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Conferences and Speeches

7th Annual Government Programs Summit 2015

Monday, March 23, 2015

2015 will be the one-stop-shop for all things government programs merging together regulatory compliance and financial calculations to maximize revenue potential.

Join us at the most comprehensive GP event to date, where you will navigate through critical legal, compliance, strategy, and financial updates of ACA expansion from regulatory leaders and policy makers. IIR’s Government Programs Summit keeps you informed on rapidly changing reporting requirements, and provides the tools to ensure correct pricing calculations to achieve compliance excellence in Government Programs. This event is designed to share collective understanding of each program, including new calculation methodologies, how healthcare reform will impact government programs and a clear view on how the program can work well, with solutions to challenges.

Donna Lee Yesner presented on the TRICARE Manufacturers Update.

This session provided an overview on the TRICARE Retail Refund Program including, with topics including:

  • Insight on handling disputes and appealing disputes (tracking, documenting, etc.)
  • Best practices for storing and retrieving utilization data
  • Figuring interest and penalties, challenging TMA’s calculations
  • Introduction of new products

Stephen Ruscus spoke about Medicare Part B and ASP Part B Drug Pricing Methodologies, Coverage, and Coding, where topics included:

  • Status of the proposal to substitute AMP for products with high ASPs and how manufacturers will handle this.
  • For coverage of products for off-label uses, how can you ensure off-label indications are properly documented in compendia and by physicians?
  • Evaluate the potential increase in payments for drugs used in the hospital outpatient setting.
  • Current efforts by OIG and State AG to obtain data on timely submission of ASP data and the implications of late filed ASPs.
  • In CMS’s proposed treatment of “intentional overfill,” understand how ASP will be calculated for “overfilled” products.
  • Determine how reimbursement of biosimilars under Part B will be handled and strategies for managing new coding protocols and a hybrid payment model.