Drexel University, One Capitol Mall, Suite 260, Sacramento, CA 95814

Course Description:

Longer Description:  Securing adequate reimbursement from payers on a new device is a prerequisite for achieving commercial success for medical technology companies. Reimbursement planning and analysis should begin at the earliest stages of the product development process, and continue through the entire product life cycle. In this seminar, reimbursement professionals recount their experiences, discuss how they address difficult reimbursement issues, and extract the lessons that every medical technology company needs to learn.

Points to be covered:

• Answering an investor’s question: Is it reimbursable?

• Creating a coding strategy for a new device or product

• Understanding the medical billing processes

• Principles and practices that determine payer coverage and payment decisions 

• Complexities of multiple Medicare payment methodologies

• Advocacy and Lobbying 

• Healthcare reform's impact on provider reimbursement

Presenters:

Beth Craig, Health Care Consulting Manager, Moss Adams 

Karie Rego, Health Care Reimbursement Attorney, Sheppard and Mullin

Ruth Tesar, Executive Director, Northern California PET Imaging Center 

Cost:

General Admission: $40; SARTA Members: $25

Price includes free parking for 4 hours at the One Capitol Mall Valet Garage on 2nd Street (valued at $8) and a continental breakfast.

If you are a SARTA member, please email members@sarta.org for member discount code.

Beth Craig, a Manager at Moss Adams LLP, is an experienced healthcare consultant with expertise developing and implementing reimbursement strategies for innovative technologies at various points along the product life cycle and regulatory channels.  Her experience includes successfully obtaining appropriate coding for technologies, working directly with payers to establish positive coverage for products/services and designing several impactful reimbursement support programs for her clients.  In her current role, she helps physicians and physician groups build successful practices through business development, strategic planning, and effective governance. 

Karie Rego, Health Care Reimbursement Attorney, Sheppard and Mullin

Karie Rego is a special counsel in the Sheppard Mullin's San Francisco and Palo Alto offices and specializes in health care reimbursement, audits, investigations and regulatory compliance.  She spent twelve years at Jones Day and McDermott, Will & Emery where she was a partner in their healthcare department.  Karie then took her expertise and worked for several years in-house at one of the largest non-profit health systems in the country.  In her in-house position, she worked on many projects to increase system-wide compliance as well as quality and reimbursement; identify and reduce reimbursement and investigation risk; and respond to and work with state and federal regulators conducting external audits.  Karie currently provides advice to health care providers, plans and life sciences companies. Karie has settled or worked on the dismissal of over fifty OIG and qui tam relator cases.  Her research was instrumental in ending the Office of Inspector General's national laboratory unbundling investigation.  She is one of only a handful of attorneys in the country that have deep reimbursement experience which is enhanced by her unique status as a certified coder.  Because of her experience in investigations, audits, reimbursement and regulatory compliance, Karie has a unique ability to quantify the risk of reimbursement and regulatory compliance issues, create targeted and effective internal audits and identify novel arguments when negotiating with the government and payers. Karie also is very skilled at helping providers, plans and life sciences companies create new arrangements that improve quality yet address today's reimbursement challenges.

Ruth Tesar, Executive Director, Northern California PET Imaging Center 

Ruth Tesar is the CEO of the Northern California PET Imaging Center, and formerly a founding officer and investor in PETNet Pharmaceuticals, now a division of Siemens, where she participated in all aspects  in the efforts to create the market for PET Imaging through a fledgling professional society, the Institute for Clinical PET, where she served as a Board member and President.  This small group consolidated the clinical and cost effectiveness data form PET centers throughout the country to secure payment for PET procedures from Medicare and private payers, clarify the FDA position for the PET radiopharmaceuticals and create awareness with referring physicians nationally regarding the clinical benefits of PET, so physicians would order PET procedures in their daily practice. She occasionally consults to commercial entities on the strategic, reimbursement and business aspects of the molecular imaging field.