Understanding and Addressing Part D Corporate Compliance Challenges
3/21/2006
(click link below to view the full invitation)
Tuesday, March 21, 2006, 8:30 a.m. - 12 noon
Registration and continental breakfast begin at 8:00 a.m.
Leslie V. Norwalk, Esq ., Deputy Administrator
Centers for Medicare and Medicaid Services
Leslie Norwalk will make the keynote address on the implementation the new Medicare prescription drug benefit and CMS efforts to monitor contractor compliance
THE PART D CONTRACTUAL WEB
Susan W. Berson, Esq., Chair, Health Care Practice
Mintz, Levin, Cohn, Ferris, Glovsky & Popeo, P.C.
CMS/Sponsor Agreements, manufacturer rebate agreements, PBM/health plan contracts, delegated and downstream contractor agreements, and pharmacy participation agreements form the complex web that constitutes the Part D program. This session will explore these contractual relationships and the interesting and challenging issues they present.
OVERVIEW OF THE FRAUD & ABUSE LAWS GOVERNING THE PART D PROGRAM
Michael D. Bell, Esq., Senior Vice President, EduNeering, Inc.
Of Counsel, Mintz, Levin, Cohn, Ferris, Glovsky & Popeo, P.C.
Both the OIG and CMS have recommended that organizations participating in the Part D program implement an effective corporate compliance program that, among other things, includes policies and procedures and specific training that address the pertinent fraud
and abuse laws. This session will provide an overview of three such laws?the Federal Anti-kickback Statute, the False Claims Act, and the Beneficiary Inducement Statute?and their implication on Part D-related compliance program operations.
THE CMS PART D FRAUD, WASTE, AND ABUSE GUIDLINES
Lauren Haley, Esq., Insurance Specialist, Benefit Integrity Group
Centers for Medicare & Medicaid Services (CMS)
On February 8, 2006, CMS released to the industry Chapter 9 of the Prescription Drug Benefit Manual, which is entitled "Part D Program to Control Fraud, Waste and Abuse." This 63-page document contains instructions on a significant number of compliance related topics ranging from compliance program staffing to contractor oversight to voluntary self reporting instances of potential fraud, waste and abuse. This session will explore the important information set forth in this CMS Manual issuance.
CROSS INDUSTRY ROUNDTABLE DISCUSSION
Representatives from industry-leading health plans and pharmacy chains will discuss methodsand approaches to achieving compliance with Part D compliance program requirements. The panel will address such topics as the division of compliance responsibilities; monitoring and auditing of planand delegated operations; employee and subcontractor training; and reporting of complaints/incidents and potential fraud.
PARTICIPANTS:
Tom Paul
Chief Pharmacy Officer, Ovations (UnitedHealth Group)
Christine Helzner
Director of Regulatory Compliance, Healthfirst (Managed Health Inc.)
Ellen M. Hunt, JD, CHC
Vice President and Compliance Officer, HCSC Insurance Services Company
C. Daniel Haron, RPh (invited)
Senior Vice President, Brooks Pharmacy/Eckerd Pharmacy
August "Dutch" Dobish
Vice President - Law Compliance, Rite Aid Corporation
Also invited are two representatives from the PBM industry.
The Willard InterContinental Hotel
1401 Pennsylvania Avenue, NW
Washington, DC 20004
202.628.9100
For directions to hotel, please visit the Willard InterContinental homepage.
RSVP: Sean Eagler at 202.661.8791 or sgeagler@mintz.com
