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.
Articles in the National Law Review database by Xavier Baker