A Special Thanks to Our Sponsors

Day One Agenda
Tuesday, February 7

8:00   REGISTRATION & WELCOME COFFEE

8:50   CHAIRPERSON’S OPENING REMARKS
John (JD) Donnelly, Founder & CEO, FRONTRUNNER HC

9:00   OPENING ICE BREAKER: SHARING INSIGHTS INTO EFFICIENT METHODS TO REMAIN UPDATED ON HEALTHCARE MARKET TRENDS IMPACTING REIMBURSEMENT
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 collect market intelligence, ultimately kicking off the event knowledge-sharing and networking platform.

9:30   PAYER ROUNDTABLE DISCUSSION: UNVEILING PERSPECTIVES INTO DIAGNOSTIC REIMBURSEMENT REQUIREMENTS
• Comparing coverage & reimbursement decision-making mechanisms
• Focus on the quality & quantity of evidence to demonstrate value
• Perspectives into partnerships with providers & value-based agreements
MODERATOR:
Christopher Ho, MYRIAD GENETICS
PANELISTS:
Dirk Slaker, OPTUM HEALTH SOLUTIONS
Krystal Revai, HEALTH ALLIANCE
Eugean Jiwanmall, INDEPENDENCE BLUE CROSS

10:15   COFFEE & NETWORKING BREAK

10:45  FIRESIDE CHAT: SHEDDING LIGHT ONTO LBM DIAGNOSTIC TEST REVIEW PROCESSES
With the prominent position that Laboratory Benefit Managers have progressively taken in the reimbursement landscape, laboratories and test manufacturers alike are eager to secure a deeper understanding of the review process itself and differing requirements from one organization to another. Through questions coming directly from the audience, LBM representatives in this session will provide replies enabling a clarified approach to diagnostic test value assessment.
Tara Burke, VP, Payment & Healthcare Delivery Policy, ADVAMED
Ben Horton, VP, Medical Director, AVALON HEALTHCARE

11:30   THE CRITICAL PATH: STRATEGIES TO MAXIMIZE REIMBURSEMENT VIA PLA & CPT CODES
• Evidence requirements for PLA vs Cat I CPT codes
• Applicable timelines & processes for code obtention
• Payer acceptance & coverage of PLA vs Cat I CPT codes
• Implications on pricing strategy for both coding pathways
Eric Lam, Sr. Director of Market Access, HULL ASSOCIATES

12:15   LUNCHEON FOR ALL SPEAKERS, SPONSORS & ATTENDEES

1:30   PANEL DISCUSSION: IMPROVING REIMBURSEMENT & PATIENT SATISFACTION BY ENSURING CLEAN ORDERS
• Common desire that payers, providers & labs may share: A clean order
• Critical points hindering clean orders:
         » Inaccurate patient data
         » Prior authorizations
         » Medical Policy
• Proactive approach to problem-solving by leveraging smart technology
• Benefits in approaching reimbursement from the front end
• Reducing claims denials, wasted time & patient/physician dissatisfaction with a clean claim
MODERATOR:
John (JD) Donnelly, FRONTRUNNER HC
PANELISTS:
Ryan Hortin, MYRIAD GENETICS
Matt Collins, MEDLAB2020

2:15   MAXIMIZE INSURANCE REIMBURSEMENT USING ACTIONABLE ANALYTICS
• Reimbursement environment complexities for newer diagnostic tests
• Advanced analytics to pinpoint areas of improvement
• Actionable analytics beyond standard financial metrics & KPIs
• Varied & multidisciplinary approach to common actions to optimize reimbursement
• Examples of analytics triggering a change to the reimbursement strategy
Tom Cronin, VP of Client Services, QUADAX
Chad Miles, Director of Client Services, QUADAX

3:00   COFFEE & NETWORKING BREAK

3:30   WHOLE GENOME SEQUENCING – IS BIGGER BETTER?
• What is a Genome
• When is it important to test
• Pro & Con of testing
• Open dialogue on audiences thoughts
Debbie Windsor, VP Market Access, GENEDX

4:15  CLARIFYING THE NO SURPRISES ACT & IMPLICATIONS FOR LABS & MANUFACTURERS
• Rationale for & implementation of the act
• Areas of impact on laboratories & developers
• Legal considerations for a robust compliance strategy
• Opportunities & positive outcomes to expect
Brian Carey, Partner, FOLEY HOAG

5:00   FIRESIDE CHAT: PROS & CONS TO ADVOCATING FOR LABORATORIES IN THE WAKE OF MEDICARE & PAMA
• Realistic approach to Medicare & PAMA frameworks
• Clarifying lobbying initiatives from independent organizations
• Paths forward & projected outcomes in the short & long term
Tara Burke, ADVAMED
Rob Dumanois, THERMOFISHER SCIENTIFIC

5:30   CLOSING REMARKS AND END OF DAY 1

Day Two Agenda
Wednesday, February 8

8:00   REGISTRATION & WELCOME COFFEE

8:20   CHAIRPERSON’S OPENING REMARKS
Dean Paluch, CRO, WAVE HDC

8:30   PANEL DISCUSSION: MEDICAL NECESSITY—HOW TO DEFINE, MEET, & MAINTAIN IT
• Remaining abreast of medical necessity criteria & changes in them
• Determining payer needs with respect to medical necessity & how to meet them
• Maintaining the evidentiary base to remain medically necessary
MODERATOR:
Randy David, QURE HEALTHCARE
PANELISTS:
Artem Boltyenkov, SIEMENS HEALTHINEERS
Rob Dumanois, THERMOFISHER SCIENTIFIC
Jerry Conway, GENEDX 
Mike Nall, BIOLOGICAL DYNAMICS

9:00   OPPORTUNITIES IN MERGING MEDICAL & PHARMACY BENEFITS TO ACHIEVE PERSONALIZED MEDICINE
• Breaking down barriers between medical & pharmacy to allow integration of personalized medicine
• Innovative approaches to bridge the relationship between the PBM & the health plan
• Deep dive into ongoing pilot programs enabling the bridge & expected outcomes
Paige Nardi, Executive Director, Market Access, SCIPHER MEDICINE

9:45   COFFEE & NETWORKING BREAK

10:15   PRACTICAL APPROACH TO THE APPLICATION OF PLA & CPT CAT. I CODE SETS
• Pros & cons to the use of PLA vs CPT Cat. I codes
• Payer feedback in the appreciation of one vs the other
• Real-life examples illustrating efficiencies gained with each set
Lee Hilborne, Corporate Medical Director, QUEST DIAGNOSTICS

11:00   OPTIMIZING EVIDENCE GENERATION VIA A SOUND APPROACH TO STUDY DESIGN
• Clinical study design most relevant to payers
• Realistic & defined approach to evidence targets
• Reaching the right type & amount of data
Samira Saad, Medical Access Partner, ROCHE DIAGNOSTICS

11:45   CASE STUDY: AUTOMATING PATIENT DATA COLLECTION & DATA CORRECTION PROCESS
• Bad data leads to decreased revenue & increased cost of reimbursement in laboratories
• Improving accuracy & reducing errors by automating patient data collection & correcting data
• Benefits of automation in reducing bad data & increasing revenue/cost savings in the reimbursement process
Seth Maheu, President/CEO, BIRDROCK LABORATORIES

12:30   LUNCHEON FOR ALL SPEAKERS, SPONSORS & ATTENDEES

1:30   REIMBURSEMENT FOR AI-POWERED DIGITAL PATHOLOGY: CURRENT STATE, GAPS & OPPORTUNITIES
• Potential frameworks to describe clinical, economic & practice value
• Addressing payor concerns & coverage criteria with evidence
• Current & emerging reimbursement pathways for AI diagnostics
• Review & impact of recent decisions by the AMA CPT & CMS
• Call to action for industry, providers & payors to advance AI adoption & coverage
Shivang Doshi, VP of Global Payor Relations & Reimbursement, PAIGE

2:15   DEMYSTIFYING THE CMS CLFS PRICING PROCESS
• New code obtention: Lack of timeline & outcome predictability
• Review of Medicare pricing process:
     » Public Meetings & comment periods
     » Advisory panel involvement
     » Engagement with medical contractors
• Clarifying the crosswalk & gapfill pricing methodologies
• ADLT alternative pricing methodology & code obtention pre or post coverage
Erik Schulwolf, Associate, FOLEY HOAG

3:00   DISSECTING THE VALID ACT & IMPACT ON  DIAGNOSTIC REIMBURSEMENT
• Review of the provisions & new IVCT category
• Impact on diagnostic test reimbursement
• Pivotal focus points in preparing for compliance
Michael Ryan, Partner, MCDERMOTT WILL & EMERY

3:45   CLOSING REMARKS AND CONFERENCE CONCLUSION