Michelle is a health policy advisor to employers and plan sponsors, health insurance issuers, third party administrators, and trade associations. Applying a strategic and pragmatic approach, she is an integral part of our health practice, which advocates for clients before the U.S. Departments of Health and Human Services (“HHS”), Labor, and Treasury and she helps clients anticipate what regulatory action is coming from those agencies, interpret federal rules and trends, and navigate compliance with applicable rules, regulations, and laws. She also works with clients to understand the intricacies of complex health legislation. Michelle’s experience covers wide-ranging laws impacting health and welfare benefits, including the Affordable Care Act (“ACA”), the No Surprises Act, the Mental Health Parity and Addiction Equity Act (“MHPAEA”), state insurance law, and Medicare and Medicaid.
Michelle joined Groom from HHS, where she spent more than a decade at the Center for Consumer Information and Insurance Oversight (‘CCIIO”), within the Centers for Medicare and Medicaid Services (“CMS”). Most recently she served as the Deputy Division Director, Division of Plan and Issuer Enforcement, Oversight Group at CCIIO. While at CCIIO, she worked across a mix of policy development, implementation, and enforcement.
As the Deputy Division Director, Michelle led the team overseeing health plan compliance with the ACA, No Surprises Act, MHPAEA, and other federal mandates. This work included conducting Market Conduct Exams, Qualifying Payment Amount Audits, MHPAEA NQTL reviews, and complaint investigations. She designed enforcement strategies to identify trends in noncompliance and improve oversight using technology tools. She also regularly briefed senior leadership on policy, enforcement, and litigation developments, engaged with external stakeholders regarding compliance and enforcement issues, and collaborated with federal partners at the Departments of Labor and Treasury on enforcement and policy implementation.
Her prior experience with CCIIO included working on the ACA Section 1332 state waiver program, ACA market reform policy, and the federal COVID-19 response. Before joining CCIIO, she worked at the American College of Physicians (“ACP”) where she served as a policy advisor to develop policy and advocate on behalf of ACP’s members.
