September 18, 2017 Hemophilia Alliance Network Solutions (HANS) Roland Lamy, VP Payer Relations

Hemophilia Alliance Network Solutions (HANS) Hemophilia Alliance Network Solutions (HANS) was created to help HTCs solve certain network participation issues

What is HANS and how is it structured? We will explain the HANS model and cover important elements of HANS as well as its best fit in helping HTCs remain relevant in payer networks: What is HANS and how is it structured? Why did we create HANS, and where is it applicable? How will HTCs intersect and collaborate with HANS? How is HANS being used today? HANS

HANS Payer / PBM HTC HANS

What is HANS? Hemophilia Alliance Network Solutions or “HANS” was created in January of 2017 (wholly owned subsidiary of Hemophilia Alliance) Limited Liability Company Created with its principal office in the State of Florida Jeff Blake – President Roland Lamy – Vice President Legal entity that allows us to create contracting opportunities between payers and HTCs HANS

What is HANS? HANS capabilities include: Contracting directly with Payers Contracting directly with Prescription Benefit Managers (PBMs) Contracting directly with self-funded Employers (or their Consultants / Brokers) Claims Processing (if applicable) A sub specialty network of participating HTCs for clotting factor distribution HANS

What is HANS? HANS is NOT … A competitor of HTCs A guarantor of payment Not an insurer Not a PBM HANS

Why Create HANS? Hemophilia Alliance has attempted many different versions of helping keep HTCs relevant in networks: “Elective Model” Direct to Payer contracting Direct to PBM networks Considered Hemophilia Alliance sponsored contracts HANS can react to PBM “exclusive” arrangements and offer competitively priced product to the ultimate “payer” HANS

Why Create HANS? HANs is designed to: Be a subspecialty network for HTC clotting factor distribution Align payer / PBM needs with HTCs in areas like billing, collection, reporting and price points Be a vehicle for HTCs to get access to new patients for clotting factor distribution Provide a method for Employers to contract directly for clotting factor distribution HANS

Why Create HANS? The Hemophilia Alliance team has had great success in the area of self-funded employers one area of possible improvement is creating a vehicle for VERY large employers covering several states, this requires common HTC policies, procedures, reporting and price HANS

So how does it work? How do HTCs collaborate with HANS? Step 1 – Hemophilia Alliance (HA) payer team will work with HTCs, Employers, PBMs and Payers to identify key targets for HANS Step 2 – HA payer team will outreach, share its value proposition and determine what is important to the entity and negotiate terms for Agreement Step 3 – HANS (through the payer team) will request “joinder” Agreement between HANS and the HTC HANS

So how does it work? How do HTCs collaborate with HANS? HANS Joinder Agreement will accomplish several things: Outline key terms between HANS and HTC Provide necessary HTC demographic data for HANS to transmit to “payer”: Tax ID NPI Address Billing and collection HANS

So how does it work? How do HTCs collaborate with HANS? HANS Joinder Agreement will accomplish several things: Allow HANS to transmit payer specific terms to the HTC Create a vehicle for HTC to intersect with their Institution if necessary for decisions: Contract terms Signature HANS will also seek to transmit “opportunity” – for example how many patients might the HTC be able to serve and how does the HTC get to the patient? HANS

So how does it work? How do HTCs collaborate with HANS? Step 4 – HANS will provide more detail to HTC on the specifics of the HANS – Payer Agreement Step 5 – HANS will ensure process of patient identification, billing procedures and payment between HTC and payer How many patients in the geography (if known)? How does patient steerage take place? Pharmacy bill or Major Medical bill? Timeliness of payment HANS

HANS – Other Important Considerations HANS targets include: Regional or national payers where HTCs are blocked from networks Large self funded employers seeking a cost effective specialty carve out Employee benefits consultants and brokers seeking value added carve out networks for their clients Reinsurers HANS

HANS – Summary of key features Negotiate with payers, employers, PBMs and brokers Provide a coordinated opportunity to access new patients for clotting factor distribution Provide consistent contractual terms across a broad range of providers Give HTC the ability to participate without vetting with ALL Institutional stakeholders (if desired) Process claims if required (Northwest Pharmacy Services) HANS

HANS – Early Success Signed first Agreement with Caresource Caresource details: Based in Dayton Ohio Offers Medicare, Medicaid and Marketplace Exchange products (vary by state) Indiana, Ohio, Kentucky, Georgia and West Virginia Plans for expansion HANS

Questions and Discussion