Edward A. Baker
Of Counsel, New York Office
646 400-1412

Edward Baker

Edward Baker represents a broad range of whistleblowers and has extensive experience with healthcare fraud under the federal False Claims Act and equivalent state acts.

Prior to joining Lieff Cabraser, Mr. Baker was an Assistant U.S. Attorney in the Eastern District of California, where he was the Civil Healthcare Fraud Coordinator, as well as the Elder Justice Coordinator, within the Affirmative Civil Enforcement practice group.

As an AUSA, Mr. Baker investigated numerous FCA cases, including allegations against physicians for medically unnecessary procedures, pharmacies for kickbacks to nursing homes, defense contractors and federal grant recipients for fraudulent billing, and hospitals for up-coding. He was the lead attorney for the United States in an FCA settlement against a group of Fresno cardiologists for performing medically unnecessary nuclear scans, and in a qui tam settlement against Omnicare, Inc., a national long-term care pharmacy, for improperly submitting claims for prescription drugs dispensed to patients in skilled nursing facilities. He worked closely with criminal prosecutors to enhance the district’s parallel proceedings practice and coordinated regular meetings of the EDCA Healthcare Fraud Task Force.

In September 2023, Ed published an auditing tip in the e-newsletter of the National Alliance of Medical Auditing Specialists (NAMAS) on the U.S. Supreme Court’s 2022 decision in U.S., et al, ex rel. Schutte, et al. v. SuperValu, Inc., et al. In December 2023, he published an additional auditing tip for NAMAS on Cigna’s 2023 $172 million False Claims Act settlement with the DOJ.

Prior to serving as an AUSA, Mr. Baker was an Assistant Attorney General for the State of Vermont, where he was the Director of the Medicaid Fraud and Residential Abuse Unit. In that capacity, he was responsible for all aspects of the management and operation of Vermont’s Medicaid Fraud Control Unit, charged with investigating and prosecuting, both civilly and criminally, fraud and patient abuse/neglect within Vermont’s Medicaid program. He was a member of the litigation table team for thirty-six states in a qui tam lawsuit against Wyeth and Pfizer for Medicaid pharmaceutical “best price” violations that ultimately resulted in a $785 million settlement. He also laid the groundwork for the enactment of the Vermont False Claims Act and held leadership positions within the National Association of Medicaid Fraud Control Units.

Prior to his eight years of government service, Mr. Baker was in private practice, first, as a litigator in the Government Enforcement Defense practice group of a large Boston law firm, then at a national plaintiff’s firm where he litigated antitrust and securities class actions.

Mr. Baker has a J.D. cum laude from the University of Wisconsin-Madison. During law school, he was a Managing Editor of the Wisconsin Law Review, and the founder of a student organization devoted to exploring the intersection of legal theory and practice. He was elected Class Orator at graduation, and was recognized for his outstanding service to the law school, and for scholarship, character, and contribution to the greater community. In addition to his law degree, Mr. Baker has an M.A. in Religion from Yale University, and an M.A. in Philosophy from Tufts University. He graduated from Dartmouth College with a B.A. in Philosophy modified with Biology.

Mr. Baker is admitted to practice in the District of Columbia, Massachusetts, New Hampshire, and Vermont; as well as in the U.S. District Courts for the Eastern District of New York, Eastern District of California, Eastern District of Wisconsin, District of Massachusetts, and the District of Vermont.

Long form bio (click to open pdf).

  • University of Wisconsin-Madison Law School, Madison, Wisconsin
    J.D, cum laude, 2001
  • Yale University, New Haven, Connecticut
  • Tufts University, Medford, Massachusetts
  • Dartmouth College, Hanover, New Hampshire
  • District of Columbia, 2020
  • New Hampshire, 2010
  • Vermont, 2010
  • Massachusetts, 2002
  • U.S. District Court, Eastern District of New York, 2021
  • U.S. District Court, District of Colorado, 2019
  • U.S. District Court, District of Vermont, 2010
  • U.S. District Court, District of Massachusetts, 2003
  • American Health Lawyers Association, Payers, Plans, and Managed Care Practice Group, Fraud and Abuse Practice Group
  • Federal Bar Association, Qui Tam Section
  • Taxpayers Against Fraud, Government Relations Subcommittee, Medicaid Managed Care Subcommittee
  • Risk Adjustment and Coding: What’s Fraud Got to Do with It?, AAPC HealthCon, April 14-17, 2024
  • The False Claims Act, 15th Annual NAMAS Auditing & Compliance Conference, December 7-8, 2023
  • FCA and Liability for Risk Adjustment, HCCA Annual Healthcare Enforcement Compliance Conference, November 5, 2023
  • The Future is Now: Managed Care Enforcement Trends and Compliance Best Practices, ABA Health Law Section 4th Annual National Managed Care Institute, October 12, 2023
  • AI and the False Claims Act, Federal Bar Association Qui Tam Section Roundtable, October 11, 2023
  • Before the Subpoena Arrives: Proactive Strategies for Payers and Providers to Get Ahead of Medicare Advantage Compliance Problems, BCBS 2023 Law, Audit, Compliance & Ethics Conference, August 6-9, 2023
  • The Essential Role of Coders and Auditors in Risk Adjustment Litigation, AAPC HealthCon, May 24, 2023
  • Risk Adjustment Panel, AAPC HealthCon, May 22, 2023
  • A Moving Target: Key Litigation and Regulatory Developments in Medicare Advantage Risk Adjustment, AHLA Health Plan Law and Compliance Institute, May 19, 2023
  • Risk Adjustment Litigation and Risk Areas for Plans, Providers, and Others, RISE CompliancePalooza 2022, Oct. 11, 2022
  • The FCA and the Controlled Substances Act, FBA Qui Tam Section Webinar, Sept. 28, 2022
  • The Current State of Risk Adjustment Litigation and Risk Areas for MA Plans, Vendors, and Downstream Entities, RISE West 2022, Sept. 1, 2022
  • FCA Medicaid Fraud Litigation: Defense, DOJ, and Relator Perspectives, NAMFCU Global Team Leader Symposium, Aug. 3, 2022
  • Updates to the MA Risk Adjustment Toolkit, AHLA Educational Webinar, July 11, 2022
  • Risk Adjustment FCA Cases: Government Overreach or Reasonable Oversight?, AHLA Annual Meeting 2022, June 29, 2022
  • An Update on FCA Legal Developments and Trends, NAMFCU Training Conference, Mar. 30, 2022
  • Fraud and Abuse: Tracking the Latest in Medicare and Medicaid Related Enforcement Actions and What it Means for Payors Going Forward, ACI Advanced Managed Care Forum, Mar. 31, 2022
  • Real Life Risk Adjustment Compliance Failures: How to Avoid Turning a ‘Glitch’ Into a ‘Gotcha’, RISE National 2022, Mar. 9, 2022
  • Selected for inclusion by peers in The Best Lawyers in America in the field of “Qui Tam Law,” 2022-2024
  • DOJ Ramps Up Enforcement Against Covid-19 Fraud,” Constantine Cannon Whistleblower Insider, April 2022
  • “Jury finds Teva Pharmaceuticals Liable for Contributing to Opioid-Related Deaths in New York State,” Constantine Cannon Whistleblower Insider, Jan. 2022
  • “WBOTY Nomination: Daniel Ellsberg and The GroundTruth Project,” Constantine Cannon Whistleblower Insider, Dec. 2021
  • “Pharmacy Owner Convicted in $174 Million Telehealth Fraud that Targeted Consumers and PBMs,” Constantine Cannon Whistleblower Insider, Dec. 2021
  • “Next Up: Infrastructure Oversight Week,” Constantine Cannon Whistleblower Insider, Nov. 2021
  • Op-Ed, “On the Anniversary of the Gettysburg Address, We Should Follow Lincoln’s Lead,” Patriot News – Lancaster PA, Nov. 21, 2021
  • “Whistleblower Reveals Facebook’s Lies: Will the SEC or Congress Act to Curtail Threats to Democracy and Teens from Social Media?,” Constantine Cannon Whistleblower Insider, Oct. 2021
  • “United States Reaches a ‘Tipping Point’ in Managed Care Enforcement,” Constantine Cannon Whistleblower Insider, July 2021
  • “FDA’s Approval of Alzheimer’s Drug Highlights Need for Whistleblowers,” Constantine Cannon Whistleblower Insider, July 2021
  • Co-Author, AHLA Medicare Advantage Risk Adjustment Litigation “Toolkit,” AHLA PPMC Practice Group, July 2021 (updated Mar. 2022, Nov. 2022)
  • Constantine Cannon, LLP, Of Counsel
  • U.S. Department of Justice, Assistant U.S. Attorney, Eastern District of California
  • Office of the Vermont Attorney General, Director, Medicaid Fraud & Residential Abuse Unit
  • Boies, Schiller & Flexner, LLP, Associate
  • New York