21st Annual
Medical Device Coverage & Reimbursement Conference
July 16-17, 2025 | Nashville, TN
Hotel Indigo Nashville
21st Annual
Medical Device Coverage & Reimbursement Conference
July 16-17, 2025
Nashville, TN
Hotel Indigo Nashville
Navigating Evolving Medical Policy Following Changes to Healthcare Administration While Envisioning Reimbursement Pathways for AI-Enabled Devices & Strengthening Case Management & Appeals Processes
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 NAVIGATING MEDICARE ADD-ON PAYMENTS: EXPERIENCE FROM THE TRENCHES IN NTAP AND TPT PAYMENT FOR HOSPITAL PRODUCTS
• Requirements for inpatient and outpatient add-on payment
• The relevance of FDA breakthrough device designation
• Assessing the updates on the latest CMS policies
• Optimizing reimbursement for products as it comes to market
Stephen Hull, Senior Vice President, Market Access
AVANIA LLC
11:45 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
Anna Wetherbee, BLUE SHIELD OF CALIFORNIA
Eugean Jiwanmall, INDEPENDENCE BLUE CROSS FAMILY OF COMPANIES
12:30 LUNCHEON FOR ALL SPEAKERS, SPONSORS AND ATTENDEES
1:30 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
Tim Johnstad, Managing Director
HEALTHCHECK 360
Mark Hiatt, Chief Medical Officer
BIOADA
2:30 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
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
• 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
5:15 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 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
9:30 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
10:15 COFFEE AND NETWORKING BREAK
10:45 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
IRHYTHM TECHNOLOGIES
Kirsten Tullia, Vice President, Payment & Health Care Delivery Policy
ADVAMED
11:45 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
RECOR MEDICAL
Mark Vesey, Director, Market Access, Americas
NIOX
12:30 LUNCHEON FOR ALL SPEAKERS, SPONSORS AND ATTENDEES
1:30 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
2:15 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, NationalDirector, Payor Access
INTRINSIC THERAPEUTICS
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
BIOADA
4:00 Closing Remarks and End of Day 2
