Alex Lucas
Overview
With a wealth of experience in health care compliance and regulatory matters, Alex Lucas serves as a trusted advisor to managed care organizations (MCO) across the country. She frequently advises clients on compliance with key legislation, including the Consolidated Appropriations Act of 2021, reproductive care and gender-affirming care laws, and various government program requirements. Alex also has experience addressing specific compliance issues involving Medicare Advantage Organizations, Medicaid MCOs, Marketplace products, and ERISA plans and administrators.
Career & Education
- University of Chicago Law School, J.D., 2013
Served in the Institute for Justice Clinic on Entrepreneurship; staff member of the Chicago Journal of International Law - University of Minnesota, B.A., high distinction, Psychology, 2009
- University of Chicago Law School, J.D., 2013
- Illinois
- U.S. District Court for the Northern District of Illinois
- U.S. District Court for the Southern District of Illinois
- U.S. Court of Appeals for the Tenth Circuit
- U.S. Court of Appeals for the District of Columbia Circuit
Alex's Insights
Firm News | 5 min read | 08.06.25
Chicago – August 06, 2025: Crowell & Moring today announced that a group of 16 highly regarded health care litigation partners is joining the firm, together with their team, and led by accomplished trial attorney Martin J. Bishop. The strategic combination creates one of the largest health care practices in the country and expands the firm’s ability to provide clients across the industry with the full spectrum of litigation, investigations, regulatory, transactional, and recovery capabilities. The team joins from Reed Smith, where Bishop served on the firm’s executive committee.
Representative Matters
- Counseled multiple managed care companies regarding compliance with and implementation of the No Surprises Act (NSA), which prohibits surprise balance billing by out-of-network providers on a federal level, as well as other requirements in the Consolidated Appropriations Act of 2021.
- Pursued litigation on behalf of MCOs against multiple providers and affiliated entities alleging improper practices in the NSA’s independent dispute resolution (IDR) process and claiming RICO violations, among other state and federal causes of action.
- Fully administered the NSA’s IDR process for multiple payors and assisted other payors in developing on IDR strategy and preparation of IDR-related written materials.
- Consulted with multiple MCOs regarding Transparency in Coverage requirements, including compliance with machine-readable file specifications and implementation of the member cost estimator tool, as well as compliance with the gag clause prohibition.
- Assisted in developing evidence of coverage (EOC) documents for state-regulated plans and individual retail policies to ensure compliance with applicable state and federal laws, with a focus on ACA and Marketplace requirements.
- Advocated for clients in regulatory audits and developed procedures to reduce exposure in such audits, including performing internal audits of MCO compliance in anticipation of regulatory review.
- Advised on compliance and risk under federal and state laws with regard to adjudication of health care claims for emergency services.
- Advised on compensation and compliance issues regarding agents, brokers, and third-party marketing organizations who market government program products and individual insurance products.
- Counseled clients regarding the internal processes necessary to ensure compliance with prompt payment requirements.
- Obtained an arbitration ruling entirely in her MCO client’s favor in an arbitration brought by a large hospital system alleging breach of contract and underpayment of many Medicaid, Medicare Advantage, and commercial health care claims.
- Secured a 12(b)(6) dismissal of an air ambulance company’s ERISA complaint when, given express exclusions in the benefit plan, the plaintiff had failed to allege that it was entitled to benefits as the patient’s assignee.
- Tried and obtained a favorable ruling on behalf of a managed care company and Medicaid MCO in an arbitration brought by a hospital system alleging improper application of the prudent layperson standard to thousands of emergency department claims.
- Obtained a summary judgment victory on behalf of a managed care company against operators of non-participating freestanding emergency departments who sought statutory penalties under the Texas prompt payment statutes with respect to thousands of health care claims.
- Secured the dismissal of claims brought by an air ambulance provider against a managed care company on the basis that the Texas Insurance Code provision regarding payment for emergency services did not create a private right of action for providers.
- Secured a 12(b)(6) dismissal of an ERISA benefits complaint against a managed care company alleging underpayment of air ambulance transportation because the plaintiff failed to identify the health benefit plan provisions entitling it to additional payment.
- Secured a 12(b)(6) dismissal with prejudice of a former policyholder’s conspiracy-based claims against a managed care company because the court lacked subject matter jurisdiction; the D.C. Circuit upheld the decision.
- Represented a managed care company in an arbitration involving cross-claims for overpayment and underpayment of nearly 700 hospital claims with complex, varied reimbursement issues.
- Secured a 12(b)(6) dismissal of a provider’s tortious interference and defamation claims against a managed care company, securing the client’s rights to advise in-network providers of their contractual obligations; this dismissal was upheld by the Tenth Circuit.
- Obtained a summary judgment dismissal of a $200 million arbitration claim against a managed care company that was sued by a hospital system for alleged violations of the Texas prompt pay statute and other provisions of the Texas Insurance Code.
- Obtained a significant summary judgment ruling in the Fifth Circuit Court of Appeals for a managed care company holding that non-insured products are not subject to Texas’s prompt pay statute.
Alex's Insights
Firm News | 5 min read | 08.06.25
Chicago – August 06, 2025: Crowell & Moring today announced that a group of 16 highly regarded health care litigation partners is joining the firm, together with their team, and led by accomplished trial attorney Martin J. Bishop. The strategic combination creates one of the largest health care practices in the country and expands the firm’s ability to provide clients across the industry with the full spectrum of litigation, investigations, regulatory, transactional, and recovery capabilities. The team joins from Reed Smith, where Bishop served on the firm’s executive committee.
Recognition
- Chambers USA: Illinois Healthcare, 2025
Alex's Insights
Firm News | 5 min read | 08.06.25
Chicago – August 06, 2025: Crowell & Moring today announced that a group of 16 highly regarded health care litigation partners is joining the firm, together with their team, and led by accomplished trial attorney Martin J. Bishop. The strategic combination creates one of the largest health care practices in the country and expands the firm’s ability to provide clients across the industry with the full spectrum of litigation, investigations, regulatory, transactional, and recovery capabilities. The team joins from Reed Smith, where Bishop served on the firm’s executive committee.
Alex's Insights
Firm News | 5 min read | 08.06.25
Chicago – August 06, 2025: Crowell & Moring today announced that a group of 16 highly regarded health care litigation partners is joining the firm, together with their team, and led by accomplished trial attorney Martin J. Bishop. The strategic combination creates one of the largest health care practices in the country and expands the firm’s ability to provide clients across the industry with the full spectrum of litigation, investigations, regulatory, transactional, and recovery capabilities. The team joins from Reed Smith, where Bishop served on the firm’s executive committee.
