regulatory counsel for a large national health insurer in its acquisition of a multi-state Medicare Advantage plan in a multi-billion dollar transaction.
- Regulatory counsel for multiple health plans in connection with the federal dual eligible demonstration program.
Kevin is a past board chair of the Eisner Pediatric and Family Medical Center and a past chair and executive committee emeritus member of the Los Angeles County Bar Association, Health Care Law Section. He received his J.D. from the University of California, Davis School of Law and his B.A. from the University of Oklahoma.
Kevin is recognized as a top lawyer in the health care field by Chambers USA, by The Best Lawyers in America and by Super Lawyers.
Affiliations
Admitted to practice: California
Highlights, News & Knowledge
Speeches & Presentations
-
"Latest Developments in Managed Care Compliance," 14th Annual Healthcare Law Compliance Symposium, Los Angeles, CA
(October 12, 2017).
Presenter: Kevin B. Kroeker.
-
"Evolving Regulatory Structure and Issues for California's Health Plans and Insurers," California Association of Health Plans' 31st Annual Conference, Palm Desert, CA
(October 11, 2016).
Panelist: Kevin B. Kroeker.
-
"Health Care," WOOPS 2015, Crowell & Moring's West Coast Ounce of Prevention Seminar, Marina del Rey, CA
(May 14, 2015).
Moderator: David J. Ginsberg; Panelists: Kevin B. Kroeker, Scott J. Moore, and Mark R. Troy.
-
"Providers becoming Payors and Payors becoming Providers – Key Legal Considerations," Crowell & Moring's Healthcare Ounce Of Prevention Seminar (HOOPS), Washington, D.C.
(October 27-28, 2014).
Presenters: Troy A. Barsky and Kevin B. Kroeker.
-
"Narrow Networks – Now or Never," Crowell & Moring's Healthcare Ounce Of Prevention Seminar (HOOPS), Los Angeles, CA
(May 13, 2014).
Presenters: Kevin B. Kroeker and Peter Roan.
-
"Medicare Advantage and Part D Developments," Crowell & Moring's Healthcare Ounce Of Prevention Seminar (HOOPS), Los Angeles, CA
(May 13, 2014).
Presenters: Christine M. Clements and Kevin B. Kroeker.
Publications
-
"Required Coverage of COVID-19 Testing for Essential Workers in California," Crowell & Moring’s Health Law Blog
(July 29, 2020).
Authors: Gary Baldwin, Kevin B. Kroeker and Alice Hall-Partyka.
-
"CMS Approves Medi-Cal Section 1135 Waivers," Crowell & Moring's Health Law
(March 25, 2020).
Authors: Gary Baldwin, Kevin B. Kroeker, and Alice Hall-Partyka.
-
"Flurry of Regulatory Activity Driven by COVID-19 Anxiety Impacts Health Plan Requirements and Permissible Actions," Crowell & Moring's Health Blog
(March 17, 2020).
Authors: Gary Baldwin, Kevin B. Kroeker, and Brian McGovern.
-
"Unpacking Republican Proposals to Roll Back Obamacare," Daily Journal
(December 12, 2016).
Authors: Kevin B. Kroeker, David Didier Johnson, Jesse Martin, and Harsh P. Parikh.
-
"Republican Plans to Reform the ACA," Daily Journal
(December 12, 2016).
Authors: Kevin B. Kroeker, David D. Johnson, Harsh P. Parikh, and Jesse C. Martin.
-
"Who Will Pay for Aid-in-Dying Drugs?" Daily Journal
(October 3, 2016).
Authors: Kevin B. Kroeker and Marisa E. Adelson.
-
"Regulatory Forecast 2016: What Corporate Counsel Need to Know for the Coming Year," a Crowell & Moring LLP publication
(January 2016).
Contributor.
-
"Health Care - In Search of Best Practices," Crowell & Moring's Regulatory Forecast 2016
(January 2016).
Contributors: A. Xavier Baker, Kevin B. Kroeker, Barbara H. Ryland, and Jodi G. Daniel.
-
"California: At The Vanguard Of Regulation," Law360
(March 3, 2015).
Co-Authors: Gary L. Baldwin, Kevin B. Kroeker, Frank R. Lindh, and Nancy Saracino.
-
"Regulatory Forecast 2015: What Corporate Counsel Need to Know for the Coming Year," a Crowell & Moring LLP publication
(January 2015).
Contributor.
-
"AB 460: Discrimination in Infertility Treatment Coverage," Daily Journal
(January 21, 2014).
Co-Authors: Kevin B. Kroeker and Marisa E. Adelson.
-
"CMS Proposed Rule On Affordable Care Act Standards For Essential Health Benefits, Actuarial Value, And Accreditation," Health Lawyers Weekly, Vol. 10, Issue 49
(December 14, 2012).
Co-Authors: Kevin B. Kroeker and Peter Roan.
Client Alerts & Newsletters
-
"Telehealth Guidance for Health Plans in California During the COVID-19 State of Emergency,"
Health Care Alert
(April 16, 2020).
Contacts: Gary Baldwin, Kevin B. Kroeker
-
"Governor Newsom Continues to Fine Tune California’s Response to COVID-19,"
Health Care Alert
(March 24, 2020).
Contacts: Gary Baldwin, Kevin B. Kroeker
-
"Payers, Providers, and Patients – Oh My!: Medical Loss Ratios (Part 2),"
Podcast: Payers, Providers, and Patients – Oh My!
(March 18, 2020).
Contacts: Kevin B. Kroeker, Joe Records, Payal Nanavati
-
"Payers, Providers, and Patients – Oh My!: Medical Loss Ratios (Part 1),"
Podcast: Payers, Providers, and Patients – Oh My!
(February 25, 2020).
Contacts: Kevin B. Kroeker, Joe Records, Payal Nanavati
-
"New DMHC Regulation Substantially Expands Number of Entities Requiring Knox-Keene Licensure,"
Health Care Alert
(March 6, 2019).
Contacts: Gary Baldwin, Kevin B. Kroeker
-
"Outlook on California’s Health Care Landscape After the 2016 Elections,"
Health Care Alert
(December 1, 2016).
Contact: Kevin B. Kroeker
-
"CMS Approves MassHealth Restructuring Utilizing Medicaid ACOs,"
Health Care Alert
(November 21, 2016).
Contact: Kevin B. Kroeker
-
"Medicare Accountable Care Organizations: The Time is Now,"
Health Care Alert
(April 15, 2014).
Contacts: Troy A. Barsky, John T. Brennan Jr., Kevin B. Kroeker, Todd D. Rosenberg
-
"Supreme Court Denies Review of Third Circuit Decision That MA Organizations Have a Direct Right of Recovery Under the Medicare Secondary Payor (MSP) Act,"
Health Care Alert
(April 16, 2013).
Contacts: Kevin B. Kroeker, Barbara H. Ryland
-
"CMS Announces Medicare Advantage and Prescription Drug Program MLR Proposed Rule—Largely Follows Commercial MLR Rules,"
Health Care Alert
(February 21, 2013).
Contact: Kevin B. Kroeker
-
"CMS Proposed Rule on Affordable Care Act Standards for Essential Health Benefits, Actuarial Value and Accreditation,"
Health Care Alert
(November 29, 2012).
Contacts: Kevin B. Kroeker, Peter Roan
Media Mentions
Firm News & Announcements