Transparency: Policy & Regulatory Update
SIIA’s Government Relations Team will provide the latest insights and discussion on regulatory and legislative activities on PBMs, price transparency, and surprise medical billing, in addition to ongoing Hill debates.

SPEAKERS:   

Chris Condeluci, Esq.
Washington Counsel
Self-Insurance Institute of America, Inc.

Ryan Work
SVP, Government Relations                    
Self-Insurance Institute of America, Inc.

Gag Clauses & Data Sharing:  What Should We Do & Where Do We Go From Here? 
The Gag Clause Prohibition has been effective for 3 years now, but are plan sponsors getting their data?  How are plan sponsors and their service providers handling the “attestations”? What can Congress, the Federal Departments – and even the courts – do to help?

MODERATOR:  

Chris Condeluci, Esq.
Washington Counsel
Self-Insurance Institute of America, Inc.

SPEAKERS:    

Mark Combs 
CEO
Self Insured Reporting                                    

Andrew H. A. Meggison
Director of Regulatory Affairs
Health Plans Inc.    

Scott Behrens 
SVP, Director, Government Relations
Lockton Companies

Decided in Court:  Lawsuits to Access Pricing and Claims Data
Self-insured plan sponsors have filed a number of lawsuits to get access to the plans’ claims data.  Other lawsuits have challenged and changed the course of the No Surprises Act. Some cases have settled, while others are still making their way through the courts.  What’s the latest?   What do these lawsuits mean for increased price and claims data transparency, and how should we plan for the future?

MODERATOR:  

Chris Condeluci, Esq.
Washington Counsel
Self-Insurance Institute of America, Inc.

SPEAKERS:    

Herman Hofman, Esq.
Partner
Varnum Law Firm

Julie Selesnick, Esq. 
Senior Counsel
Berger Montague 

Hugh O’Toole 
CEO
Innovu

Hospital & Provider Price Transparency:  Is It Making a Difference?
Compliance with the Hospital Transparency Rule is still woefully low despite the threat of increased penalties.  However, there is an increase in the percentage of hospitals and providers that are making efforts to post pricing information on a public website.  Is this pricing information proving useful for self-insured plan sponsors and participants?  What more can be done?

MODERATOR:  

Ryan Work
SVP, Government Relations                    
Self-Insurance Institute of America, Inc.

SPEAKERS:    

Patrick Haig 
CEO
GoodBill 

Cheryl Matochik
Managing Director
Third Horizon Strategies

Ahmed Marmoush 
CEO
Handl Health

Surprise Billing Arbitration:  The Future of Uncertainty 
The last year has proven to be challenging for self-insured plans and their service providers defending against disputes initiated by providers over out-of-network care.  With fits and starts and changes to the Federal IDR process and the development of the QPA, what should industry participants know and where is this headed? 

MODERATOR:  

Chris Condeluci, Esq.
Washington Counsel
Self-Insurance Institute of America, Inc.

SPEAKERS:    

Ed Bolton (Invited)
Premier CIDRE

Christine Cooper 
President
aequum 

Nick Welle (Invited)
Partner
Chair, Health Benefits Practice
Foley & Lardner LLP

Eric Hanna (Invited)
Vice President, Claims and Access Solutions
Vālenz® Health

How Do We Get There:  PBMs, Gene Therapy and Drug Pricing Tools
Policymakers and regulators are taking a serious look at PBM practices and drug pricing transparency. With ever-increasing drug costs, and more and more states including self-insured plans in legislative activities, what does the future hold for PBM transparency and the cost of prescription drugs?  What best practices are in place for self-insured plans?

MODERATOR:  

Ryan Work
SVP, Government Relations                    
Self-Insurance Institute of America, Inc.

SPEAKERS:    

Kristi Bohn
Vice President, Lead Actuary
RGA

Alex Houle
Director of Clinical & Claim Services
The Phia Group 

Dave Parker 
Vice President of Sales & Marketing
True Scripts

Melissa Pearce, MD 
Medical Director Stop Loss
Symetra 

Will Price Transparency Lead to Lower Costs?
Great strides have been taken by the government and the private-sector to increase price transparency, but the question on everyone’s mind is:  Will all of the new information and data that is now available matter? Will it actually lead to lower costs for self-insured plans and healthcare consumers?  Taking into account all the topics and lessons learned throughout the Forum, this panel-led town hall will explore what transparency means for the cost of healthcare.

MODERATOR:  

Chris Condeluci, Esq.
Washington Counsel
Self-Insurance Institute of America, Inc.

SPEAKERS:    

Francois de Brantes 
Senior Partner
HVC Incentives Advisory Group

Dawn Cornelis
Co-Founder
ClaimInformatics 

Angelo Masciantonio (Invited)
Chief Strategy Officer
Granular Insurance 

Scott Ogburn
Senior Vice President
ECM Solutions