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Peter Roan

Partner

proan@crowell.com
Phone: +1 213.443.5571
515 South Flower St., 40th Floor
Los Angeles, CA 90071-2201

Peter Roan is a Health Care Group partner in Crowell & Moring’s Los Angeles office. With over 30 years of experience, Peter concentrates his practice on litigation in the health care and insurance industries. He represents managed care organizations, health benefit plans, Medicare Advantage Organizations, Medicaid managed care plans, insurers, plan administrators, plan sponsors, physician organizations, other health care providers and suppliers, ambulatory surgical, skilled nursing and other health care facilities, and trade associations in various litigation and regulatory matters. Peter’s health care litigation experience includes payer / provider and other disputes and defending class action, bad faith, wrongful death, ERISA, unfair business practices, False Claims Act and RICO cases. Peter represents health care payers that offer or administer group and individual insurance, as well as payer organizations participating in government sponsored health programs including Medicare Advantage, Medicaid, TRICARE and FEHBP. He also represents clients facing regulatory enforcement action both in court and before the agencies, and in peer review proceedings and follow-on litigation.

Peter received his bachelor’s degree from the University of Iowa and his law degree from Marquette University.

Representative Engagements

  • Successfully secured dismissal of a bad faith lawsuit brought by a Medicare Advantage plan member against a Medicare Advantage Organization because the plan member had not exhausted Medicare administrative remedies and because the claims were preempted by the Medicare Act.
  • Secure dismissals of lawsuits against Medicare Advantage Organizations by non-contracted hospitals because the hospitals claims were subject to the exhaustion requirement.
  • Successfully obtained reinstatement of a specialty pharmacy following an appeal of the pharmacy’s disenrollment by the state Medicaid agency.     
  • Defeated arbitration claims by durable medical equipment supplier against a Medicaid managed care plan and obtained judgment for damages and attorney’s fees on the plan’s counterclaim based on the supplier’s fraud.  
  • Successfully represented Medicaid managed care plan in dispute concerning the actuarial soundness of payments made by the state Medicaid agency.  
  • Represented workers compensation insurers and administrators in a federal court RICO and antitrust action brought by a business that provided management and billing services to physicians that dispensed prescription medications to workers compensation patients; the antitrust case was dismissed on motions resulting in a settlement. 
  • Defeated class certification in a consumer class action alleging that the client health plan systemically violated laws requiring coverage of reconstructive surgery. 
  • Secured dismissal of a lawsuit brought by a provider of air ambulance services against over 80 insurers and public and private employers alleging that the Airline Deregulation Act preempted state laws that created the payment rate for air ambulance services. 
  • Successfully represented a managed care organization in an arbitration alleging the organization systemically underpaid thousands of hospital claims worth tens of millions of dollars and established through sampling and audit work that the claims were grossly overstated. 
  • Represented a health plan in binding arbitration brought by several hospitals that asserted the plan had systemically underpaid them for services provided to the plan's members under numerous separate contracts covering all plan types; the case was settled following arbitration hearings. 
  • Represented a health plan in actions brought by emergency service providers who contended that the plan was required to pay billed charges when the plan’s contracted physician group that accepted financial risk for emergency services from the plan failed to pay; the trial court dismissed the claims which were upheld on appeal. 
  • Recovered $8 million in overpayments for a health plan following binding arbitration commenced against a hospital that refused to return the overpayments based on numerous legal and factual grounds. 
  • Represented a trade association in a federal court challenge to state laws and regulations that the client asserted were preempted under Medicare laws resulting in a permanent injunction against the enforcement of over 100 state laws and regulations.

Education

  • University of Iowa, B.B.A. (1982)
  • Marquette University Law School, J.D. (1985)

Affiliations

Admitted to practice: California

View More

"Supreme Court Clarifies that the Arbitrator, and Not the Court, Determines when Arbitration Is Required Under the Federal Arbitration Act," Health Care Alert (January 10, 2019). Contact: Peter Roan
Client Alert / Newsletter
"Recent Shifts and Lessons Learned in DOJ False Claims Act Enforcement," Los Angeles County Bar Association, Los Angeles, CA (January 9, 2019). Presenters: William S.W. Chang and Peter Roan.
Speech/Presentation
"Managed Care Lawsuit Watch - September 2017," Managed Care Lawsuit Watch (September 6, 2017). Contacts: Christopher Flynn, Peter Roan
Client Alert / Newsletter
"California Supreme Court Prohibits Waiver of Public Injunctive Relief in Arbitration Agreements," Crowell & Moring's Health Law Blog (April 12, 2017). Authors: Peter Roan, Harsh P. Parikh and Jesse C. Martin.
Publication
"Ninth Circuit Bars Providers from Enforcing ERISA Protections on ERISA Plan Administrators," American Health Lawyers Association Payers, Plans, and Managed Care Newsletter (April 7, 2017). Authors: Harsh P. Parikh and Peter Roan.
Publication
"Managed Care Lawsuit Watch - February 2017," Managed Care Lawsuit Watch (February 2, 2017). Contacts: Christopher Flynn, Peter Roan, Brian C. Lewis, Rochelle-Leigh Rosenberg, Lauren R. Nunez
Client Alert / Newsletter
"New California Law To Target Surprise Bills Impacts Payor Relationships With Non-Contracted Professionals," Crowell & Moring's Health Law Blog (October 18, 2016). Authors: Harsh P. Parikh and Peter Roan.
Publication
"New California Law to Curb Surprise Medical Bills Will Impact Relationships Between Health Plans and Non-Contracted Professionals," Health Care Alert (October 18, 2016). Contact: Peter Roan
Client Alert / Newsletter
"Managed Care Lawsuit Watch - August 2016," Managed Care Lawsuit Watch (September 6, 2016). Contacts: Christopher Flynn, Peter Roan, Lauren R. Nunez, Rochelle-Leigh Rosenberg, Joe Records, Brian C. Lewis
Client Alert / Newsletter
"CMS Proposes Significant Changes Impacting Medicare Appeals Processes," American Health Lawyers Association Payers, Plans, and Managed Care Newsletter (July 18, 2016). Authors: Peter Roan and Harsh P. Parikh.
Publication

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