Overview

Health plans, insurers, and others in health care turn to attorney Gary Baldwin to help them navigate intricate state and federal health care laws and regulations.

Drawing on his experience as a regulator, Gary delivers strategic insights on regulatory compliance and offers practical, tailored solutions to address complex regulatory challenges.

Gary’s practice focuses on all aspects of health plan regulatory compliance, including adherence to the Knox-Keene Act, the Affordable Care Act, and California’s Medi-Cal program requirements. He assists clients with obtaining regulatory approvals from state agencies, particularly the California Department of Managed Health Care (DMHC), including approvals related to licensing and mergers and acquisitions involving managed care organizations. Clients rely on him to prepare regulatory license filings (ranging from license applications to material modifications and amendments) and provider and administrative service agreements. Additionally, Gary advises on corporate governance matters, financial matters, and potential regulatory enforcement actions.

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Before joining Epstein Becker Green, Gary was a partner in the Health Care Group of an international law firm. Prior to entering private practice, Gary spent over 13 years in various leadership roles at the DMHC. As Deputy Director, Plan and Provider Relations, he advised the DMHC 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 to Covered California, advising on issues pertaining to the approval of the health plan products offered on the exchange. Previously, as Assistant Chief Counsel in the Division of Licensing, Gary oversaw the review of commercial and Medi-Cal licensing filings, including applications, material modifications, and amendments to health plan documents, and managed the DMHC’s network staff.

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Focus Areas

Credentials

Education

  • University of California, Davis School of Law (J.D.)
  • California State University, Sacramento (B.S.)

Bar Admissions

Events

Past Events

  • Practising Law Institute: Medi-Cal Managed Care and Its Path Forward: Re-Procurement, Cal-AIM, and Behavioral Health
  • California Association of Health Plans, Legal and Regulatory Affairs Meeting: New DMHC Licensure Regulation & Guidance
  • California Association of Health Plans, Legal and Regulatory Affairs Meeting, Delegation Agreements
  • California Association of Health Plans, Legal and Regulatory Affairs Meeting: Conscience Rights in Health Care
  • California Association of Health Plans, Legal and Regulatory Affairs Meeting: Legal Update – Restricted License Regulation
  • California Association of Health Plans, Legal and Regulatory Affairs Meeting: Federal Health Care Reform – Update
  • California Association of Health Plans, Legal and Regulatory Affairs Meeting, Federal Health Care Reform – Discussion Panel
  • California Society of Healthcare Attorneys Annual Meeting and Spring Seminar: Healthcare Reform Under the Trump Administration - What We Expected, What We Got, and What’s Next
  • California Association of Health Plans, 2016 Annual Conference: Evolving Regulatory Structure and Issues for California’s Health Plans and Insurers
  • California Association of Health Plans, Legal and Regulatory Affairs Meeting: Federal and State Network Requirements

Insights

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