2016 Coverage, Reimbursement & Health Policy Conference Agenda



*Speakers will be added as confirmed

Click Here for a PDF of the Agenda

Wednesday, November 16, 2016

3:30pm - 5:30pm - Reimbursement and the Product Development Cycle: Inception through Commercialization

"Reimbursement" is a concept that reflects the strategy and implementation activities that result in market access as to how the product and associated services may be covered by health insurance, may be described by codes, and may be paid. Now that providers and patients in addition to payers, have financial risk, reimbursement activities must take into account the economic and financial implications for all parties. Importantly, actions related to reimbursement are different based on where the product is in its stage of development. This session will illustrate how the reimbursement tactics, strategy and implementation road-map align with the product development cycle and the business strategy.

  • Judy Rosenbloom, Founder & President, JR Associates
  • Jo Ellen Slurzberg, Vice President, Global Health Policy/Reimbursement, JR Associates

5:30pm - 7:00pm - Networking Reception

Thursday, November 17, 2016

7:30am - 8:55am - Networking & Continental Breakfast

8:55am - 9:00am - Welcoming Remarks

  • Mark Leahey, President & CEO, MDMA

9:00am - 9:45am -Quality Over Quantity: The New Normal in Health Care

Over the last few years, the healthcare reimbursement landscape has begun to shift towards a greater emphasis on quality and value after decades of fee-for-service payments. Both Medicare and commercial payers are piloting and/or implementing efforts to reduce costs and improve care coordination and quality of healthcare delivery. Learn about the current and changing reimbursement landscape, including changes in evidentiary requirements in quality and performance measurement, some of the challenges device manufacturers encounter when defining a product’s financial value, what it could mean for you, and if there is a future for fee-for-service in the shifting landscape.

  • Kevin Ashpole, Director, Pharmacy Consulting Practice, OPTUM Consulting

9:45am - 10:30am - Demonstrating Value to Private Payers and Providers

While private payers are adapting to Affordable Care Act requirements, they continue to be challenged with requests for costly specialty pharmaceuticals and device-driven procedures.  It has always been difficult to gain a private payer’s attention and attain positive coverage for new technologies, and the current reimbursement environment exacerbates those efforts.  Leading experts will review strategies companies can take to identify and fulfill insurer requirements and help ensure their technologies reach patients and providers. Topics for discussion include coverage processes, evidence development, population and disease management, and health economics. 

  • Richard Gajdowski, MD, MBA, MPH, Senior Medical Director, UPMC Health Plans
  • Jerry Stringham, MBA, President & CEO, Medical Technology Partners

10:30am - 10:45am - Networking Break

10:45am - 11:45am - Securing Coverage with CMS

We expect Medicare fee-for-service coverage policy and its evidence reviews will continue to be a benchmark even as Medicare moves to alternative value based payment systems. Hear from a leading CMS policy maker what the agency is doing to support the development of evidence for new devices. Learn strategies for meeting with local Medicare Administrative Contractors (MACs), how to demonstrate value of the device, and what mistakes to avoid while working with local MACs.

  • Tamara Syrek Jensen, Director, Coverage and Analysis Group, CMS
  • Laurence Clark, MD, FACP, National Government Services
  • Louis Jacques, Senior Vice President & Chief Clinical Officer, ADVI
  • Murray Sheldon, MD, Associate Director for Technology & Innovation, CDRH, FDA

11:45am - 1:00pm - Buffet Luncheon & Election Update

MDMA’s President & CEO will provide an update on Congressional and election activities, and what to expect with a new administration and Congress in place for 2017 and beyond.

  • Mark Leahey, President & CEO, MDMA
  • Beth Roberts, Partner, Hogan Lovells

1:00pm - 1:45pm - Navigating CPT and RUC

The CPT and RUC processes can be confusing and challenging. A former AMA CPT Director will help you understand what evidence you need to secure a CPT code and maximize your product's reimbursement, while a current AMA staff member will provide a background of the RUC and how the RUC provides value recommendations to CMS.

  • Michael Beebe, Senior Vice President, ADVI
  • Dawn Gray, Director of Reimbursement and Regulatory Affairs, Society for Cardiac Angiography and Interventions (SCAI)

1:45pm - 2:30pm - On the Horizon: Reimbursement and Telehealth

Medical device companies are increasing the integration of cloud based data and mobile applications, resulting in various telehealth capabilities. These features influence health care by connecting the patient to the provider remotely, and storing quantitative data for physician review. These products introduce reimbursement complexity related to where they fit within health plan benefits, how the product or application and related provider services can be described in coding nomenclature, and how these features and services will be paid. This session will introduce key questions providers and payers are asking and what factors manufacturers have to address to gain adoption.

  • Judy Rosenbloom, Founder & President, JR Associates
  • Jo Ellen Slurzberg, Vice President, Global Health Policy/Reimbursement, JR Associates

2:30pm - 2:45pm - Networking Break

2:45pm - 3:30pm - CMS and the New World of Value

Earlier this year, CMS released four new episode payment models that change the way Medicare pays hospitals, physicians, and any provider within 90 days of the defined episode. These models move toward value-based payment approaches that incentivize providers to share in savings, but to also assume risk.  As CMS continues to develop new reimbursement models and incentives for innovators, hear from the agency on how you and your teams can prepare for this new environment, and what other reforms CMS is working on.

  • Christine Ritter, Acting Director, Patient Care Models Group, CMS

3:30pm - 4:30pm - International Opportunities, Familiar Challenges

International Reimbursement issues continue to change and present problems for medical device manufacturers. Learn about the status of new reimbursement policies and challenges: a)  in Europe (including changes at the NHS and Brexit fallout, and new limitations on German DRG medtech costs),  b) in Asia (including Japan's new cost-effectiveness program and the spread of reference pricing in Asia including China) and c) in Latin America.

  • Stephen Hull, Founder & President, Hull Associates
  • Ed Rozynski, Senior International Advisor, MDMA


Sessions and speakers are subject to change without notice. MDMA reserves the right to cancel or reschedule any program, whereupon full registration fees will be refunded or applied to the rescheduled program in accordance with the registrant's preference. In the event of canceled programs, MDMA assumes no responsibility for transportation, hotel, or other expenses incurred by registrants.