Partner Manatt, Phelps & Phillips, LLP Washington, DC
Additional Fees Apply
With rising medical treatment costs and increased scrutiny of health care reimbursement and access, health policy is more important than ever. Two specific health policy topics warrant a comprehensive understanding for managed care professionals to plan and operationalize changes effectively in advance of 2025.
With the rollout of the Medicare Part D benefit redesign and the introduction of the Medicare Prescription Payment Plan (M3P) starting in 2025, payers need to create an internal implementation plan to ensure compliance with the Centers for Medicare and Medicaid Services (CMS) regulations and program guidance for this important new program. The first portion of this Pre-Conference Program will provide a quick update on implementation of the Inflation Reduction Act (IRA) and primarily focus on reviewing the details of M3P to make sure you’re prepared. Attendees will have an opportunity to engage in several interactive planning scenarios to better understand the role of the M3P program for differently situated Medicare enrollees.
The second portion of this Program will focus on the role of pharmacy benefit managers (PBMs) in the supply chain and the current legislative activity to reform their practices at the state and national levels. Faculty will dive into the legislative activity, what measures seem most likely to be enacted and implemented, and the likely impact on the PBM business model in the future. To better understand the impact of PBM reform on various stakeholders, attendees will have an opportunity to engage in workshop-style scenario planning.
Learning Objectives:
At the completion of this activity, participants should be able to:
Explain the latest updates to the Inflation Reduction Act (IRA) and the possible impact on managed care pharmacy practice.
Apply the tips provided to ensure your Medication Prescription Payment Plan complies with the Centers for Medicare and Medicaid Services (CMS) regulations and understand how the M3P program impacts different beneficiary profiles.
Define the various perspectives around pharmacy benefit manager reform and the rationale for legislative action.
Explain the most likely legislative activities related to PBM reform to be approved and the impact on PBMs.
Using case studies, describe the impact of PBM legislation on various supply chain stakeholders.
