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A. Xavier Baker

Partner

xbaker@crowell.com
Phone: +1 202.624.2842
1001 Pennsylvania Avenue NW
Washington, DC 20004-2595

A. Xavier Baker is a partner in Crowell & Moring's Health Care Group and is located in the Washington, D.C. office. He advises clients on health care 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 health care service providers and trade associations on complex regulatory issues.

Xavier supports his clients in navigating both federal and state health insurance regulatory schemes, including the rapidly evolving demands under the Affordable Care Act, potential repeal and replacement legislation, and regulatory changes under the Trump Administration. Clients look to him for cutting-edge strategic counseling, risk management, regulatory policy, and government affairs assistance to meet the challenges posed by this fast-paced environment. He is knowledgeable about federal health care programs, including Medicare, Medicaid, the Federal Employees Health Benefits Program, and TRICARE. Xavier also assists clients with their myriad compliance obligations, including Mental Health Parity and Addiction Equity Act audits and investigations, non-discrimination requirements under Affordable Care Act Section 1557, risk adjustment, and medical loss ratio issues.

Recent representative engagements:

  • Analysis of emerging regulatory issues under the Affordable Care Act on behalf of health insurers including medical loss ratio compliance risks, compliance with the annual excise tax on health insurers, premium increase and rate review, and other emerging issues.
  • Representing a managed care organization in response to multiple investigations by the U.S. Department of Health and Human Services Office of Civil Rights regarding compliance with non-discrimination requirements under Affordable Care Act Section 1557.
  • Representing a managed behavioral health care organization in response to a joint state and federal investigation of compliance with the Mental Health Parity and Addiction Equity Act for both fully-insured and self-funded plans.
  • Conducting an internal investigation regarding compliance with Medicare Part D and other issues on behalf of a healthcare provider's Special Litigation Committee in response to a shareholder derivative suit.
  • Advising a Medicaid managed care organization regarding potential fraud and abuse by providers including investigations and litigation.
  • Overseeing a multistate review and revision of a health plan’s provider contracts across multiple lines of business and development of provider incentive arrangements.
  • Providing general counseling, regulatory analysis, and support for pharmacy benefit management contracting for both health plans and pharmacy benefit managers.
  • Counseling health plans on Medicare secondary payer obligations.
  • Assisting health plans with identifying and handling potential federal program overpayments and compliance issues, including risk adjustment data validation audits.
  • Advising Federal Employee Health Benefits Program carriers on compliance and contracting issues.
  • Representing a Medicaid managed care organization in administrative disputes and litigation with a State concerning actuarial soundness of capitation rates, government contracting, and related performance and transition of care issues.
  • Analyzing the Clinical Laboratory Improvement Amendments for health plans and providers.

In addition, Xavier has an active pro bono practice. He successfully represented a Rwandan immigrant seeking political asylum, helped her to obtain her Green Card, and reunited her with her children through derivative asylum. Xavier assisted a special advisory committee regarding the D.C. Medical Liability Captive Insurance Company. He has used his health care regulatory experience to provide health care policy analysis on a diversified set of public policy initiatives to combat pediatric asthma in Washington, D.C. He also led a team of Crowell and Moring attorneys to provide guidance on legal requirements for assisted reproductive technology and custodial issues nationwide. And he co-authored an amicus brief cited by the majority in Whole Woman’s Health v. Hellerstedt, 579 U.S. ____ (2016) on behalf of interested health care provider professional organizations.

Xavier maintains an active role in the legal community. He is a member of the Hispanic National Bar Association, the Hispanic Bar Association of D.C., in which he serves as a mentor to new attorneys and law students, the ABA Health Law Section, and the American Health Lawyers Association, where he serves as the Vice Chair for Research and Website for the Payers, Plans, and Managed Care Practice Group. Xavier is a Leadership Council on Legal Diversity Fellow for 2017.

Xavier graduated from Duke University School of law in May 2004 and from Boston College in 2001, where he obtained a master's degree concurrently with his undergraduate degree. Prior to Crowell, Xavier worked at a prominent D.C. law firm for five years and at a litigation boutique in Minneapolis for two years. He is admitted in the District of Columbia, Minnesota, and the Supreme Court of the United States.

Education

  • Boston College, B.A. classics, philosophy (2001)
  • Boston College, M.A. philosophy (2001)
  • Duke University School of Law, J.D. (2004)

Affiliations

Admitted to practice: District of Columbia, Minnesota

Professional Associations
American Health Lawyers Association
American Bar Association Health Law Section
Hispanic Bar Association of D.C.
Hispanic National Bar Association

View More

"What's At Stake In High Court Row Over ACA Constitutionality," Law360 (August 18, 2020). Authors: Jay DeSanto, Daniel W. Wolff, A, Xavier Baker, and Debbie Lin.
Publication
"In the Midst of a Pandemic, the Validity of the Affordable Care Act will be Revisited this Fall," Litigation Alert (August 6, 2020). Contacts: Jay DeSanto, Daniel W. Wolff, A. Xavier Baker
Client Alert / Newsletter
"NY DFS Proposes Strict Measures Relating to Mental Health Parity Compliance," Health Care Alert (July 17, 2020). Contacts: A. Xavier Baker, Kathy Hirata Chin, Christopher Flynn, Brian McGovern, Paul Mourning, Jared L. Facher
Client Alert / Newsletter
"Trump Administration Scales Back Obama-era Healthcare Nondiscrimination Regulations," Health Care Alert (June 16, 2020). Contacts: A. Xavier Baker, Joe Records
Client Alert / Newsletter
"Supreme Court Rules in Favor of Health Plans in Landmark $13 Billion Affordable Care Act Case," Government Contracts Bullet Points (April 28, 2020). Contacts: Stephen J. McBrady, Daniel W. Wolff, Clifton S. Elgarten, Jacinta Alves, A. Xavier Baker, Skye Mathieson, Charles Baek
Client Alert / Newsletter
Maine Community Health Options Wins U.S. Supreme Court Ruling Enforcing Government Payment Obligation Under Affordable Care Act ‘Risk Corridor’ Cases (Apr.28.2020)
Firm News / Announcement
"Appeals Court Hears Argument on Short-term, Limited Duration Insurance Plan Rule; STLDI Plans are not Required to Provide $0 Cost-share of COVID-19 Diagnostic Testing," Crowell & Moring’s Health Law Blog (April 15, 2020). Authors: A. Xavier Baker and Ian Logan.
Publication
"The $2 Trillion COVID-19 Stimulus Law and Its Impact on the Health Care Industry," Crowell & Moring Webinar (April 1, 2020). Presenters: Jacinta Alves, A. Xavier Baker, Jodi G. Daniel, Jerrica Mathis, and Matthew Vicinanzo.
Speech/Presentation
The National Law Journal Names A. Xavier Baker a Health Care Law Trailblazer (Apr.01.2020)
Firm News / Announcement
"CMS Approves Additional 1115 and 1135 Waivers to Empower State Medicaid Responses to COVID-19," Crowell & Moring's Health Law (March 27, 2020). Author: A. Xavier Baker.
Publication

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Crowell & Moring LLP is an international law firm with more than 500 lawyers representing clients in litigation and arbitration, regulatory, and transactional matters. The firm is internationally recognized for its representation of Fortune 500 companies in high-stakes litigation, as well as its ongoing commitment to pro bono service and diversity. The firm has offices in Washington, DC, New York, Los Angeles, San Francisco, Orange County, London, Brussels, and Shanghai.

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