NOV 20, 2013 10:00 AM PST

Navigating the Evolving Molecular Diagnostic Reimbursement Landscape to Optimize Coverage and Payment and Identify Opportunities

  • Vice President, Client Services, Quorum Consulting
      Nicole Littmann is a leading expert in development and implementation of reimbursement strategy for innovative medical technologies, with over 15 years of experience in health care and public policy, 10 of those years in reimbursement consulting. Ms. Littmann has worked across various diagnostic and therapeutic areas, including molecular pathology, oncology, cardiology/cardiac surgery, and spine/orthopedics. From the time CMS implemented unique payment pathways for new technologies, she has been at the forefront of securing carve-out payment for her clients' technologies under Medicare. She has well-established relationships with payer decision-makers at both coverage and payment policy levels, as well in-depth technical and procedural knowledge of the AMA and CMS processes to secure CPT and HCPCS codes for these technologies. Ms. Littmann has helped manufacturers, providers, and patients navigate the health care system for access to medical innovation through clinical trial coverage and reimbursement, running efficient coding and billing hotlines, and implementing customized, effective appeals programs and patient assistance programs.

    2013 has proven to be a year of paradigmatic shifts in molecular diagnostics reimbursement policy. In this session, we will review and analyze these key policy and payment developments and discuss how your company can optimize the adoption of novel molecular diagnostic tests by developing strategies that consider the dynamic and changing reimbursement landscape. The key learning objectives from this presentation are as follows:

    - Understand the current coding landscape and potential payment rates for these lab services
    - Learn the implications for the new McKesson/American Medical Association partnership
    - Be aware of coding development for future next-generation sequencing technology
    - Learn about the different levels of evidence that drive coverage for diagnostic tests

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