Medicare Compliance: Mandatory MFN Model for Part B Reimbursement

Model Participants, Subject Drugs, Payment Methodology and Add-on Payments, Price Reporting

A live 90-minute CLE video webinar with interactive Q&A


Wednesday, February 10, 2021

1:00pm-2:30pm EST, 10:00am-11:30am PST

or call 1-800-926-7926

This CLE webinar will analyze key issues arising out of the Most Favored Nation (MFN) Interim Final Rule for Medicare Part B reimbursement for drugs and biologics. The panel will discuss the implications for Medicare reimbursement and the impact on drug manufacturers, healthcare providers. and patients. The panel will also summarize the status of litigation challenging the Interim Final Rule.

Description

On Nov. 20, 2020, the Centers for Medicare & Medicaid Services issued an Interim Final Rule implementing a mandatory MFN Model for Medicare Part B reimbursement effective Jan. 1, 2021. The MFN Model sets Medicare Part B payment for the most expensive drugs and biologics in the Medicare program based on the lowest available international reference price in an index list of foreign countries. The new rule restructures payments for physician-administered drugs and biologics to physicians, hospitals, outpatient departments, ambulatory surgery centers, and other providers and suppliers in the Medicare Part B program. As a result, drug manufacturers will need to reassess their pricing strategies and modify their price reporting calculations, and providers will need to prepare for modified Medicare payment rates for certain drug and biologic products.

Listen as our authoritative panel analyzes key issues arising out of the MFN Interim Final Rule for Medicare Part B reimbursement for drugs and biologics. The panel will focus on the implications for Medicare reimbursement and the impact on manufacturers, providers. and patients. The panel will also discuss the status of litigation challenging the Interim Final Rule.

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Outline

  1. MFN Interim Final Rule
    1. Model participants
    2. Drugs and biologics subject to model
    3. Payment methodology
    4. Add-on payments
    5. Manufacturer price reporting
    6. Provider hardship exemption
    7. Beneficiary protections
  2. Implications for healthcare provider reimbursement
  3. Implications for manufacturers
  4. Status of litigation challenging the Interim Final Rule

Benefits

The panel will review these and other key issues:

  • What is the nature and scope of the MFN Model?
  • How will the MFN Model affect Medicare Part B reimbursement for drugs and biologics?
  • How will be MFN Model impact drug manufacturers? Hospitals? Physicians? Other providers?
  • What is the status of litigation challenging the MFN Model?

Faculty

Farber, David
David J. Farber

Partner
King & Spalding

Mr. Farber specializes in litigation, regulatory matters, and public policy, with a focus on healthcare, Medicare and...  |  Read More

Pinto, Preeya
Preeya Noronha Pinto

Partner
King & Spalding

Ms. Pinto assists life science manufacturers with strategic reimbursement planning during all stages of the product...  |  Read More

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