A Special Thanks to Our Sponsors

Day One Agenda
Thursday, May 23

 8:00   REGISTRATION & WELCOME COFFEE

8:50   CHAIRPERSONS OPENING REMARKS
Ann Lambrix, VP RCM Solutions
LIGHTHOUSE LAB SERVICES

9:00   OPENING ICE BREAKER: SHARING SUCCESSES IN CREATING EFFICIENCIES TO OPTIMIZE REIMBURSEMENT STRATEGIES
Through this interactive session, participants in the event are given the unique opportunity to meet with fellow delegates and speakers, all while exchanging tips on preferred methods to enhance reimbursement strategies, such as collaborating with new solution providers, bridging communication gaps with other corporate teams, finding new ways to stay updated on industry trends or other examples, ultimately kicking off the event knowledge-sharing and networking platform.

9:30   PANEL DISCUSSION: UNDERSTANDING THE PSYCHOLOGY OF THE PAYER  & CLINICIAN TO PURSUE MARKET ACCESS EFFECTIVELY
• Appealing to what matters most to the payer
• Addressing medical directors as clinicians
• Elaborating upon payers’ mindset, mission & vocabulary
• Targeting the payer’s primary focus: Patients/members
Mark Hiatt, Chief Medical Officer
RADSITE
Dennis Robbins, Former  Visiting Scholar & Research Fellow in Medical Ethics
HARVARD SCHOOL OF PUBLIC HEALTH
Eugean Jiwanmall, Sr Research Analyst; Medical Policy & Technology Evaluation
INDEPENDENCE BLUE CROSS

10:15  COFFEE & NETWORKING BREAK

10:45   FIRESIDE CHAT: SHEDDING LIGHT ON LBMs’ PREPONDERANT POSITION IN THE REIMBURSEMENT LANDSCAPE
• Position of LBMs vis-à-vis private payer organizations
• Increasing reliance of payers on LBM decisions
• Methodology for test validation & decision-making process
• Opportunities for labs & developers to communicate
• Involvement & areas of focus once the test is on the market
• Forecast of LBM weight in the foreseeable future
Ben Horton, VP, Senior Medical Director
AVALON HEALTHCARE SOLUTIONS
Paige Nardi, VP Market Access, Reimbursement & Billing
HEPQUANT

11:30   PAYER ROUNDTABLE: CLARIFYING METHODOLOGIES TO MAKE INFORMED COVERAGE DECISIONS
• Technology evaluation process walkthrough
• Preferences towards clinical testing methodologies
• Expectations towards evidence to demonstrate:
         » Clinical utility
         » Economic value
• Positive decision criteria: Key data to secure coverage
• Policy development & updating mechanisms & influences
MODERATOR:
Paige Nardi, VP Market Access, Reimbursement & Billing
HEPQUANT
PANELISTS:
Eugean Jiwanmall, Sr Research Analyst; Medical Policy & Technology Evaluation
INDEPENDENCE BLUE CROSS
Mike Detolla, SVP, Product Strategy
OPTUM in the panelists
Gabriel Bien-Willner, Program Medical Director, MolDX & CMO
PALMETTO GBA

12:30   LUNCHEON FOR ALL SPEAKERS, SPONSORS & ATTENDEES

1:30   PANEL DISCUSSION: CLARIFYING Z-CODES & INCREASING REQUIREMENTS FROM PAYERS
• Z-codes history & purpose in the diagnostic field
• Rationale for recent shift in UHC’s requests for Z-codes
• Implications for test developers in obtaining payment
• Managing the ripple effect & forecast of the near future
Gabriel Bien-Willner, Program Medical Director, MolDX & CMO
PALMETTO GBA
Sarah Overton, Director, Revenue Cycle Management
VELSERA
Ann Lambrix, VP RCM Solutions
LIGHTHOUSE LAB SERVICES

2:15   FIRESIDE CHAT: PAYERS’ PERSPECTIVES ON AI-POWERED TECHNOLOGIES
As artificial intelligence (AI) has become increasingly integrated into the diagnostic offerings of labs; helping, for example, to identify biomarkers for panels, patients for trials, and therapies for patients; examining how payers will respond in terms of coverage and reimbursement is of crucial importance. Further questions raised by the industry include whether AI will  be integrated with, or separate from the technologies it powers in policy and payment in addition to the overall enthusiasm and appetite for AI-enabled diagnostics.
Mark Hiatt, Chief Medical Officer
RADSITE
Orest Boyko, Chief Scientific Officer & Founding Member
AMERICAN BOARD OF AI IN RADIOLOGY (ABAIR)
Hassan Tetteh, CEO
HUMANCARE TECHNOLOGIES

3:00   COFFEE & NETWORKING BREAK

3:30  LESSONS LEARNED IN NAVIGATING MEDICARE & MEDICAID AUDITS
• Understanding the contractors
• Navigating the appeals process
• Challenging adverse audit results
• Responding to audits & potential consequences from negative audits
Julia Dawson, Associate Director, Managed Care
PACIFIC EDGE DIAGNOSTICS

4:15  PANEL DISCUSSION: DEFINING CRITICAL COMPONENTS OF A HOLISTIC APPEALS STRATEGY
• Addressing the increasing volume of appeals to manage
• Methods to expedite first & second level lab-submitted appeals
• Diving further into third, fourth level appeals & more
• Potential partnerships with patients & appealing to outside entities
Darla Wanitschke, Director of Customer Success, RCM Implementation
TELCOR
Julia Dawson, Associate Director, Managed Care
PACIFIC EDGE DIAGNOSTICS
Anna Ogloblina, Director of Product Management
BOSTONGENE

5:00   Closing Remarks & End of Day 1

Day Two Agenda
Friday, May 23

8:30   REGISTRATION & WELCOME COFFEE

8:50   CHAIRPERSON’S OPENING REMARKS
Darla Wanitschke, Director of Customer Success, RCM Implementation
TELCOR

9:00   UNVEILING STRATEGIES TO STREAMLINE & OPTIMIZE PRIOR AUTHORIZATION PROCESSES
A common challenge faced by most laboratories and test developers resides in managing cumbersome prior authorization processes to ultimately obtain payment for the use of a test. Through a practical case study, followed by small group discussions, the audience is given the unique opportunity to learn from fellow participants and exchange lessons and experience pertinent to the use of third party service providers, proven strategies to create efficiencies, as well as methods to alleviate the administrative burden in handling prior authorization tasks and paperwork.

PART 1 – CASE STUDY
Christopher Ho, Sr. VP, Customer Operations Group
MYRIAD GENETICS

9:30   PART 2 – SMALL GROUP DISCUSSIONS
Suzanne Belinson, VP of Commercial Markets
TEMPUS

10:15   COFFEE & NETWORKING BREAK

10:45   MASTERING & ENHANCING STRATEGIES TO OPTIMIZE EVIDENCE PRODUCTION
Given the critical importance of demonstrating clinical utility, scientific validity, and economic value to healthcare payer organizations in order to secure coverage and reimbursement, teams must ensure a sound evidence generation strategy is in place. Working off of each participant’s personal experience, this session enables attendees to discuss with peers in a small group format, and share valuable lessons learned relevant to methods aiming at enhancing evidence generation in the clinical setting.

PART 1 – CASE STUDY: PRACTICAL APPROACH TO ANALYZE EVIDENCE NEEDS & REACH TARGETED GOALS
Anna Ogloblina, Director of Product Management
BOSTONGENE

11:30   PART 2 – SMALL GROUP DISCUSSIONS: SHARING EXPERIENCE & LESSONS LEARNT
Anna Ogloblina, Director of Product Management
BOSTONGENE
Suzanne Belinson, VP of Commercial Markets
TEMPUS

12:15   LUNCHEON FOR ALL SPEAKERS, SPONSORS & ATTENDEES

1:15  DISSECTING FDA’S FINAL RULE GOVERNING LDTS & EFFECT ON LABORATORIES
• Amendment to 21 C.F.R. Part 809
• General Phaseout of Enforcement Discretion
• Tests Exempted from the Phaseout Policy Entirely
• Tests Exempted from Part of the Phaseout Policy
• Implementation Expectations
• Impact on Laboratories
• What Should Laboratories Do Now?
Christine P. Bump, Principal
PENN AVENUE LAW & POLICY

2:00  IMPACT OF THE INFLUX IN BIOMARKER STATE LAWS ON DIAGNOSTIC REIMBURSEMENT
• Clarifying the rationale for biomarker-specific legislation
• Panorama of current implementation & expectations for the future
• Enforcement in practice & effect on diagnostic labs to date
• Successes or lack thereof in communicating with State agencies
Erik Schulwolf, Associate
FOLEY HOAG

2:45   LABORATORY SALES & MARKET ACCESS PROGRAMS: CURRENT LEGAL PERSPECTIVES & COMPLIANCE CHALLENGES
• Types of patient assistance/guidance services
• Best practices & potential pitfalls
• Eliminating Kickbacks in Recovery Act
• Addressing post-EKRA sales commissions
• Potential impact of the recently proposed Anti-Kickback amendments
• Recent federal enforcement actions
Colin Zick, Partner
FOLEY HOAG

3:30   Closing Remarks & Conference Conclusion