Medicare Congress: Agenda: Day One

Pre-Conference

Day One

Day Two

Agenda: Medicare Congress Day I Tuesday, November 1, 2005
8:00 a.m.	Welcome and Introduction: The Role of Government in the Implementation of Medicare Part D John K. Iglehart Founding Editor, Health Affairs National Correspondent, New England Journal of Medicine Washington, DC (Co-Chair) Dan Mendelson President and Founder, Avalere Health Former Associate Director for Health Office of Management and Budget Washington, DC (Co-Chair)
8:15 a.m.	The Future of Medicare Alex M. Azar II Deputy Secretary of the United States Department of Health and Human Services US Department of Health and Human Services Washington DC
8:45 a.m.	Implementing the New Medicare Prescription Drug Program Mark B. McClellan, MD, Ph.D. Administrator, Centers for Medicare and Medicaid Services Former Commissioner, Food and Drug Administration Washington, DC
9:30 a.m.	CDC's Perspective on the Medicare Part D Benefit Dr. George Mensah Acting Director National Centers for Chronic Disease Prevention and Health Promotion Washington DC
10:00 a.m.	The Beneficiaries Perspective on the New Medicare Prescription Drug Program Tricia Neuman, ScD Director, Medicare Policy Project Vice President, Kaiser Family Foundation Washington, DC Presentation Material (Acrobat) Presentation Material (Powerpoint) John Rother Director of Policy and Strategy, AARP Washington, DC Bruce Stuart, Ph.D. Professor and Executive Director Peter Lamy Center on Drug Therapy and Aging University of Maryland Baltimore, MD Handout Material (Acrobat) Handout Material (Microsoft Word) Scott Steinke Managing Editor, FDC Reports Chevy Chase, MD (Moderator)
10:45 a.m.	Break
11:00 a.m.	Concurrent Sessions I
	1.01 MMA Implementation: Status of MMA Implementation CMS is charged with implementing some of the most sweeping changes to Medicare in over 30 years. This session will provide a review of the implementation timeline and the status of CMS activities. Bob Donnelly Former Director, Medicare Drug Benefit Group Center for Beneficiary Choices Center for Medicare and Medicaid Services Baltimore, MD John Richardson Director, Medicare Practice Avalere Health Washington, DC Presentation Material (Acrobat) Presentation Material (Powerpoint)
	1.02 MMA, Private Plans, and Competition: Commercial Health Plan Response to MMA Throughout its history, the Medicare program has tested various models designed to integrate private health insurance organizations. The passage of the MMA included one of the most aggressive initiatives to expand the role of private insurers. This session will provide context for the ways in which plans have assessed the new Medicare marketplace and how they are crafting their benefit structure(s). Janet Newport Vice President of Public Policy PacifiCare Health Systems, Inc. Cypress, CA Presentation Material (Acrobat) Presentation Material (Powerpoint) David Ogden Senior Actuary Milliman USA Milwaukee, WI Presentation Material (Acrobat) Presentation Material (Powerpoint)
	1.03 Medicaid and MMA Administrative Challenges: Determining Eligibility and Enrollment for Low-Income Beneficiaries In 2006, the new Medicare prescription drug benefit will replace Medicaid drug coverage for dual eligible beneficiaries and offer assistance to those qualifying for Low Income Subsidies (LIS). This session will describe the critical issues related to eligibility and enrollment pathways for these vulnerable populations, and discuss mechanisms for addressing challenges in fragmented care. Gale Arden Director, Disabled and Elderly Health Programs Group Centers for Medicare and Medicaid Services Washington, DC Presentation Material (Acrobat) Presentation Material (Powerpoint) Karl Kurtz Director, Idaho Department of Health & Welfare Boise, ID Presentation Material (Acrobat) Presentation Material (Powerpoint) John Luehrs AARP Washington DC
	1.04 Marketing Part D Plans: Educating Beneficiaries The new benefit will affect prescription drug coverage for nearly every Medicare beneficiary. CMS is charged with communicating these changes. This session will provide context for the overall communication strategy, an update on implementation, and discuss the ways in which CMS is working with other stakeholders to educate beneficiaries. Kathleen Harrington Director, Office of External Affairs Centers for Medicare and Medicaid Services Washington, DC Stephen McConnell Senior Vice President, Advocacy and Public Policy The Alzheimer's Association Chicago, IL
	1.05 Fee for Service Trends: The Future of Medicare FFS This session will focus on the sustainability of the Medicare fee-for-service program, particularly as new programs like Part D seek to develop alternative models of care. Richard Foster Chief Actuary, Centers for Medicare and Medicaid Services Washington, DC Presentation Material (Acrobat) Presentation Material (Powerpoint) Mark Miller Executive Director, Medicare Payment Advisory Commission Washington, DC Presentation Material (Acrobat) Presentation Material (Powerpoint)
	1.06 Quality, Evidence, and Drug Safety: Quality Improvement Programs in Medicare In MMA, Congress expanded Medicare's system for drug plan and provider performance measurement, public reporting, and quality improvement. This session will focus on provisions made through the MMA targeted at MA plans, expanding the role of QIOs, quality programs for Part D providers, electronic prescribing, and new quality demonstration programs. Stuart Gutterman Senior Program Director, Medicare's Future The Commonwealth Fund Washington, DC David Schulke Executive Vice President American Health Quality Association Washington, DC Presentation Material (Acrobat) Presentation Material (Powerpoint) Phyllis Torda Vice President, Product Development National Committee for Quality Assurance Washington, DC Presentation Material (Acrobat) Presentation Material (Powerpoint)
Noon	Networking Luncheon in the Exhibit Hall
1:00 p.m.	Afternoon Plenary Session: The Role of the Private Sector in the Implementation of Medicare Part D Thomas A. Scully, Esq. Senior Counsel, Alston & Bird Senior Advisor, Welsh, Carson, Anderson and Stowe Former Administrator, Centers for Medicare and Medicaid Services Washington, DC (Co-Chair) Presentation Material (Acrobat) Presentation Material (Powerpoint)
1:30 p.m.	The Manufacturer Perspective Marion McCourt Vice President, Government Affairs Policy and Managed Markets AstraZeneca Wilmington, DE Presentation Material (Acrobat) Presentation Material (Powerpoint)
2:00 p.m.	The PBM Perspective Jan Berger Sr. Vice President, Chief Clinical Officer, Caremark Nashville, TN Presentation Material (Acrobat) Presentation Material (Powerpoint) Mark Merritt President, Pharmaceutical Care Management Association Washington, DC
2:30 p.m.	The Health Plan Perspective Karen Ignagni Chief Executive Officer and President Americas Health Insurance Plans Washington, DC Presentation Material (Acrobat) Presentation Material (Powerpoint) Dale Wolf Chief Executive Officer Coventry Health Care Inc. Bethesda, MD Presentation Material (Acrobat) Presentation Material (Powerpoint)
3:00 p.m.	Wall Street's Perspective Charles Boorady Managed Care Analyst Smith Barney CitiGroup New York, NY Presentation Material (Acrobat) Benjamin Edmands Principal, JPMorgan Partners LLP New York, NY Christopher McFadden Managing Director, Global Investment Research Goldman Sachs & Co. New York, NY Presentation Material (Acrobat) Nancy-Ann DeParle Senior Advisor, JPMorgan Partners Former Administrator, Health Care Financing Administration Washington, DC (Moderator)
4:00 p.m.	Break
4:30 p.m.	Concurrent Sessions II
	2.01 MMA Implementation: Employer Response to Part D Under MMA, employers are offered tax-exempt government subsidies if they continue current retiree health benefits. Employers will be assessing the value of the subsidy and determining whether to continue retiree coverage or encourage enrollment in Part D. This session will engage thought leaders in a discussion about employer perceptions about the subsidy and the potential impact on the nearly one-third of beneficiaries who currently rely on employer-sponsored plans for drug coverage. Cara Jareb, FSA, MAAA Director of Retiree Medical Consulting Watson Wyatt Worldwide Arlington, VA Presentation Material (Acrobat) Presentation Material (Powerpoint) Mark Hamelburg Director, Employer Policy and Operations Group Center for Beneficiary Choices Centers for Medicare and Medicaid Services Washington, DC Presentation Material (Acrobat) Presentation Material (Powerpoint)
	2.02 MMA, Private Plans, and Competition: PDP v. MA/PDP The MMA envisions that the Medicare prescription drug benefit will be administered regionally by either stand-alone prescription drug plans or Medicare Advantage managed care plans. Both of these options face unique business challenges that may result in vastly different offerings. This session will explore the current expectations for plans participating in the two sides of Part D. Mark Rubino Chief Pharmacy Officer, Aetna Hartford, CN
	2.03 Medicaid and MMA Administrative Challenges: Coordinating Prescription Drug Coverage for Dual Eligibles There are significant differences between the new benefit and drug coverage currently available to low-income Medicare populations. This session will explore the challenges facing states, the federal government, and the private sector in ensuring that these vulnerable populations have continuous care. Kevin Concannon Director, Iowa Department of Human Services Des Moines, IA Andrea Cohen Medicare Rights Center New York, NY Presentation Material (Acrobat) Presentation Material (Powerpoint)
	2.04 Marketing Part D Plans: Fraud and Abuse The new Part D prescription drug benefit brings with it new challenges in navigating federal fraud and kickback laws. This session will focus on possible compliance challenges under Part D. Peter P. Parvis, Esq. Partner, Venable LLP Washington, DC Janet Rehnquist, Esq. Partner, Venable LLP Former Inspector General, Department of Health and Human Services Washington, DC Presentation Material (Acrobat) Presentation Material (Powerpoint)
	2.05 Fee for Service Trends: The Chronic Care Improvement Program Among some of the MMA's most far reaching provisions are several new programs and demonstration projects intended to improve chronic care. This session will focus on these provisions from the perspective of CMS and provider organizations. Sandra M. Foote Director, Division of Chronic Care Improvement Programs Centers for Medicare and Medicaid Services Washington, DC Presentation Material (Acrobat) Presentation Material (Powerpoint) Jason Grant Vice President, Governmental Operations American Healthways Nashville, TN Presentation Material (Acrobat) Presentation Material (Powerpoint) Sandeep Wadhwa, MD, MBA Vice President of Care Management Services McKesson Health Solutions Broomfield, CO Presentation Material (Acrobat) Presentation Material (Powerpoint)
	2.06 Quality, Evidence, and Drug Safety: Health Information Trends and the Impact of Part D National and regional initiatives in health information are rapidly expanding, with recent activities including HHS' fast track infrastructure RFPs, the creation of the American Health Information Community (AHIC) advisory committee, CMS' EHR and PHR activities, and RHIO and other local projects and pilots testing an array of technologies and initial data sharing. This session will provide an overview of these developments, their implications for quality, evidence and drug safety, as well as national and regional perspective on how Part D plays a role. W. Holt Anderson Executive Director North Carolina Healthcare Information and Communications Alliance, Inc. Research Triangle Park, NC Presentation Material (Acrobat) Presentation Material (Powerpoint) Shannah Koss Director of Health Information Technology Avalere Health Washington, DC Presentation Material (Acrobat) Presentation Material (Powerpoint)
5:30 p.m.	Break
5:45 p.m.	Concurrent Sessions III
	3.01 MMA Implementation: Part D Data Implementation As with any new reimbursement program, Part D establishes an entirely new transaction and reporting infrastructure that will need to evolve as all participants gain a better understanding of what does and does not work. This session will engage a panel of participants to discuss the status of the part D implementation effort and some the questions and concerns that are growing as the deadline draws near. Catherine C. Graeff, RPh, MBA Senior Vice President, Communication and Industry Relations National Council for Prescription Drug Programs Scottsdale, AZ Presentation Material (Acrobat) Presentation Material (Powerpoint) Daniel Kazzaz President, Rapid Data Integration, Inc. Bethesda, MD Presentation Material (Acrobat) Presentation Material (Powerpoint)
	3.02 MMA, Private Plans, and Competition: Formulary Design - Balancing Cost and Access A key challenge for new formulary designs is to balance cost and access. This session will focus on the policy issues underlying the formulary structure for Part D, including USP's role in crafting the model therapeutic classification system used by CMS and the experience of manufacturers engaging in formulary negotiations for Part D. Susan S. de Mars, Esq. Chief Legal Officer United States Pharmacopeia Rockville, MD Presentation Material (Acrobat) Presentation Material (Powerpoint) Harvey Maldow, RPh, MS Director, Professional Relations AstraZeneca Wilmington, DE Presentation Material (Acrobat) Presentation Material (Powerpoint) Margaret Nowak Avalere Health Washington, DC (Moderator) Presentation Material (Acrobat) Presentation Material (Powerpoint)
	3.03 Medicaid and MMA Administrative Challenges: Priorities for State Legislators Federal Medicaid spending will continue to increase, but cost sharing will increasingly fall to states. States face persistent budget shortfalls, along with the implications of "the clawback" and lost purchasing power. This session will discuss state leaders' experience with innovative cost management strategies and other mechanisms to help regain purchasing power and expand with the needs of a growing Medicaid population. Leticia Van de Putte Chair, Veteran Affairs and Military Installations Committee, Texas Senate Co-Chair, Reforming States Group San Antonio, TX Presentation Material (Acrobat) Presentation Material (Powerpoint) Matt Salo Legislative Director, Health National Governors Association Washington, DC Vikki Wachino Director, Health Care Center for Budget and Policy Priorities Washington, DC Presentation Material (Acrobat) Presentation Material (Powerpoint)
	3.04 Marketing Part D Plans: Beneficiary Enrollment and Its Impact on Part D Premiums The session will examine the impact on the average Part D premium if enrollment in the new prescription drug benefit is lower than expected. Specifically, this session will describe how CBO produced its premium estimates, examine the impact on premiums if certain sub-categories of beneficiaries do not enroll, present Part D premium estimates under five possible enrollment scenarios for 2006, and discuss the implications for federal policy if enrollment is lower than projected. Chiquita White Manager, Avalere Health Washington, DC
	3.05 Fee for Service Trends: A Look at Medicare Part B MMA mandated significant changes in the market for physician administered drugs under Part B. This session will focus on the changes to the Part B market, including the delay in the start of a proposed competitive acquisition program. The session will also consider the longer term outlook for Part B drugs now that beneficiaries will have access to coverage for self-administered therapies under Part D. Scott Reid Caremark Nashville, TN Lauren Barnes Manager, Avalere Health Former U.S. Payment & Coverage Group Director (Amgen) Washington, DC Presentation Material (Acrobat) Presentation Material (Powerpoint) Joshua Berlin Senior Editor, Medicare Drug Focus, FDC Reports Chevy Chase, MD (Moderator)
	3.06 Quality, Evidence, and Drug Safety: The View from FDA and AHRQ The Medicare prescription drug benefit will have a profound impact on the demands for and uses of data regarding the "real world" use of prescription drugs. This session will focus on Medicare-related data initiatives underway outside of CMS, include the AHRQ Sec. 1013 comparative effectiveness programs and upgrades to FDA's drug safety oversight system. Jean R. Slutsky Director, Center for Outcomes and Evidence Agency for Healthcare Research and Quality Washington, DC Jeffrey Shuren, MD, JD Assistant Commissioner for Policy Food and Drug Administration Rockville, MD
6:45 p.m.	Adjournment and Networking Reception

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