Xavier’s practice includes a variety of health care regulatory compliance issues in health care transactions and business arrangements. He represents clients that are involved in, or invest in, the health care and life sciences industries.
He has a particular focus on regulatory and compliance issues related to the Affordable Care Act and federal health care programs such as Medicare, Medicaid, and TRICARE. He regularly advises health plans and other payor-side organizations participating in Medicare Advantage, Part D, and Medicaid Managed Care, and often advises health plans and related organizations on complex issues related to copay accumulators, copay maximizers, and alternative funding programs; utilization management and prior authorization; the 340B program; and risk adjustment and medical loss ratio. He also has experience with accountable care organization compliance and contracting, and has advised risk-based providers and organizations on compliance with state insurance requirements.
Xavier also provides regulatory counsel to private equity firms and other investors in mergers and acquisitions involving a variety of targets, including health systems and other health care providers, pharmacies, health insurance plans and pharmacy benefit managers, accountable care organizations, laboratories, health care technology companies, and risk adjustment vendors.
On behalf of health care providers (including health care facilities and agencies, physician groups, and veterinary practices), Xavier has extensive experience advising clients on compliance with corporate practice of medicine and fee splitting prohibitions, and state and federal licensure and regulatory filing requirements. He also routinely advises these and other health care industry clients on legislative and regulatory trends, including on issues such as drug pricing and risk adjustment.
While in law school, Xavier served as an intern in the US Department of Health and Human Services’ Office of Inspector General and Vermont Legal Aid’s Office of the Health Care Advocate. He also worked as a senior research assistant at The George Washington University Milliken Institute School of Public Health, where he contributed to projects around health care regulatory issues.
viewpoints
PBM Policy and Legislative Update — Winter 2024
April 9, 2024 | Blog | By Theresa Carnegie, Tara E. Dwyer, Rachel A. Alexander, Bridgette Keller, Madison Castle, David Gilboa, Xavier Hardy, Abdie Santiago, Hassan Shaikh, Sophia Temis
Safeguarding Reproductive Rights
February 23, 2024 | Article
Mintz IRA Update — Demystifying the IRA’s Small Biotech Exception
February 21, 2024 | Blog | By Xavier Hardy, Abdie Santiago
Mintz IRA Update — Second Edition: Q1 2024
February 21, 2024 | Blog | By Rachel A. Alexander, Theresa Carnegie, Tara E. Dwyer, Madison Castle, Mitchell Clough, Xavier Hardy, Stephnie John, Bridgette Keller, Abdie Santiago, Hassan Shaikh
Mintz IRA Update — Legal Challenges to the Medicare Drug Price Negotiation Program Continue
February 21, 2024 | Blog | By Xavier Hardy, Matthew Tikhonovsky
Health Law Diagnosed — Mintz Health Law Team: Reflecting on What We Are Grateful For
February 5, 2024 | Podcast | By Bridgette Keller
HHS Court Filings Indicate that Agency Intends to Preserve Copay Accumulators
December 4, 2023 | Blog | By Theresa Carnegie, Xavier Hardy, David Gilboa
Court Strikes Down HHS Rule on Copay Accumulators: Implications for Health Plans and PBMs
October 9, 2023 | Blog | By Theresa Carnegie, Xavier Hardy, David Gilboa
Mintz IRA Update — Inaugural Edition
September 20, 2023 | Blog | By Theresa Carnegie, Tara E. Dwyer, Mitchell Clough, Xavier Hardy, Stephnie John, Bridgette Keller, Lauren Moldawer, Pat Ouellette, Hassan Shaikh
Mintz Health Law: What We Are Grateful For
January 11, 2023| Podcast|
News & Press
HHS Pushes Back on Accumulator Ruling, Prompting Wait-and-See Situation
December 21, 2023
Mintz Advises Kindred Healthcare in Sale to LifePoint Health, Launching ScionHealth
December 23, 2021
Mintz Advises Kindred at Home in $5.7 Billion Sale to Humana
August 23, 2021
Monopsony Issues in the Post-ACA World: How the Affordable Care Act May Impact Monopsony Analyses in the Review of Health Insurance Mergers
October 1, 2016
Events & Speaking
Involvement
- Member, American Health Lawyers Association