Day Two - CST/CDT (Central Daylight, GMT-5)
Understand how 340B ceiling prices are calculated and how these intersect with PBM contract structures.
Review recent lawsuits and political pressure from both state and federal regulators.
Examine real-world implications of 340B reforms on FQHCs, hospital outpatient departments, and manufacturers.
Hear expert insights on rebate vs. discount models, and how clearinghouses may resolve double-dipping and compliance disputes.
Explore service cross-subsidization in rural U.S. healthcare: impacts on access, provider viability, and policy solutions for underserved communities.
- Michelle Pinzon - Senior Associate General Counsel, Northwell Health
- Daryl Berke - Assistant General Counsel, Sanofi
.
Define what 'network adequacy' means in practice—and who’s enforcing it.
Discuss rural access issues where 20% of Americans face limited pharmacy networks.
Explore payer strategies to build value-based, yet compliant, pharmacy networks.
Consider the role of regulators in shaping future adequacy rules post-COVID.
- Ian Parnigoni, Pharm.D. - Vice President Account Management, VytlOne
- Nichole Palusinski Pharm.D - Clinical Pharmacist, Illinois Department of Healthcare and Family Services Drug Rebate Unit
- Jacob Drettwan - Pharmacy Owner, Curry’s Family Pharmacy
Understand looming state-level cutbacks in Medicaid coverage and emergency care.
Examine the ripple effects on patient access, hospital operations, and specialty care.
Hear payer and consultant strategies for navigating dual-eligible and vulnerable populations.
Explore emerging policy alternatives and federal budget shifts.
- Andrew York, J.D., Pharm.D. - Executive Director, Maryland Prescription Drug Affordability Board
Analyze the impact of HCSC’s acquisition of Cigna’s Medicare Advantage business.
Explore what it means for Cigna to retain its PBM, and whether decoupling adds risk or opportunity.
Consider integration challenges and payer strategy going forward.
- Jay Weaver - Vice President Payor Relations, PantheRx Rare Pharmacy
Learn from legal and financial experts about structuring modern, smarter PBM contracts.
Examine real-world examples of improved models, enhanced audit tools, and innovative spread protections.
Understand new language around GLP-1 medications, accumulators, and transparent rebate frameworks.
- Jay Weaver - Vice President Payor Relations, PantheRx Rare Pharmacy
- Dominic Adducci - Director of Pharmacy Transformation, Blue Shield of California
Highlight key takeaways from the FTC’s investigation into PBMs, including patient perspectives and gaps in regulatory focus.
Explore prior authorization burdens and their impact on timely access to care.
Discuss barriers created by rebate-driven formularies and the implications for patients.
- Stefanie Baran - Senior National Account Director- Market Access, Paratek Pharmaceuticals
A moderated Q&A panel exploring the future of integration, regulation, and innovation in the PBM landscape.
Panelists will share predictions on how patient access, digital tools, and state mandates will evolve over the next year.
Discussion will be guided by a facilitator posing targeted questions to representatives from key stakeholder groups.
- Ian Parnigoni, Pharm.D. - Vice President Account Management, VytlOne
- Josh Golden - Senior Vice President, Strategy, Capital Rx