21st Annual
Medical Device Coverage & Reimbursement Conference
July 16-17, 2025 | Nashville, TN
Navigating Evolving Medical Policy Following Changes to Healthcare Administration While Envisioning Reimbursement Pathways for AI-Enabled Devices & Strengthening Case Management & Appeals Processes
Payers & IROs:
Ed Bolton
CEO
NEXUS
Marc Cohen
Program Manager – Strategy and Development – Clinical & Care Delivery Programs
BLUE CROSS BLUE SHIELD OF MICHIGAN
Anna Wetherbee
Director, Strategic Planning and Performance
BLUE SHIELD OF CALIFORNIA
Eugean Jiwanmall
Senior Research Analyst for Medical Policy & Technology Assessment
INDEPENDENCE BLUE CROSS FAMILY OF COMPANIES
Industry Experts:
Kenneth Boyle
Director, US Markets, HEOR
IRHYTHM TECHNOLOGIES
Aryeh Goldberg
COO
BRUIN BIOMETRICS
Vignesh Iyer
VP, Global Medical Affairs & Market Access
BRUIN BIOMETRICS
Christopher Salmen
VP, Health Economics & Patient Access
CARLSMED
Amy Palatiello
Senior Director, Health Policy and Reimbursement Strategy
MEDTRONIC
Dawn Bina
Director, Payer Accounts
GE HEALTHCARE
Nayan Ghosh
Director, Head of Life Sciences & HealthTech
MARWOOD GROUP
Harry Kovelman
Chief Medical Officer
MYOMO
Rob Ungvary
Director, Field Reimbursement
OLYMPUS
Erin Mayfield
Director, Payor Access
INTRINSIC THERAPEUTICS
Lee A. Fleisher
Former CMS Chief Medical
Officer Principal & Founder
RUBRUM ADVISING
Michelle Guertin
Senior Manager, US AWM Market Access & Reimbursement Strategy
SMITH + NEPHEW
Matthew Lopez
VP, Market Access & Payer Relations
IRHYTHM TECHNOLOGIES
Mark Vesey
Director, Market Access, Americas
NIOX
Alyssa Foster
Partner
4FRONT STRATEGIC PARTNERS
Mark Hiatt
Chief Medical Officer
RADSITE
Sandeep Patil
Vice President, Market Access
NEVRO
Jeffrey Zigler
Vice President, Market Access & Reimbursement
SI-BONE
Tim Johnstad
Managing Director
HEALTHCHECK 360
8:00 REGISTRATION AND WELCOME COFFEE
8:50 CHAIRPERSON’S OPENING REMARKS
9:00 OPENING ICE BREAKER: BUILDING NEW CONTACTS AND SHARING BACKGROUNDS WITHIN THE MEDICAL DEVICE COVERAGE AND REIMBURSEMENT LANDSCAPE
The opening ice breaker will kick-off the event with an opportunity for all participants to move around the conference room and meet new delegates by engaging in short and targeted discussions. In this interactive session, participants are encouraged to meet with peers from different companies and briefly share insight into professional backgrounds, shedding light on the diversity of profiles in the participating audience and kicking off the program networking platform.
9:30 PANEL DISCUSSION: EXPECTATIONS FOR MEDICAL POLICY UPDATES UNDER NEW ADMINISTRATION
• Goals of next administration for healthcare spending
• Implications for Medicare & Medicaid populations
• Adapting market access strategies to shifting payer landscapes
• Preparing for policy changes & sustainable reimbursement success
Aryeh Goldberg, BRUIN BIOMETRICS
Alyssa Foster, 4FRONT STRATEGIC PARTNERS
Nayan Ghosh, MARWOOD GROUP
10:30 COFFEE AND NETWORKING BREAK
11:00 ESTABLISHING AN NCD BY WAY OF THE MEDICARE COVERAGE WITH EVIDENCE DEVELOPMENT PATHWAY
• Qualifications for Medicare’s Coverage With Evidence Development
• Proper data collection & reporting to support technology adoption
• adequate clinical trial involvement from Medicare population
• Reimbursement options for providers & patients in clinical trials
• Proactive steps to transition to NCD without conditional approval
Eugean Jiwanmall, Senior Research Analyst for Medical Policy & Technology Assessment
INDEPENDENCE BLUE CROSS FAMILY OF COMPANIES
11:45 PAYOR COMMUNICATION TASK FORCE: OPPORTUNITIES FOR PAYOR INVOLVEMENT BEFORE REGULATORY PRODUCT APPROVAL
• Review of FDA program initiatives involving payor organizations
• Early Payer Feedback Program
• Parallel Review
• Eligibility, application process & timelines for utilization of programs
• Criteria which appeals most to payors considering participation
• Reflections on advantages & challenges from initial enrollment
Vignesh Iyer, VP, Global Medical Affairs & Market Access
BRUIN BIOMETRICS
12:30 LUNCHEON FOR ALL SPEAKERS, SPONSORS AND ATTENDEES
1:30 PAYER PANEL DISCUSSION: DETERMINING BEST PRACTICES TO OPTIMIZE PATIENT OUTCOMES WHILE CONTROLLING COSTS
• Influence of increased Medicare Advantage plan utilization
• Medical policy’s role in financial stability for health plan & members
• Balancing new technology with traditional coverage pathways
• Factoring health equity & social determinants of health into decisions
• Preferred interactions with manufacturers for meaningful exchange
Aryeh Goldberg, BRUIN BIOMETRICS
Marc Cohen, BLUE CROSS BLUE SHIELD OF MICHIGAN
Anna Wetherbee, BLUE SHIELD OF CALIFORNIA
Eugean Jiwanmall, INDEPENDENCE BLUE CROSS FAMILY OF COMPANIES
2:30 APPROACHES TO GAIN COVERAGE WITH EMPLOYER GROUPS
• Understanding the decision-making process within employer-sponsored plans
• Engaging with benefits managers, HR leaders, & third-party administrators
• Presenting data to align with employer priorities of employee health & cost savings
• Strategies for ongoing engagement & contract renewals with employer groups
Mark Hiatt, Chief Medical Officer
RADSITE
Tim Johnstad, Managing Director
HEALTHCHECK 360
3:15 COFFEE AND NETWORKING BREAK
3:45 ADDRESSING INDUSTRY CONCERNS REGARDING MEDICARE ADVANTAGE DENIAL RATES
• Recent trends in Medicare Advantage policies across health plans
• Review of litigation concerning Medicare Advantage denials
• Expectations for legislation & policy changes under new administration
Amy Palatiello, Senior Director, Health Policy and Reimbursement Strategy
MEDTRONIC
4:30 SMALL GROUP DISCUSSION: RESPONDING TO INCREASING UTILIZATION OF MEDICARE ADVANTAGE COMMERCIAL PLANS
• Sharing successes in overturning denials during appeals process
• Patient education opportunities to advocate for coverage
• Prior authorization requirements specific to medicare advantage
Michelle Guertin, Sr Manager, US AWM Market Access & Reimbursement Strategy
SMITH + NEPHEW
Christopher Salmen, VP, Health Economics & Patient Access
CARLSMED
5:00 Closing Remarks and End of Day 1
Day Two Agenda
Thursday, July 17
8:00 REGISTRATION AND WELCOME COFFEE
8:20 CHAIRPERSON’S OPENING REMARKS
8:30 NAVIGATING THE PROCESS OF SECURING & IMPLEMENTING A NEW CPT CODE
• Ensuring procedure meets the AMA requirements for a new code
• Collaboration with relevant medical organizations for support
• Crafting compelling submissions with clinical data & economic impact
• Development of interim strategies while awaiting CPT code assignment
Jeffrey Zigler, Vice President, Market Access & Reimbursement
SI-BONE
9:15 CALL FOR CASE STUDIES: COMMERCIALIZATION OF DIGITAL HEALTH/AI PRODUCTS WITHOUT A MEDICARE BENEFIT CATEGORY
This session will explore practical revenue-generating opportunities for digital health and artificial intelligence (AI) solutions. Industry leaders and innovators will share case studies highlighting successful monetization strategies, emphasizing either payer or consumer-driven models. Attendees will gain insights into sustainable business approaches that ensure financial viability while delivering value to patients and healthcare systems.
Kenneth Boyle, Director, US Markets
HEOR
Matthew Lopez, Vice President, Market Access & Payer Relations
IRHYTHM TECHNOLOGIES
10:00 COFFEE AND NETWORKING BREAK
10:45 FIRESIDE CHAT: EXPLORING CURRENT CHALLENGES & OPPORTUNITIES IN PRIOR AUTHORIZATION
• Examination of CMS Interoperability & Prior Authorization Final Rule
• Meeting heightened PA requirements from commercial payers
• Assessing growing demands on providers & reimbursement teams
• Leveraging technology, advocacy, & best practices to reduce denials
Sandeep Patil, Vice President, Market Access
NEVRO
Mark Vesey, Director, Market Access, Americas
NIOX
11:30 WORKSHOP: INFORMING HCP BILLING PRACTICES WITH THOUGHTFULLY EXECUTED REIMBURSEMENT GUIDES
• Identifying actual customer utilization & satisfaction with guides
• Critical information to include or exclude in order to be effective
• Considerations for legibility, format & compliance requirements
• Aligning field reimbursement support with reimbursement guide instructions
• Tracking improvement of revised reimbursement guides with customer base
Dawn Bina, Director, Payer Accounts
GE HEALTHCARE
Rob Ungvary, Director, Field Reimbursement
OLYMPUS
12:15 LUNCHEON FOR ALL SPEAKERS, SPONSORS AND ATTENDEES
1:15 A CLOSER LOOK AT THE PATIENT JOURNEY THROUGH APPEALS: PROVIDING HOPE, GUIDANCE & RESILIENCE ALONG THE WAY
• Identifying cases with favorable probability to pursue
• Resources to educate patients about health insurance processes
• Bolstering patient engagement during lengthy timelines
• The role of patient advocates, providers & legal to strengthen appeals
• Opportunities for patients to support & advocate the claim
Erin Mayfield, Director, Payor Access
INTRINSIC THERAPEUTICS
2:00 STRENGTHENING APPEALS TO IMPROVE RESULTS AT THE ALJ LEVEL
• Key differences between lower-level appeals & ALJ hearings
• Managing deadlines & ensuring compliance with appeal requirements
• Coordinating with providers, legal teams, & patient advocates
• Practical knowledge to build compelling arguments in ALJ setting
Harry Kovelman, Chief Medical Officer
MYOMO
2:45 COFFEE AND NETWORKING BREAK
3:15 INDEPENDENT REVIEW: IMPACT ON COVERAGE & REIMBURSEMENT OF MEDICAL DEVICES
• Examining the relationship between IROs & health plans
• Clinical & economic evidence that strengthens a case for coverage
• Common pitfalls in evidence submission & how to avoid them
• Strategies for clarifying discrepancies & reinforcing key evidence
Ed Bolton, CEO
NEXUS
Mark Hiatt, Chief Medical Officer
RADSITE
4:00 CMS PERSPECTIVE: OPPORTUNITIES TO ACCELERATE REIMBURSEMENT STRATEGY UNDER TCET FINAL RULE
• Clarification on eligibility for TCET & payment pathway
• Proper outreach to CMS to secure coverage along TCET timeline
• Evidence requirements for FDA vs. CMS medicare coverage
• Safer Technologies Program (SteP) recognition under CMS
Lee A. Fleisher, Former CMS Chief Medical Officer Principal & Founder
RUBRUM ADVISING
4:45 Closing Remarks and End of Day 2
Previous Attendees Include:
Graduate/Associate Project Manager, 3SHAPE
Senior Medical Director, AETNA
Global HEOR Manager, ALCON
Commercial Counsel, North America, ALIGN TECHNOLOGY
Director, Reimbursement & Market Access, ALLERGAN
VP, Reimbursement & Patient Services, BAXTER
Business Development and Partnerships, BLUE HEALTH INTELLIGENCE
Director, Market Access, BLUEWIND MEDICAL
Principal Health Economist, BOSTON SCIENTIFIC
Director of Healthcare Economics, CANON MEDICAL SYSTEMS USA
Head of US Operations, Remote Care, CARL ZEISS MEDITEC
Sr. Director Healthcare Economics & Market Access, COOPERSURGICAL
Director, GHER, EDWARDS LIFESCIENCES
HEOR Manager, HERAEUS MEDICAL GMBH
Sr Research Analyst, INDEPENDENCE BLUE CROSS
Director, Payor Access, INTRINSIC THERAPEUTICS
Dir. Global Access, Value & Economics-Digital Tech, INTUITIVE SURGICAL
VP, Reimbursement & Market Access, MAINSTAY MEDICAL
Sr Analyst, Healthcare Economics, Policy & Reimbursement, MEDTRONIC
Director, Government Affairs & Market Access, NEVRO CORP
Director of Market Access, Americas, NIOX PLC
Global HEMA, Sr. Manager, GI-ET Medical, Scientific Affairs, OLYMPUS
National Medical Director, OPTUM HEALTH SOLUTIONS
Counsel, OSBORNE CLARKE
President, REMINGTON MEDICAL
Market Access Manager, SPR THERAPEUTICS
Sr. Manager, Field Reimbursement and Market Access, STRYKER
Market Access Specialist, TERUMO BCT
Director, Reimbursement and Payer Relations, THERANICA
Senior Counsel, THOMPSON HINE
National Account Manager, UNITED THERAPEUTICS CORPORATION
Reimbursement & Market Access Associate, VARIAN MEDICAL SYSTEMS
Manager, CSMA, VERANEX
Director Health Economics & Value Analytics, VIZ INC
Market Access Manager, VUNO
US Reimbursement Director, W.L. GORE & ASSOCIATES
Who should attend:
Executives that will find this program of greatest relevance are those currently responsible for securing coverage for emerging technologies, broadening market access & demonstrating the safety, effectiveness and value of product lines, as well as strengthening relationships with government and commercial payers. Job titles of those executives that will find this program to be most applicable to the job function include:
• Reimbursement
• Market Access
• Health Economics
• Health Policy
• Payer Policy
