NMDP Overview: Financial Resources

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Presentation transcript:

NMDP Overview: Financial Resources Stephanie Farnia, MPH Director, Payer Policy September 30, 2015

Our Team Stephanie Farnia Kristen Bostrom: Program Coordinator Kristen Edsall: Payer Relations Manager Alicia Silver: Health Policy Analyst

Kristen Edsall R.N., B.S.N., M.S.N., CPUR 23 years experience in Payer industry Utilization Management Case Management Medical Policy Regulatory & Compliance Quality Empire BCBS, MN BCBS, Optum, Medica Role = Payer Outreach and TC Support

Our Focus: Financial Barriers to HCT Work on your behalf to improve HCT coverage at a national level Work together with ASBMT Offer free resources you can use to: Understand the impact of the ACA Navigate Medicare coverage Work with your local payers Improve coding and billing, appeals, and much more Connect with other HCT financial staff Connect with other HCT our BMT Financial E-Forum Need more….how to get their financial people connected to the newsletter and other resources…who do contact or where on the website?

Why focus so much on Medicare? Aging population Low Reimbursement Limited Coverage Intense Frustration for Programs and Patients **Very different payment and coverage rules than for Solid Organ Transplant.

Efforts to Expand Medicare Coverage Disease indications not covered today: Sickle Cell Disease Lymphoma Myelofibrosis Multiple Myeloma (modifications) All others that are not currently clarified Expansion request is under review 2015: Sickle Cell and Myelofibrosis (Decision expected by November) 2016: MM and Lymphoma (Review will likely start in Q1 2016)

New Resources Coming in 2016 New tools and information to help you: Better understand how payers work Understand government and commercial payer services, processes and policies Build effective relationships and engage more deeply with payers in order to help obtain appropriate reimbursement Understand coverage details and avoid mistakes Know where to turn when you need help Will be available online at Network.BeTheMatchClinical.org/reimbursement Learn More at Tandem – Feb 18th at 7:30 a.m.

How to Get Involved Network.BeTheMatchClinical.org/Reimbursement Sign up to receive Reimbursement eNews Join the BMT Financial E-Forum