AdvaMed Payment Policy Forum
May 21, 2024: 8:15 AM – 4:15 PM ET
May 22, 2024: 8:15 AM – 12:00 PM ET
Explore and discuss the current Centers for Medicare & Medicaid Services (CMS) process and policies, payment for digital health technologies, private payer challenges and more.
AdvaMed Payment Policy Forum
May 21, 2024: 8:15 AM – 4:15 PM ET
May 22, 2024: 8:15 AM – 12:00 PM ET
AdvaMed Payment Policy Forum
May 21, 2024: 8:15 AM – 4:15 PM ET
May 22, 2024: 8:15 AM – 12:00 PM ET
AdvaMed’s in-person Payment Policy Forum is designed for experienced medtech professionals that have a comprehensive understanding of the evolving landscape of medtech payment policies. This is the perfect opportunity to gain insights from leaders from CMS and industry experts as they delve into pressing payment policies. Join our mailing list to be the first to receive key programming updates!
Join these participating companies and speakers at the AdvaMed office for the Forum at 1301 Pennsylvania Ave NW Ste 400, Washington, D.C. 20004.
This Forum will provide you with:
- Actionable strategies for achieving successful payment outcomes and tips on how to best navigate working with CMS
- In-person networking opportunities and a live Q&A with our expert panel of speakers and CMS leaders
- Dynamic discussions about timely payment challenges medtech companies are facing
Who Should Attend:
- MedTech market access professionals and leaders. This event will dive deeper into key coding, coverage and payment issues.
- MedTech professionals looking to engage CMS staff and other key opinion leaders.
- Those who have previously attended AdvaMed’s MedTech Coverage, Coding and Reimbursement 201 Workshop.
The 2024 agenda is now live! You can view the program below and download a copy of it here. Don’t miss any program or speaker updates- join our mailing list to be the first to receive the latest event information.
Tuesday, May 21 | |
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8:15 am – 9:00 am | Check in & Networking Breakfast |
9:00 am – 9:05 am | Welcome Remarks |
9:05 am – 11:00 am | Medicare Advantage Bootcamp Jim Mathews, Principal, Health Policy Alternatives Pierre Poisson, Principal, Health Policy Alternatives – Contextualize recent and rapid growth of the Medicare Advantage Program and discuss similarities to/differences from Traditional Medicare – Explore ins-and-outs of Medicare Advantage program administration, including supplemental benefits program – Discuss ongoing concerns regarding Medicare Advantage plans, including increasing use of prior authorization – Review recent CMS regulations and guidance on increased oversight of the Medicare Advantage program |
11:00 am – 11:15 am | Break |
11:15 am – 12:00 pm | Pre-Lunch Keynote: Medicare Technologies Ombudsman TJ Sutphin, New Technology Liaison and Acting Pharmaceutical and Technology Ombudsman, Centers for Medicare & Medicaid Services Keynote remarks include: – A review of the role of the new technology ombudsman – A discussion of opportunities to receive assistance navigating CMS – An introduction to CMS Guide to Medical Technology Companies |
12:00 pm – 1:00 pm | Networking Lunch |
1:00 pm – 2:00 pm | Commercial Payor Issues Moderator: Carla Monacelli, Strategic Advisor, JD Lymon Ben Finder, Vice President of Coverage Policy, American Hospital Association A panel discussion of issues including: – Current issues with commercial payors, including utilization management and customer service – Tips on interacting and obtaining coverage with commercial payer plans – Study design and evidence generation |
2:00 pm – 3:00 pm | Medicaid Issues Moderator: Julie Khani, Corporate Vice President, Government Affairs and Corporate Communications, Hologic Phillip Burrell, Director, Marwood Group Craig Kennedy, President and CEO, Medicaid Health Plans of America Andrey Ostrovsky, Managing Partner, Social Innovation Ventures; Former US Medicaid Chief Medical Officer This panel discussion will cover: – Medicaid unwinding – Medicaid coverage and payment for pediatric devices – Impact of Medicaid reimbursement policy on women’s health – Coding implication for diagnostic tests |
3:00 pm – 3:15 pm | Break |
3:15 pm – 4:15 pm | Digital Health Tech Payment Moderator: Kirsten Tullia, Senior Vice President, Payment and Healthcare Delivery Policy, AdvaMed Richard Frank, Principal, Frank Healthcare Advisors, LLC Brian Lee, Partner, Alston & Bird Paul Radensky, Senior Counsel at McDermott, Will & Emery LLP A panel discussion of issues including: – Payment for different types of digital health technology, including digital therapeutics and AI-enabled imaging – Coverage of AI and ML technologies across settings of care – Opportunities for improvement in CMS’ durable medical equipment pathways to reflect innovative new technologies |
4:15 pm | Networking Reception |
Wednesday, May 22 | |
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8:15 am – 9:00 am | Networking Breakfast |
9:00 am – 9:05 am | Welcome Remarks |
9:05 am – 10:00 am | AMA CPT Session: Coding Change Application Process and Challenges Moderator: Tara Burke, Vice President, Payment and Healthcare Delivery Policy, AdvaMed Zach Hochstetler, Vice President, Coding and Payment, American Medical Association Josh Makower, Professor of Medicine & Bioengineering, Director & Co-Founder, Stanford Byers Center for Biodesign at Stanford University School of Medicine; Founder & Exec Chairman, ExploraMed – Review code change application criteria (CCA) and process – Overview of preliminary findings from Stanford Biodesign stakeholder survey on CPT application process – Discuss CPT CCA process challenges |
10:00 am – 10:50 am | CMS Session #1: Medicare FFS Moderator: Kirsten Tullia, Senior Vice President, Payment and Healthcare Delivery Policy, AdvaMed Jason Bennett, Director, Technology, Coding, and Pricing Group, Center for Medicare, Centers for Medicare & Medicaid Services Ryan Howe, Director, Hospital & Ambulatory Policy Group, Centers for Medicare & Medicaid Services TJ Sutphin, New Technology Liaison and Acting Pharmaceutical and Technology Ombudsman, Centers for Medicare & Medicaid Services CMS leaders will provide an overview of their roles within Medicare Fee for Service and their policy priorities, highlighting opportunities for medtech engagement in policy development. Robust question-and-answer session to follow. |
10:50 am – 11:10 am | Networking Break |
11:10 am – 12:00 pm | CMS Session #2: Medicare Coverage Moderator: Amber Stock, Vice President, Payment and Healthcare Delivery Policy, AdvaMed Tamara Syrek-Jensen, Director, Coverage and Analysis Group, Center for Clinical Standards and Quality, Centers for Medicare & Medicaid Services Elizabeth Truong, Director, Division of Policy Coordination & Implementation, Centers for Medicare & Medicaid Services CMS leaders will provide an overview of their roles in Medicare and Medicaid coverage policymaking, including the National Coverage Determination and Local Coverage Determination development processes, and their policy priorities. Robust question-and-answer session to follow. |
12:00 pm | Program Concludes |
Jason Bennett, Director of the Technology, Coding, and Pricing Group, Centers for Medicare & Medicaid Service
Jason Bennett is the Director of the Technology, Coding, and Pricing Group at the Centers for Medicare & Medicaid Services (CMS). This Group serves as a focal point for manufacturers to engage with Medicare fee-for-service on coding and payment for new products that Medicare beneficiaries and their clinicians may choose when making their health care decisions. Since joining CMS in 2017, Jason has served in leadership and senior advisor roles on Medicare policy and program issues. Prior to joining CMS, Jason served in a series of progressive management and analytical roles across the Department of Health and Human Services since 2005. His prior roles include serving in the Office of the Secretary, the Health Resources and Services Administration (HRSA), and as the first-ever chief of staff at the Administration for Community Living (ACL), working on aging and disability policies and programs. His broad range of operational and policy experience includes the response to the COVID-19 pandemic, 340B drug discount program, organ transplantation, workforce development and shortage issues, rural health, food and drug regulation, post-acute care and long-term services and supports, end-stage renal disease, the launch of the Medicare Part D program in 2005-2006, and budget formulation and execution.
Ben Finder, Vice President of Coverage Policy, American Hospital Association
Benjamin Finder, M.P.H., is Vice President of Coverage Policy at the American Hospital Association (AHA). He provides policy and data analysis to support the Association in its advocacy efforts and in the development of well-informed policy positions.
Prior to joining the AHA, he was a senior analyst at the Medicaid and CHIP Payment and Access Commission, a legislative advisory commission that provides policy analysis and makes recommendations to Congress. He has also served as an associate director at the District of Columbia’s Medicaid agency, the Department of Health Care Finance, and as a policy analyst at the Kaiser Family Foundation, where he performed data analysis of health expenditures, and trends in employer-sponsored health insurance.
Mr. Finder holds a Master of Public Health from The George Washington University, where he concentrated in health policy and health economics. He received his bachelor’s degree from Washington University in St. Louis.
Richard A. Frank, MD, PhD, Principal, Frank Healthcare Advisors, LLC
Zach Hochstetler, Vice President, Coding and Payment, American Medical Association
Zach Hochstetler is the director of CPT Editorial and Regulatory Affairs in the American Medical Association’s Health Solutions business unit. Zach’s work focuses on several key areas that include leading and setting strategic direction for the CPT Editorial Panel and directing the communication of health care policies, through identification and resolution of national payment and reporting problems. He is also the secretary of the CPT Editorial Panel, ensuring that the process remains open and transparent.
Ryan Howe, PhD, Director, CMS/Hospital & Ambulatory Policy Group
Ryan Howe is the Director of the Hospital and Ambulatory Policy Group in the CMS Center for Medicare. He has previously served in several leadership positions within the Center for Medicare and focused expertise on a wide range of payment issues, including for professional and other ambulatory services, hospital services, telehealth services and Part B drugs.
Julie Khani, Corporate Vice President, Government Affairs and Corporate Communications, Hologic
Julie Khani leads Hologic’s internal and external communications and government affairs strategies, enhancing and protecting the company’s reputation and brand with policymakers, the media, key stakeholders and the general public. She was president of the American Clinical Laboratory Association prior to joining Hologic in 2021. Previously, she served in senior roles at the National Association of Chain Drug Stores, Ford Motor Company and Planned Parenthood Pennsylvania Advocates. She holds a Bachelor of Arts from New York University and a Master of Public Administration from George Washington University.
Brian Lee, JD, MPH, Partner, Alston & Bird LLP
Brian Lee is a partner with Alston & Bird’s Health Care Group and focuses his practice on regulatory and legislative issues concerning federal reimbursement for and regulation of physicians, hospitals, post-acute care providers, insurers, and manufacturers. Brian assists clients in navigating Medicare coverage and reimbursement requirements and Medicare payment policies and provides counsel on the development and implementation of strategic initiatives in response to congressional and administrative coverage and reimbursement changes.
Brian currently serves as legislative and regulatory counsel for state and national health care trade associations, innovative technology manufacturers, and providers and suppliers participating in alternative payment models and delivery system reform initiatives.
Before joining Alston & Bird, Brian served as a consultant for a health care policy research and management consulting firm, where he advised government entities on congressional action and their impact on Medicare, counseled on Medicare reimbursement issues, and developed methods to assess, review, and evaluate alternative payment models, including changes that waive the Anti-Kickback Statute and Stark Law.
Chris Lyle, Partner, JD Lymon
Josh Makower, MD, MBA, Director, Stanford Biodesign
Josh Makower is the Yock Family Professor of Medicine and Bioengineering at the Stanford University Schools of Medicine and Engineering, and is the Director and Co-Founder of the Stanford Byers Center for Biodesign. Josh is the Founder and Executive Chairman of ExploraMed, a medical device incubator that has created 10 companies over the past 20 years. Lastly, Josh is also a Senior Advisor to Patient Square Capital, and an Advisory Venture Partner with Sofinnova Partners. Josh currently serves on the boards of Elevage, Revelle Aesthetics, ExploraMed, Moximed, Willow, X9 and Coravin.
Josh holds over 300 patents and patent applications for various medical devices in the fields of cardiology, ENT, general surgery, drug delivery, plastic surgery, dermatology, aesthetics, obesity, orthopedics, women’s health, and urology. He received an MBA from Columbia University, an MD from the NYU School of Medicine, and a Bachelor’s degree in Mechanical Engineering from MIT. Josh is a Member of the National Academy of Engineering, a Fellow of The National Academy of Inventors and The American Institute for Medical and Biological Engineering and was awarded the Coulter Award for Healthcare Innovation by the Biomedical Engineering Society in 2018.
Andrey Ostrovsky, MD, Managing Partner, Social Innovation Ventures; Former US Medicaid Chief Medical Officer
TJ Sutphin, Acting Pharmaceutical & Technology Ombudsman, Centers for Medicare & Medicaid Services
Anthony (TJ) Sutphin serves as the acting Medicare Pharmaceutical and Technology Ombudsman (PTO) within the Centers for Medicare & Medicaid Services (CMS) Offices of Hearings & Inquiries (OHI). In this capacity, he also serves as a new technology liaison working closely with colleagues in the Technology, Coding and Pricing Group and other CMS Groups to support engagement with medical device, pharmaceutical, and biotechnology manufacturers and other stakeholders. He has experience with and works to assist medical technology innovators with engaging CMS and addressing coding, payment, and coverage matters/concerns and inquiries. Prior to taking on this role, TJ worked as an Associate Ombudsman providing key support to the Medicare Beneficiary Ombudsman (MBO), Competitive Acquisition Ombudsman (CAO), and PTO in assisting Medicare beneficiaries and other stakeholders.
Tamara Syrek Jensen, JD, Director, Coverage and Analysis Group, Centers for Medicare & Medicaid Services
Tamara is the Director of the Coverage and Analysis Group in the Centers for Clinical Standards and Quality at the Centers for Medicare & Medicaid Services (CMS). CAG is responsible for developing evidence based polices such as national coverage determinations (NCDs) and overseeing the local coverage determination process. Tamara leads the CMS collaboration with FDA, including the CMS-FDA parallel review program and the investigational device exemption (IDE) program. To assist in generating evidence for the Medicare population, Tamara is one of the principal authors in creating and implementing coverage with evidence development (CED), an initiative that allows for Medicare coverage while developing evidence through clinical studies, including registries. Tamara was recently awarded the 2022 CMS Executive of the Year.
Elizabeth Truong, MHS, Director of the Division of Policy Coordination and Implementation at the Centers for Medicare & Medicaid Services
Elizabeth Truong is the Director of the Division of Policy Coordination and Implementation at the Centers for Medicare & Medicaid Services (CMS). This Division is primarily responsible for providing oversight of Medicare’s local coverage determinations, implementation of national coverage determinations, and rulemaking for national coverage policies. Ms. Truong’s 20 years at CMS includes experience in developing Medicare payment policies to reimburse hospitals and clinicians (the Inpatient Prospective Payment System, the Long-Term Care Hospital Prospective Payment System, and the Physician Fee Schedule) as well as leading the development and implementation of innovative payment models that bundled hospital and physician reimbursement to better align payment incentives. She also served as the Director for the Budget and Audit Division at CMS’ Innovation Center.
Registration Pricing
Check to see if your company is an AdvaMed member here.
AdvaMed Member Companies: $1025.00
AdvaMed Accel Member Companies: $725.00
Non-Members: $1495.00
Government/Academic: $725.00
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