Xavier Baker is a partner in the Corporate Practice Group in the Washington, D.C. office and member of the firm's Healthcare team.
Areas of Practice
Xavier advises clients on healthcare insurance and managed care regulations, investigations, transactions, and litigation. He counsels national and regional health insurers, pharmacy benefit managers, care coordination organizations, and other specialty healthcare service providers and trade associations on complex state and federal regulatory issues involving Medicare, Medicaid, the Federal Employees Health Benefits Program, TRICARE, and commercial health insurance. Clients look to him for cutting-edge strategic counseling, risk management, regulatory policy, and government affairs assistance to meet the challenges posed by this relentlessly evolving environment.
Xavier helps managed care organizations and providers design and implement benefits and services that both comply with the Mental Health Parity and Addiction Equity Act and improve access to behavioral health care. He counsels clients undergoing state market conduct exams, government investigations by states attorneys general and the federal Department of Labor, and other audits and inquiries related to compliance with the Mental Health Parity and Addiction Equity Act and similar state laws. Xavier has extensive experience helping health plans develop internal auditing procedures, compliance documentation, and disclosure materials.
In addition, Xavier advises health plans in response to investigations by the U.S. Department of Health and Human Services Office of Civil rights concerning non-discrimination requirements under Affordable Care Act Section 1557. Xavier has represented plans in response to Section 1557 investigations regarding benefit design and non-medical transportation. He also assists health plans structure joint ventures, transactions, and other arrangements to mitigate Section 1557 compliance risks.
Xavier also counsels health plans and providers on medical loss ratio reporting, government audits, and strategic considerations. And he has assisted health plans and intermediary organizations with state HMO, utilization management, TPA, and other licensure requirements for Medicare Advantage and commercial health insurance products.
Further, Xavier has represented trade associations in amicus briefs before the United States Court of Appeals for the Fifth Circuit and the Supreme Court of the United States regarding the constitutionality of the Affordable Care Act.
More Legal and Business Bylines From Xavier Baker
- 2023 Payment Rule’s Nondiscrimination Provisions and Anticipation of New Section 1557 Rules - (Posted On Tuesday, May 17, 2022)
- Medicaid and Health Equity: CalAIM’s Bold Experiment - (Posted On Monday, May 16, 2022)
- CMS Issues Contract Year 2023 Final Rule for Medicare Advantage Organizations and Prescription Drug Sponsors - (Posted On Monday, May 16, 2022)
- The Biden Administration’s and HHS’s Plan to Advance Health Care Equity - (Posted On Thursday, April 28, 2022)
- Less is More: Brevity is the Soul of Wit - (Posted On Thursday, April 14, 2022)
- Tri-Agencies Report MHPAEA Compliance Lacking, But Don’t Name and Shame Plans and Issuers . . . Yet - (Posted On Thursday, January 27, 2022)
- Tri-Agencies Release Guidance on Coverage of OTC COVID-19 Tests - (Posted On Tuesday, January 11, 2022)
- CMS’ Contract Year 2023 Policy and Technical Changes to the Medicare Advantage and Medicare Prescription Drug Benefit Programs - (Posted On Monday, January 10, 2022)
- Back to the Future: 2023 Payment Rule Would Revert Nondiscrimination and Guaranteed Availability Provisions to Pre-Trump Forms, Returns Standardized Plan Options - (Posted On Wednesday, January 05, 2022)
- State, Federal, and Private Enforcement of Mental Health Parity Compliance - (Posted On Wednesday, November 03, 2021)