Part D Master Class

Aug 6, 2020 ‐ Aug 7, 2020


Through a combination of sessions and dual tracks, The RISE Part D

Master Class provides a unique opportunity for compliance, vendor management and audit professionals to gain a wide scope of knowledge,tactics and strategies to better enable them to successfully pass a CMS audit. Over two days, collaborate on four top-of-mind issues for health plans when it comes to Part D:

1. PBM contracting and the financial, compliance, and accountability

implications

2. The new CMS guidance for drug management programs

3. Audit preparedness

4. FDR oversight

Come away armed with concrete tools, benchmarks, best practices, and

case studies of what works that’s specific to your job function.

Standard: $500.00

Sessions

Welcome and Chairperson’s Opening Remarks & Part D Legislative and Regulatory Updates

Aug 6, 2020 10:00am ‐ Aug 6, 2020 11:05am

Identification: 001- THURS01 - THURS02


Welcome and Chairperson’s Opening Remarks

Aug 6, 2020 10:00am ‐ Aug 6, 2020 10:15am

Identification: THURS01

Speaker(s):

Part D Legislative and Regulatory Updates

Aug 6, 2020 10:15am ‐ Aug 6, 2020 11:05am

Identification: THURS02

• COVID-19 updates: expanded telehealth, surveillance reports, new rates and more
• Get a deeper understanding of the Part D changes finalized in MA CY 2021/2022 and the Part D Technical Rule
• Learn about CMMI’s Part D Senior Savings Model and what it means for your plan
• Prepare for legislative proposals to reform the Part D program

Speaker(s):

COVID-19: Part D Operational Considerations

Aug 6, 2020 11:15am ‐ Aug 6, 2020 12:00pm

Identification: THURS03

  • Develop a new strategy to respond to CMS’ changed assessment method of plan sponsors’ 5-star metrics
  • Establish oversight over the changes made because of COVID centric guidance
  • Inventory monitoring practices to aid preparations for CY2022

Speaker(s):
  • Ryan Davis, Manager, Pharmacy Medicare Programs, Kaiser Permanente

Understand the Impact to Part D: Litigation, Legislation, and CMS Changes Built to Combat Opioid Overuse

Aug 6, 2020 12:30pm ‐ Aug 6, 2020 1:30pm

Identification: THURS04

• Discuss recent Part D changes to drug management programs* and new program audit protocols
• Get guidance around CMS’ Overutilization Monitoring System (OMS) to prevent and combat opioid overuse
• Understand the ongoing concern of opioid multidistrict litigation (MDL) to manufacturers, wholesalers and pharmacies

Speaker(s):
  • Amy A. Poe, Attorney, Hall, Render, Killian, Heath & Lyman
  • Brian Wehneman, R.Ph., Director, HCS Compliance and Risk Management, Humana

Perfecting the Framework for Your Medication Therapy Management Program

Aug 6, 2020 1:40pm ‐ Aug 6, 2020 2:25pm

Identification: THURS05

• Learn how other plans are prioritizing and determining who is at-risk and who should get the resources
• Review the 2020 Overutilization Monitoring System guidance from CMS and its potential impact to CY2021
• Discuss the most common Medicare noncompliance issues for MTMs and how to fix them

Speaker(s):
  • Gary Melis, R.Ph., Clinical Pharmacist, Network Health

Special Considerations Around Formulary Design

Aug 6, 2020 2:35pm ‐ Aug 6, 2020 3:20pm

Identification: THURS06

• Leverage formulary design to drive selection, efficiency, quality, and financial results
• Understand the financial nuances with formulary placement for biosimilar drugs as their presence grows in the market
• Review the ramifications of formulary placement for authorized generic medications as their presence grows in the market

Speaker(s):
  • Cody Olsen, PharmD, BCPS, Pharmacy Operations and Quality Manager, SelectHealth

Managing of Benefits & Chairperson’s Summary of Day One

Aug 6, 2020 3:20pm ‐ Aug 6, 2020 4:30pm

Identification: 002- THURS07 - THURS08


Managing of BenefitsManaging of Benefits

Preview Available

Managing of Benefits

Aug 6, 2020 3:30pm ‐ Aug 6, 2020 4:15pm

Identification: THURS07

• Learn how various plans review cases and make coverage determination calls
• Delve into the pitfalls for the compliant administration of Part B versus Part D coverage determinations
• Study how to successfully operationalize other Part D specific requirements, such as Transition Logic, timeliness requirements, and ESRD

Speaker(s):
  • Ryan Davis, Manager, Pharmacy Medicare Programs, Kaiser Permanente

Chairperson’s Summary of Day One

Aug 6, 2020 4:15pm ‐ Aug 6, 2020 4:30pm

Identification: THURS08

Speaker(s):
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