Kristen O'Brien

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Kristen O’Brien is an accomplished healthcare executive with a deep understanding of regulatory advocacy and healthcare policy efforts. Kristen offers a strong background and a keen eye for solutions to barriers and challenges impacting healthcare clients. With more than 10 years of experience, her work focuses on implementing new laws through the rulemaking process, as well as working with relevant agency officials to develop and improve agency guidance. Read Kristen O’Brien's full bio.

CMS Releases CY 2025 Advance Notice for Medicare Advantage and Part D


By and on Mar 21, 2024
Posted In Employee Benefits, Health and Welfare Plans

On January 31, 2024, the US Centers for Medicare & Medicaid Services (CMS) released the Advance Notice of Methodological Changes for Calendar Year (CY) 2025 for Medicare Advantage (MA) Capitation Rates and Part C and D Payment Policies. CMS also released a press release and fact sheet. The advance notice is released on an annual basis and includes proposed updates...

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What Does Landmark AI Executive Order Mean for Healthcare?


By and on Dec 6, 2023
Posted In Digital Health, Employee Benefits, Health and Welfare Plans

On October 30, 2023, the Biden administration released a long-awaited Executive Order (EO) on the “Safe, Secure, and Trustworthy Development and Use of Artificial Intelligence.” The EO acknowledges the transformative potential of AI while highlighting many known risks of AI tools and systems. It directs a broad range of actions around new standards for AI...

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An Update on the No Surprises Act


By , and on Sep 28, 2023
Posted In Employee Benefits, Health and Welfare Plans



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Texas District Court Overturns Portions of the IDR Process


By , , and on Sep 14, 2023
Posted In Employee Benefits, Health and Welfare Plans

On August 3, 2023, the US District Court for the Eastern District of Texas ruled on the implementation of the No Surprises Act in Texas Medical Association, et al. v. US Department of Health and Human Services, et al. (TMA IV). In TMA IV, the plaintiffs challenged two things: The increased administrative fee to participate...

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Congress Advances Four Bipartisan Healthcare Bills


By , , and on Jul 24, 2023
Posted In Employee Benefits, Health and Welfare Plans

The US House and Senate returned from recess, beginning a three-week sprint toward the August break. The bipartisan healthcare legislation on pharmacy benefit managers (PBMs) and healthcare transparency is moving through both the House and Senate. The House Education and the Workforce Committee held a markup of a bipartisan healthcare package of four bills. The...

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Federal Government to Wind Down Vaccination Mandates


By , and on May 9, 2023
Posted In Employee Benefits, Health and Welfare Plans

The Biden administration has announced that the federal government will wind down its remaining COVID-19 vaccination mandates (including those for federal workers, contractors and international air travelers) effective May 11, 2023. This action coincides with the conclusion of the COVID-19 public health emergency (PHE). Additionally, the US Department of Health and Human Services (HHS) will...

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District Court Vacates Provisions of No Surprises Act Final Rule


By , and on Mar 10, 2023
Posted In Employee Benefits, Health and Welfare Plans

On February 6, a US district court in Texas vacated provisions of the No Surprises Act final rule related to the independent dispute resolution (IDR) process for determining payment for out-of-network services. The district court granted summary judgment to the Texas Medical Association, which had brought suit against the US Departments of Health and Human...

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HHS Announces Record Number of ACA Marketplace Enrollments


By , and on Feb 23, 2023
Posted In Employee Benefits, Health and Welfare Plans

On January 25, 2023, the US Department of Health and Human Services (HHS) announced that more than 16.3 million people nationwide selected an ACA Marketplace health plan during the 2023 open enrollment period that ran from November 1, 2022, until January 15, 2023, for most marketplaces. According to HHS, total plan selections include 3.6 million people...

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Supreme Court OKs CMS Vaccine Mandate but Blocks OSHA Rule


By , , , and on Jan 18, 2022
Posted In Employee Benefits, Employment, Health and Welfare Plans, Labor

On January 13, 2022, the Supreme Court of the United States released two emergency opinions that change the landscape of the three federal vaccine rules. In summary: A 5-4 Court majority let the Centers for Medicare & Medicaid Services (CMS) enforce its vaccine mandate nationwide, impacting specified healthcare facilities. A 6-3 majority blocked the US...

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Fifth Circuit Brings Enforcement Back into the Mix: The Latest Court Moves with the CMS Vaccination Mandate


By , , and on Dec 21, 2021
Posted In Employee Benefits, Employment, Health and Welfare Plans, Labor

A flurry of litigation in federal district and appellate courts has led to an even split between states in which the COVID-19 vaccine mandate issued by the US Centers for Medicare and Medicaid Services (CMS) may be implemented and states in which such implementation has been prevented. Additional appeals are expected shortly; however, the practical...

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