Washington, DC (PRWEB) July 25, 2014
CMS recently has imposed a series of stiff sanctions against some health plans for providing inadequate access to prescription drugs. Agency audits are uncovering violations that pose serious threats to the health and safety of beneficiaries in areas such as rejected pharmacy claims and misclassifications of drug coverage determinations, and CMS is taking quick and firm actions to halt them. On Aug. 5, the Atlantic Information Services webinar, “Avoiding Costly Part D Sanctions: Rx Access Strategies for Plans and PBMs,” will provide the details of what CMS is looking for and steps can be taken to make sure plans and PBMs don’t wind up in the crosshairs of government regulators.
Steve Arbaugh, managing principal and CEO of ATTAC Consulting Group, LLC, Jane Galvin, managing director of regulatory affairs for the BlueCross and BlueShield Association, and Anne Hance, partner in the McDermott Will & Emery law firm, will analyze the CMS requirements that are causing plans so much trouble and offer strategies plans and their partners can institute to prevent pharmaceutical-access problems. In a lively 60-minute presentation, followed by 30 minutes of responses to individual questions, they will provide answers to these and other questions:
- What are the statutory and regulatory requirements regarding access to pharmaceuticals in Part D? How are they likely to change in the near future?
- What is CMS finding in terms of violations of drug-access standards in its audits and via member complaints? What actions is the agency taking in response, including civil monetary penalties and intermediate sanctions?
- What steps does CMS expect Part D plans to take to monitor and oversee their PBMs?
- What specifically are regulators looking for in plans’ policies on the use of prior authorization, step therapy and transition supplies of medications?
- How do CMS’s recent revisions to the Notice of Denial of Medicare Prescription Drug Coverage change the requirements that plans and their partners must comply with?
- What do regulators expect from plans in their handling of protests and appeals of coverage determinations on pharmaceuticals?
- How should plans and PBMs administer formularies to avoid access problems despite the necessity for frequent changes?
- What does CMS expect in terms of outreach to prescribers and beneficiaries on pharmaceutical-access issues? What operational and other strategies should plans employ to accomplish this?
Visit http://aishealth.com/marketplace/c4a33_080514 for more details and registration information.
Atlantic Information Services, Inc. (AIS) is a publishing and information company that has been serving the health care industry for more than 25 years. It develops highly targeted news, data and strategic information for managers in hospitals, health plans, medical group practices, pharmaceutical companies and other health care organizations. AIS products include print and electronic newsletters, websites, looseleafs, books, strategic reports, databases, webinars and conferences. Learn more at http://www.AISHealth.com.