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ICA 2011 Conference

 

PRO PHARMA will attend The International Claims Association 2011 Annual Education Conference in Encore at Wynn Las Vegas

October 2-5, 2011

Craig S. Stern, PharmD, MBA, President, Pro Pharma Pharmaceutical Consultants, Inc. will present "SPECIALTY INJECTABLES….HOW TO SOLVE PAYMENT PROBLEMS"

This presentation will focus on key issues affecting timely and appropriate pricing and payment of Specialty Injectables, such as::

      • Effective Specialty Vendor Contracting
      • NDC vs. HCPCS Descriptions
      • Multiple NDCs to one HCPCS Code
      • Multiple HCPCS to one NDC

Discussion will center on establishing key principles and “rules” for Specialty Injectable Pricing to include, but not be limited to:

      • Generic Bias
      • One Record Per JCode
      • One Price Per JCode
      • Minimum/Maximum, Average and Median

Clarification and education of attendees on the basic foundations for Specialty Injectable Pricing which are:

      • Package Size
      • Quantity Submitted
      • Quantity Used vs. Package Size

 

This presentation will create stimulating discussion Solutions for effective and accurate Specialty Injectables Claims Payment to include Pricing Solutions, Historical Pricing and Query Based Solutions.

Objectives:

At the end of this presentation, attendees will be able to:

        • Articulate how to design an effective Specialty Injectables Claims Payment program in your organization
        • Describe the key barriers to establishing an effective Specialty Injectable Claims Pricing system.
        • Discuss the elements of pricing specialty claims at AWP, WAC or ASP
        • Identify options for pricing claims under miscellaneous codes

This presentation and content will work well for either Breakout and/or General Session, for those with any level of experience w/ MMA Part D, introductory, intermediate or advanced.

Audio Visual requirements include a laptop, an LCD projector, lavaliere mike, screen, etc. Presenter, Craig Stern, will bring a flash drive w/ the presentation.

Dr. Stern has over fifteen (15) years of experience working w/ Public and Private Entities, Unions, Trusts, and Health Plans to maximize their benefits, manage utilization, increase quality and to control costs whenever possible. His C/V/Resume, Presentations List and Bio will itemize in more detail those applicable areas of expertise desired for this presentation. Dr. Stern's work with payers and PBMs, Specialty Vendors and JCode pricing on a daily basis serves as an excellent foundation both in knowledge and experience for ICA member benefit.

Please check back later for detailed information and slides from Dr. Stern's presentation

For more information please contact Carol Stern @ 818-701-5438
or carol.stern@propharmaconsultants.com