Photo of Katrina A. Pagonis

Katrina A. Pagonis

Partner

Education

University of California, Berkeley, B.A., 2001

Johns Hopkins Bloomberg School of Public Health, M.P.H., 2005

Georgetown University Law Center, J.D., 2005

Yale Law School, L.L.M., 2006

Bar Admissions

  • 2009, California
Profile
Presentations & Speaking Engagements
News
Publications

Katrina Pagonis is co-chair of the firm's regulatory department and a nationally recognized expert on implementation of the Affordable Care Act’s market reforms, including the federal regulation of government-sponsored and private managed care plans and the establishment and operation of Health Insurance Exchanges (“Marketplaces”) like Covered California. Ms. Pagonis regularly advises clients on the impact of health care reform, as well as emerging health care reform proposals (from repeal-and-replace to single payer) at the state and national levels.  She also provides regulatory and strategic advice to health care providers concerning managed care issues more generally, including out-of-network reimbursement, network configuration (narrow and tiered networks), reference pricing and cost-sharing limits, managed care contracting, and enrollment assistance activities.

In addition, Ms. Pagonis regularly assists health care providers—including hospitals, long-term care providers, suppliers, pharmacies, hospices, physicians and medical groups—with a broad range of regulatory and Medicare/Medicaid reimbursement matters.  She is an expert in site-neutrality initiatives for hospital outpatient services, meaningful use of electronic health records, health care technology, clinical trial agreements, antitrust, and internal investigations.  Ms. Pagonis represents providers in government investigations and False Claims Act cases and assists providers that have credible information regarding potential overpayments with the investigation, identification, reporting, and returning of overpayments. Ms. Pagonis is a former judicial law clerk of the U.S. Court of Appeals for the Ninth Circuit and the U.S. District Court for the District of Nevada.  Until 2012, she was a full-time professor of health law at Hamline University School of Law in St. Paul, Minnesota.

Professional Affiliations

  • American Health Lawyers Association, Chair of the Healthcare Reform Task Force
  • American Bar Association, Health Law Section
  • California Society of Healthcare Attorneys

Community/Civic Activities

  • Advisory Board Member, Health Law Institute at Mitchell Hamline School of Law (2016 – present)
  • The ACA and the Transformation of the California Health Care Marketplace: Covered California, California Society for Healthcare Attorneys (Squaw Valley, April 2014)
  • Affordable Care Act Webinar: How it Affects Lawyers and Small Businesses, The National Bar Association (April 2014)
  • False Claims Act and 60-Day Reporting and Repayment Rule, U.C. Hastings College of the Law, Guest Lecturer for Health Law II (March 2014)
  • Managed Care Contracting, California Dental Association, Dental Benefits Workshop (Sacramento, March 2014)
  • Managed Care Webinar, California Association for Health Services at Home (March 2014)
  • Access to Coverage and Care, the Exchanges, and Competition, U.C. Hastings College of the Law, Guest Lecturer for Health Law II (February 2014)
  • Covered California and Providers, LACBA Health Care Law Section (Los Angeles, December 2013)
  • Health Insurance Exchange Challenges and Solutions, Part V: Beyond January—Exchange‑Related Issues on the Horizon, American Health Lawyers Association Webinar (with Joel Hamme, Tim Jost, and Caitlyn Sweaney, October 2013)
  • Covered California: Issues on the Horizon for Providers, Hooper, Lundy & Bookman Managed Care Seminars (Los Angeles & Berkeley, October 2013)
  • Covered California: Legal and Business Concerns for Providers, Santa Clara University Law, Health Law I, Guest Lecture (October 2013)
  • Insurance Exchanges and Inherent Changes Being Implemented Throughout the Health Insurance Marketplace, Dale Baker Conference on Health Reform (with Cliff King, Las Vegas, September 2013)
  • Covered California: Enrollment & Marketing Opportunities for Providers, Plans and Agents, California Society for Health Care Attorneys Teleconference Presentation (September 2013)
  • Health Exchanges: Proactive Legal Strategies for Providers, HLB-Strafford Webinar (with Martin Corry and Jack Ebeler, September 2013)
  • Covered California: What Providers Need to Know Today About California’s Health Insurance Exchange, Hooper, Lundy & Bookman Webinar (with Martin Corry and Amanda Hayes-Kibreab, September 2013)
  • Health Insurance Exchange Challenges and Solutions, Part II: Enrollment Assistance and Privacy and Security, American Health Lawyers Association Webinar (with L. Cook and D. Madala, August 2013)
  • Enrollment Assistance in AAPI Communities: The Provider’s Role, Asian Health Care Leaders Association National Conference (July 2013)
  • The Exchanges: Managed Care Contracting under the ACA, The Summit by ReviveHealth (New Orleans, May 15, 2013, with Glenn Solomon)
  • Covered California: Health Benefits Exchange, U.C. Berkeley School of Public Health, Guest Lecturer for Legal Issues in Health Care (April 22, 2013)
  • Managed Care Special Topics: Preparing for the Medi-Cal Managed Care Rural Expansion, Hospital Council of Northern & Central California (April 18, 2013, with Felicia Sze)
  • Covered California: Health Benefits Exchange, LACBA/LACMA, The New Health Care Landscape (Los Angeles, March 7, 2013)
  • Wellness Programs: Current Landscape & Coming Changes, HFMA (San Diego, February 28, 2013, with Johan Otter)
  • Insurance Exchanges and Inherent Changes Being Implemented Throughout the Health Insurance Marketplace (Or “Is it 2014 Yet?”), The Conference on Health Reform (Las Vegas, September 21, 2012, with Cliff King)
  • Federalism and the Individual Health Insurance Mandate, Hamline Law Alumni CLE (February 2012, with Morgan Holcomb)
  • Hot Topics in Health Law: Palliative Care Issues, Ramsey County Bar Association CLE (St. Paul, MN, November 2009)

News

Publications

Fraud & Abuse and the Exchanges: HHS Concludes that the Exchanges and Qualified Health Plans are not Subject to the Anti-Kickback Statute, Hooper, Lundy & Bookman, Health Law E-Alert (November 2013)

Covered California’s Enrollment Assistance Program, Health Law Perspectives 15:6 (with Kaitlyn Halesworth, September 2013)

Medi-Cal, The Exchanges, and Bridge Plans, Health Law Perspectives 15:2 (with Felicia Sze April 2013)

Smallpox Vaccination from Jenner to Jacobson: The Police Power, Individual Liberty, & Government Responsibility (for 2013 submission)

Gostin, Jacobson v. Massachusetts: The Police Power and Civil Liberties in Tension, in Health Law and Bioethics: Cases in Context (Richard Saver et al. eds., 2009, with Lawrence O.)

Contextualizing Personalized Medicine Evidence-Based Medicine in the Genomic Era, O’Neill Institute for National and Global Health Law Personalized Medicine Forum (Washington, DC, June 2008, Paper Presentation with Patricia A. King)

For media assistance, please contact Maura Fisher at 202-580-7714.