Kevin O'Brien

Executive Director & Advisor to PEO

Chicago

Kevin O’Brien has provided accounting, financial, economic, and operational consulting services to health service organizations involved in the healthcare, health insurance, and pharmaceuticals industries.

Mr. O’Brien is a leader in the firm’s International Healthcare and Pharmaceutical practices. He has extensive experience with government paid programs (e.g., Medicare, Medicaid, Federal Employees Program, and TriCare) and the intricacies of the numerous reimbursement and cost-reporting requirements associated with these programs.

Mr. O’Brien has been recognized as an expert in federal and state courts and other venues. The subject matter of his expert testimony has included regulatory guidance, fraud investigations, damage calculations, business valuations, and claims processing policies, procedures, and practices.

He was the testifying expert on the Cleveland Tyson v. Amerigroup Illinois and Amerigroup Corp. qui tam case, which resulted in the largest jury award ever granted under the False Claims Act. Additionally, Mr. O’Brien has testified on numerous matters involving the usual, customary, and reasonable rates charged by hospitals to payers in conjunction with out-of-network emergency room services.

In the area of managed care, Mr. O’Brien has developed and monitored financial and operational budgets for health maintenance organizations, preferred provider organizations, and exclusive provider organizations, among others. He has performed systems reviews and implementations and has recommended changes in internal controls resulting in improved operational efficiencies and safeguards over plan and program assets. He has also performed rate setting, profit improvement, and operations studies to identify the reasons for lack of profit and determined means of improving profits or eliminating losses.

Mr. O’Brien has provided consulting and expert services to pharmaceutical manufacturers, distributors, re-packagers, wholesalers, retailers, pharmacy benefit management companies, and various regulatory bodies. He has assessed pricing strategies, rebate formulae, and inventory tracking methodologies. Specifically, Mr. O’Brien has analyzed pharmaceutical product markets, valued pharmaceutical products in conjunction with co-promotion agreements, and performed compliance and operational reviews of numerous pharmaceutical clients.