AGENDA
Tri-Annual
DIAGNOSTIC COVERAGE & REIMBURSMENT CONFERENCE
December 9-10, 2025 | Boston, MA
Omni Parker House Hotel
Understanding Fluctuations in Payer & LBM Policies, Dissecting Factors Influencing Coverage & Pricing Including MolDx Evolution & Impact, all while Remaining Abreast of Changes in Legislation
Jim Koger
Vice President, Product
AVALON HEALTHCARE SOLUTIONS
Christine Bump
Principal
PENN AVENUE LAW & POLICY
Dr. Gabriel Bien-Willner
Medical Director, MolDX & CMO
PALMETTO GBA
Tara Cepull
Industry Strategy & Outreach Advisor
QUADAX, INC.
Dan McGuinn
VP of Business Development
FRONTRUNNERHC
Ann Lambrix
Vice President of Revenue Cycle Management
LIGHTHOUSE LAB SERVICES
Jerry Conway
Senior Vice President, Market Access
BELAY DIAGNOSTICS
Erik Schulwolf
Counsel
HOGAN LOVELLS US LLP
Kerry Bush
President & COO
CAIRN DIAGNOSTICS
Jonathan Bugart
Director, US Marketing
ABBOTT
Jennifer Archer
Senior Director of Market Access
ARTERA AI
Jonathan Burgart
Director, US Marketing
ABBOTT
Marc Kellner
IT-VP, Product Management
QUADAX, INC
Dr. Steven Goldberg
Chief Medical Officer
HEALTHTRACKRX
Paige Nardi
Executive VP of Market Access, Reimbursement & Billing, HEPQUANT
Rebecca Hulinsky
Director of Genome Strategy & Solutions
QUEST DIAGNOSTICS
Darla Wanitschke
Vice President, Customer Success
TELCOR
Eric Lam, PhD
Sr. Vice President, Market Access and Reimbursement
AVANIA
Wesley Buckingham
VP, Medical Affairs
REVEAL GENOMICS
Avania
Speaker Pending
Eugean Jiwanmall
Senior Research Analyst, Medical Policy & Technology Evaluation
INDEPENDENCE BLUE CROSS
Danielle Tangorre
Partner
ROBINSON & COLE, LLP
Mark Hiatt, MD, MBA, MS
Chief Medical Officer
RADSITE
John Donnely (JD)
Founder & CEO
FRONTRUNNERHC
Jon Minken
Vice President, Market Access
LUCID DIAGNOSTICS
Kevin Liang
Vice President, Strategy & Growth
OPTUM GENOMICS
Countdown to the Diagnostic Coverage & Reimbursement Conference
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Who Should Attend
Executives working within diagnostic testing and life sciences organizations who will find this program most relevant are those navigating compliance with evolving coverage and reimbursement policies, preparing for new state and federal regulations, adapting to payer requirements, and addressing provider and patient expectations for timely access to advanced testing.
Market Access
Reimbursement
Payer Relations/Strategy
Health Policy
Government Affairs
National Accounts
Agenda – Day One
Tuesday, December 9
8:00 REGISTRATION & WELCOME COFFEE
8:40 CHAIRPERSON’S OPENING REMARKS
John Donnely (JD), Founder & CEO
FRONTRUNNERHC
8:50 PANEL DISCUSSION: REDEFINING SCREENING & DIAGNOSTIC BOUNDARIES IN COVERAGE POLICY
• FDA and CMS distinctions shaping definitions of screening versus diagnostics
• Preventative versus diagnostic coding rules driving coverage determinations
• Implications for multi-cancer early detection and minimal residual disease tests
• Navigating the ‘valley of death’ between regulatory approval and CMS reimbursement
Moderated by: Dan McGuinn, FRONTRUNNERHC
Kevin Liang, OPTUM GENOMICS
Eugean Jiwanmall, INDEPENDENCE BLUE CROSS
Wesley Buckingham, REVEAL GENOMICS
*Additional payer leaders to be announced soon
9:35 REDUCING HEALTH DISPARITY AND INCREASING ACCESS: WHAT IT MEANS FOR DIAGNOSTIC LABS AND HEALTH PLANS
• Define health disparity and its impact on diagnostic coverage.
• Explore how health plans operationalize access goals at the community level.
• Show how labs can align with payer initiatives to improve access and patient outcomes.
• Highlight how demonstrating social responsibility can strengthen a lab’s value proposition.
Mark Hiatt, MD, MBA, MS, Chief Medical Officer
RADSITE
Speaker Pending, POINT32HEALTH
10:20 COFFEE & NETWORKING BREAK
10:50 THE IMPACT OF PAMA, SALSA, AND CLIA ON TODAY’S DIAGNOSTIC LANDSCAPE
• Current status of PAMA reform and potential congressional fixes
• Ongoing SALSA and CLIA revisions and their Implications for labs
• Dissecting the disconnect between FDA and CMS policymaking processes
• Anticipating 2026 regulatory shifts and their impacts on lab reimbursement
Christine Bump, Principal
PENN AVENUE LAW & POLICY
11:35 FIRESIDE CHAT: THE EMERGING ROLE OF LAB BENEFIT MANAGERS (LBMs)
• Transparency, value proposition, and payer reliance
• Opportunities for labs to better collaborate with LBMs
• Policy automation and the newest impacts on labs
Ann Lambrix
LIGHTHOUSE LAB SERVICES
Jim Koger
AVALON HEALTHCARE SOLUTIONS
12:20 LUNCHEON
1:20 EVIDENCE GENERATION AND CLINICAL UTILITY FOR PAYER ADOPTION
• Defining intended use and aligning evidence with payer policy frameworks
• Clarifying payer expectations for clinical utility and outcome relevance
• Addressing barriers that limit payer acceptance of new diagnostics
• Designing study approaches that demonstrate real-world value to payers
Kerry Bush, President & COO
CAIRN DIAGNOSTICS
2:10 AVANIA CASE STUDY PRESENTATION
Eric Lam, PhD, Sr. Vice President, Market Access and Reimbursement
AVANIA
2:50 TRANSFORMING MEDICARE ADVANTAGE ACCESS & PRIOR AUTHORIZATION MANAGEMENT
• Rising documentation burdens and expanded administrative requirements for labs
• Downstream impact of budget cuts, contracting disputes, and payer cost controls
• Strategies enabling stronger alignment with evolving Medicare Advantage requirements
• Collaborative lab-physician approaches for easing prior authorization challenges
Dr. Steven Goldberg, Chief Medical Officer
HEALTHTRACKRX
3:30 COFFEE & NETWORKING BREAK
3:40 REDEFINING AUDIT PREPAREDNESS & COMPLIANCE FOR FUTURE-PROOF PAYMENTS
• Discover the flags that trigger payer audits and how to avoid them
• Anti-kickback, Stark, and state-specific restrictions
• Documentation efficiencies and compliance to ensure reimbursement
• Aligning compliance practices with evolving payer reimbursement models
Danielle Tangorre, Partner
ROBINSON & COLE LLP
4:30 OVERCOMING BARRIERS TO AI-DRIVEN DIAGNOSTIC ADOPTION
• Payer skepticism and emerging acceptance of AI-driven diagnostics
• Clinical evidence thresholds required for coverage decisions
• Coding and reimbursement challenges for algorithm-only outputs
• Lessons from early AI diagnostic adoption and payer engagement
Jennifer Archer, Senior Director of Market Access
ARTERA AI
5:30 CLOSING REMARKS AND END DAY ONE
Agenda – Day Two
Wednesday, December 10
8:00 REGISTRATION & WELCOME COFFEE
8:20 CHAIRPERSON’S OPENING REMARKS
Tara Cepull, Industry Strategy & Outreach Advisor
QUADAX, INC.
8:30 MOLDX MASTERY: DRIVING SUCCESSFUL SUBMISSIONS AND ACCELERATING MARKET ACCESS
• MolDX’s technical assessments process and what is covered
• Policy development and payer adoption (Medicare vs Commercial)
• Strategies for successfully navigating MolDX submissions
• Case study examples of successful vs stalled submissions
Dr. Gabriel Bien-Willner, MD, PhD, FCAP, Chief Medical Director, MolDX & CMO
PALMETTO GBA
9:15 PANEL DISCUSSION: 2026 STRATEGIC PLAYBOOK FOR CONTRACTING & NETWORK ACCESS WITH PAYERS
• Actionable solutions for laboratories struggling to secure payer contracts
• Case study examples navigating complex IPA and HMO contracting structures
• Influence of evidence generation and clinical utility on payer decision-making
• Long-term contracting strategies designed to strengthen payer partnerships
Paige Nardi, HEPQUANT
Jon Minken, LUCID DIAGNOSTICS
Moderated by: Darla Wanitschke, TELCOR
10:00 COFFEE & NETWORKING BREAK
10:20 PROACTIVE CLAIMS MANAGEMENT & REVENUE OPTIMIZATION
• Prior authorization, medical record requests, and expanded pre-payment reviews
• AI applications for streamlining and accelerating the revenue cycle
• Case study examples demonstrating improved claim pull-through rates
• Role of payer portals, advanced automation, and predictive analytics tools
Marc Kellner, IT-VP, Product Management
QUADAX, INC
Tara Cepull, Industry Strategy & Outreach Advisor
QUADAX, INC.
11:00 THE RETURN OF THE CLINICAL LAB FEE SCHEDULE (CLFS) IN 2026
• Review of CLFS’ tri-annual reporting standards
• Previous impacts on labs who opted not to report
• Evolving methods: Crosswalking vs Gap-filling
• Implications for test pricing and reimbursement
Erik Schulwolf, Counsel
HOGAN LOVELLS US LLP
12:00 LUNCHEON
1:00 ADVANCING COVERAGE PATHWAYS FOR NEXT-GENERATION SEQUENCING (NGS)
• Review of the 2025 Medicare update on CLIA-certified and physician-ordered testing
• Expanded documentation, coding, and compliance requirements for NGS claims
• Commercial payer responses and evolving criteria for NGS coverage decisions
• Future reimbursement outlook and long-term implications for NGS adoption
Rebecca Hulinsky, Director of Genome Strategy & Solutions
QUEST DIAGNOSTICS
1:45 DRIVING INNOVATION THROUGH PHARMA-DIAGNOSTICS COLLABORATION
• Shared models between Rx companies and diagnostics for biomarker advancement
• Lessons learned from cardiovascular and oncology biomarker development
• Opportunities for earlier integration of diagnostics into drug development pipelines
• Balancing risks and reward in Rx & Dx alliances to unlock sustainable revenue growth
Paige Nardi, Executive Vice President of Market Access, Reimbursement, & Billing
HEPQUANT
2:30 COFFEE & NETWORKING BREAK
2:50 THE (TRUE) VALUE OF THE LAB
• Reframing the lab from cost center to profit driver through accurate valuation and strategic investment
• Strengthening hospital financial performance by targeting high-ROI lab initiatives
• Immediately actionable projects to enhance patient care, reduce financial leakage, and generate new revenue streams
Jonathan Burgart, Director, US Marketing
ABBOTT
3:30 DRIVING PATIENT ENGAGEMENT & NEXT-GEN DIAGNOSTIC HUBS
• Direct patient engagement in shaping coverage and reimbursement decisions
• Operational lessons from successful and failed patient hub models
• Emerging direct-to-consumer strategies with high adoption rates and access
• Balancing competing priorities across payers, providers, and patient needs
Jerry Conway, Senior Vice President, Market Access
BELAY DIAGNOSTICS
4:00 CLOSING REMARKS AND CONFERENCE CONCLUSION
Attendees by Job Title
%
VP or Higher
%
Director
%
Manager
%
Associate
%
Other
Previous Attendees Include
Senior Payer Relations Specialist, ADAPTIVE BIOTECHNOLOGIES
Executive Director, Market Access, ARTERA
Executive Director, Market Access, ASPIRA WOMEN’S HEALTH
Chief Medical Officer, AVALON HEALTHCARE SOLUTIONS
Client Manager, BEACONONE HEALTHCARE PARTNERS
Senior Vice President, Market Access, BELAY DIAGNOSTICS
Vice President, Market Access, BILLIONTOONE INC.
National Account Director, BIODESIX
Vice President, Market Access, BIO-TECHNE/EXOSOME
Director, Lab and Precision Medicine, BLUE CROSS BLUE SHIELD
Senior Consultant, BLUE CROSS BLUE SHIELD
Senior Director, Market Access, CAREDX
National Account Manager, Managed Care, CASTLE BIOSCIENCES
Vice President of Reimbursement, CASTLE BIOSCIENCES
Director, Billing & Reimbursement, CLEVELAND DIAGNOSTICS
Senior Global Director, ELI LILLY
Revenue Cycle Billing Manager, EUROFINS – TRANSPLANT GENOMICS
Corporate Account Director, Market Access, EXOSOME DX
Director of Market Access, GENEDX INC
Chief Executive Officer, GENOMIND
Chief Commercial Officer, GLX ANALYTICS
Vice President, Payer and Revenue Management, GOPATH DIAGNOSTICS
Senior Director, Reimbursement & Policy, GRAIL
Vice President, Managed Care, GUARDANT HEALTH
Vice President, Market Access, Reimbursement & Billing, HEPQUANT
Senior Director of Market Access, HOLOGIC
Precision Medicine Value & Access, J&J INNOVATIVE MEDICINE
Medical Affairs Director, MERCK
Medical Affairs Director, MERCK
Associate Director, Appeals & Denials, NATERA INC.
Vice President of Market Access, NAVERIS
Director, Traditional Medicare, QUEST DIAGNOSTICS
Vice President of Sales, SYNERGEN HEALTH
Vice President of Customer Success, TELCOR
….And Many Many More
