Kate Sullivan Morgan
Partner, Dallas
Telephone: +1 214 259 0940
Email: kate.morgan@dentons.com
Website bio: https://www.dentons.com/en/kate-morgan

Kate specializes in complex multi-state health insurance and health care regulatory challenges, drawing on more than fifteen years of experience both in-house and at top tier international law firms. Kate is a well-known expert in payor/provider issues and is adept in the intricacies of the Affordable Care Act (ACA) and state health insurance and managed care laws, and the interplay of the two. Additionally, she has been part of industry-defining changes in digital health, data transparency and the post-CAA fiduciary landscape.

Kate has advised health insurance and managed care clients on a broad range of regulatory issues, including state and federal mandated benefits; state and national health care reform; group health laws (e.g., extra-territorial applicability, withdrawal from group business); joint ventures; HIPAA and state conversion and continuation of coverage provisions; state privacy laws; utilization review requirements; company licensing; broker and agent issues; and applicability and interpretation of other relevant statutes and regulations. Kate also provides regulatory advice regarding non-traditional healthcare models to third party administrators, consulting companies, and financial institutions, including negotiating with state insurance regulators to obtain insurance license exemptions for such models. She has a stellar record of positive outcomes when representing clients before state regulators in investigations and enforcement actions.

In addition, Kate has significant experience with provider contracting issues, including Value-Based Contracting such as Accountable Care Organizations (ACOs) and other complex risk and pay-for-performance (P4P) financial reimbursement models. She has negotiated and drafted contracts between insurers/HMOs and provider organizations, including large hospital physician systems, Physician Organizations (POs), and Independent Practice Associations (IPAs) and has advised on a variety of payment structures, including fee-for-service, capitation, and global budgeted fee-for-service, among others. She has also advised on related issues, including joint ventures, provider owned payors, recoveries, provider data requests, risk mitigation, performance measurement, and a variety of multi-party agreements.

In connection with regulatory approvals of mergers and acquisitions of insurance companies, Kate has obtained approval of Forms A, requests for exemption and disclaimers of control on behalf of insurers. She has prepared, filed and obtained approval of certificates of authority, re-domestications, and producer appointments, in all 50 states, Kate served as the lead associate representing property and casualty insurers in contested rate cases and rule challenges before state departments of insurance and administrative law judges.

Experience

• Oscar Health: Representation of company from start-up to maturity with respect to state licensure, provider agreements and network, policies and procedures, agent/broker arrangements, and general regulatory advice. 
• CareConnect Insurance Company, Inc.: Outside General Counsel to company for broad range of legal work related to health insurance operations. 
• Multinational finance and insurance corporation: Counseled company on health insurance regulatory issues, including with respect to travel, accident, critical illness, and other lines prior to and through the implementation of the Affordable Care Act (the ACA).
• Not-for-profit health care services provider: Counseled health system on various health care considerations and represented it in its joint venture with major payor. 
• National behavioral health players: Representation of three leading behavioral healthcare companies in a broad range of regulatory matters, including with respect to reimbursement models and contracting.
• National Accountable Care Organization (ACO): Created the legal strategy to stand up one of the first standalone ACOs, including representation of the company before state regulators.
• Leading healthcare technology company: Representation of a leading healthcare technology company during various start-up and mature company phases. This included development of regulatory, producer, and provider frameworks and contracts.
• New market entrant in women’s health: Represented a new player in the women’s health space, partnering with actuaries and product teams to design a compliant cutting edge business model.
• National health insurance company: Regulatory counsel for multiple insurance plans nationally. Included building first commercial ACO model (contracting, financial, strategy) and also representing the plans with various acquisitions and several other confidential transactions.

Community Involvement and Pro Bono

Kate is an active member of her local public school community, having previously led non-profits, advocacy groups, and more. She is passionate about access to education with a particular focus on neurodivergent students. Her pro bono work has focused on healthcare and immigration cases, including expanding access to substance use disorder programs, citizenship matters before the Ninth Circuit Court of Appeals, and a successful asylum application on behalf of a Nepali activist.

Prior and Present Employment

In addition to her years of experience with international top law firms, Kate has also served in multiple in-house roles giving her a unique edge when it comes to health law and the day-to-day trials and tribulations of our clients. Most recently, Kate served as Senior Vice President, Complex Care and Associate General Counsel at a leading digital health company, Transcarent. In these roles, Kate was responsible for establishing Transcarent’ s overall healthcare regulatory framework, running product and provider legal strategy and M&A processes, and serving as counsel to the affiliated virtual/telehealth clinic (Friendly-PC model), among other things. Recognized as an operator and executor, Kate also held several business roles, including building a novel value-based cancer care program and leading network strategy and Centers of Excellence efficiency initiatives. Kate was the lead attorney for physician contracting at Blue Cross Blue Shield of Massachusetts, including with respect to the development of the first Accountable Care Organization (ACO) model. She has also counseled other clients, including payviders, as outside General Counsel via secondment.

Areas of Focus

Practices

• Appellate Advocacy
• Insurance Legislative and Administrative Advocacy
• Insurance Related Insolvencies
• Litigation and Dispute Resolution
• Business Agreements and Commercial Contracts
• Joint Ventures
• Directors and Officers
• Health and Welfare Benefits
• Plan Governance
• ERISA Litigation
• Regulated Industries
• Strategic Advisory and Entrepreneurial Services
• Venture Capital

Industry Sectors

• Health Maintenance Organization (HMO) Insurance Regulation
• Health Care
• Insurance
• Insurance Administrative Hearings and Appeals
• Insurance Litigation and Arbitration
• Insurance Regulation
• Property, Casualty and Liability Insurance
• Private Equity
• Accident and Health Insurance
• Captive Insurance Services
• Insurance Transactions and Mergers and Acquisitions
• Insurance Joint Ventures
• Insurance Reorganizations
• Insurtech

Education

• Northeastern University School of Law, 2006, JD
• University of Notre Dame, 1999, BA

Admissions and Qualifications

• California
• Texas
• US Court of Appeals for the Ninth Circuit
• US District Court for the Northern District of California