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On November 20, 2020, CMS issued the Most Favored Nation (MFN) Model for Medicare Part B Payment.  The MFN model starts on January 1, 2021.  Although the IFR provides a 60-day comment period (deadline January 19, 2021) the provisions of IFR are effective immediately.  For several providers including physicians and group practices, this policy ties Medicare payment to international prices for the top 50 Medicare Part B drugs and pays a flat fee add-on of $148.73.   If implemented on January 1, 2021 the reimbursement for many of drugs the practices use will begin to drop substantially.  Practices will have to analyze the economics of providing and billing these drugs.  We hope you can join us for an overview of the MFN model, including details about drug categories, and payment methodologies that impact your practice. LUGPA physicians and administrators are encouraged to attend. 

The webinar took place December 15, 2020 at 5:00 pm Eastern Time.

Presenters:

Deepak A. Kapoor, MD

Dr. Deepak A. Kapoor is Chairman and Chief Ecosystem Officer of Solaris Health Holdings, LLC, Market President for Integrated Medical Professionals, PLLC (IMP)  and President of Advanced Urology Centers of New York. His expertise includes basic science research in molecular biology, as well as extensive experience in oncologic and reconstructive surgery.

Dr. Kapoor is Clinical Professor of Urology at the Icahn School of Medicine at Mount Sinai, Chair of the LUGPA Health Policy Committee, Past President of LUGPA, and Chairman of SCRUBS RRG. He has also served as a Director of UroPAC and Chairman of Access to Integrated Cancer Care. Dr. Kapoor was founder of the New York Urology Trade Association and Integrated Medical Foundation. In addition, he is a Fellow of the American College of Physician Executives.

Dr. Kapoor has published and lectured extensively on clinical, business and health policy issues and is Associate Editor of the journal Urology Practice. He serves on a number of medical advisory boards, including the New York State Governor´s Prostate Cancer Advisory Panel. Dr. Kapoor has received numerous accolades, including the 2011 AUA Ambrose-Reed socioeconomic essay award, the 2014 New York Section AUA Russell W.  Lavengood distinguished service award and was recognized in 2018 by LUGPA for outstanding contributions to health policy and the preservation of independent medicine

John McManus

Mr. McManus is the President and founder of The McManus Group LLC, a consulting firm specializing in strategic policy, political counsel and advocacy for health care clients with issues before Congress and the Administration. The McManus Group services clients who are leaders in their respective field across the health care spectrum from the pharmaceutical, biotechnology and medical device industries, to physician groups and employee benefit managers. The McManus Group was founded in 2004 and has built a reputation of substantive policy expertise that is trusted by key policy makers in both legislative chambers and in the Administration.

Before founding The McManus Group, Mr. McManus served Chairman Bill Thomas as the Staff Director of the Ways and Means Health Subcommittee, where he led the policy development, negotiations and drafting of the Medicare Prescription Drug, Improvement and Modernization Act of 2003. The MMA provided a market-based, comprehensive prescription drug benefit, reformed Medicare and established Health Savings Accounts. Mr. McManus worked for Chairman Thomas for six years where he also played an instrumental role in the Medicare Commission, Patients’ Bill of Rights and other Medicare legislation.

Before working for Chairman Thomas on Capitol Hill, Mr. McManus worked for Eli Lilly & Company as a Senior Associate from 1994-97 and for the Maryland House of Delegates from 1993-94 as a Research Analyst, briefing the Chairman of the Economic Matters Committee and the members of the Health Subcommittee.

Mr. McManus earned his Masters of Public Policy from Duke University and Bachelor of Arts from Washington and Lee University. Mr. McManus serves on the Board of Advisors of the Williams School of Commerce, Economics and Politics of Washington and Lee University.

Cass Schaedig

With over 30 years in the healthcare industry, Cass Schaedig has perfected the ability to mine, synthesize and distill healthcare data to reveal and analyze the core functions of medical practices. Cass joined IntrinsiQ Specialty Solutions in 2015 and serves as Vice President of Provider Analytics. Equipped with the power of InfoDive® - the flagship product of the company she founded in 1997 - Cass helps practices refine their operations to ensure peak efficiency and profitability. In past roles, Cass developed and delivered innovative solutions that addressed hospital and payer industry needs and challenges.

Most Favored Nation (MFN) Model Interim Final Rule (IFR): The Impact on Your Practice