Aimed Alliance Presents
Unfair Formulary Changes: Advising Employers on Unnecessary Risks When Selecting Pharmacy Benefit Coverage
Part Two of a Two-Part Series on Nonmedical Switching
As an insurance agent or broker, it is imperative to understand and advise employers on access barriers to treatments that allow plan beneficiaries to remain healthy and productive. Some insurers institute policies that force stable individuals to change their medications after the plan year has begun, sometimes disrupting the delicate clinical equilibrium they have found. This mid-year switching can harm plan beneficiaries, potentially violate state and federal laws, and put plan administrators at risk for liability. To learn more, join us for Part II of our free webinar series on nonmedical switching.
Who should attend?
- Insurance brokers and agents; and
- Anyone interested in learning about nonmedical switching.
Wednesday, Aug 2, 2017 from 12 p.m. to 1 p.m. ET
Online pre-registration is required. Please click here to register.
What is Nonmedical Switching?
Nonmedical switching, sometimes referred to as mid-cycle formulary changes, occurs when an insurer requires a stable patient to switch from his or her current, effective medication to a less costly alternative by removing the medication from the formulary list, moving a medication to a higher cost tier, or increasing the out-of-pocket costs owed. Nonmedical switching can negatively impact patients’ health and result in adverse events, including increases in health care utilization and missed work days.
Speakers will discuss:
- Nonmedical switching policies and their impact on plan beneficiaries’ health;
- State and federal requirements for small and large group plans;
- The legal landscape and potential liability arising out of nonmedical switching;
- Legislative efforts to deter nonmedical switching; and
- Tips for insurance brokers and agents when advising employers on selecting insurance plans and pharmacy benefit coverage.
- Gary R. Branning, M.B.A., President of Managed Market Resources (MMR) and Professor at Rutgers Graduate Business School
- Carol Mandel, Esq., Managed Care Consultant
- Stacey L. Worthy, Esq., Executive Director of Aimed Alliance
Gary Branning, M.B.A.
Mr. Branning is President of MMR, a health care consulting company, in Mount Olive, NJ that offers various healthcare stakeholders innovative solutions for the navigating the complex U.S. market. Areas of focus include U.S. healthcare structure, marketplace trends, policy, and access and reimbursement. Mr. Branning is also an Associate Professor at Rutgers Graduate School of Business and Guest Lecturer at Blanche and Irwin Lerner Center for Pharmaceutical Management Studies. Mr. Branning received his Bachelor of Science degree in business administration from Wagner College, and an MBA in finance from Fairleigh Dickinson University.
Carol Mandel, Esq.
Ms. Mandel is an experienced corporate attorney whose professional career has focused on commercial health insurance, regulatory law, and public health policy. Most recently, as the Chief Compliance Officer with the Evergreen Health Cooperative, Ms. Mandel built the compliance program for a Maryland HMO’s Consumer Operated and Oriented Plan (CO-OP). Prior to her position with the CO-OP, Ms. Mandel was an Associate General Counsel with United Healthcare and worked in public health policy at Georgetown University. Ms. Mandel obtained her law degree from Southwestern University School of Law and her undergraduate degree from Pitzer College.
Stacey L. Worthy, Esq.
Stacey L. Worthy, Esq. is the Executive Director of the Alliance for the Adoption of Innovations in Medicine (Aimed Alliance), a not-for-profit organization that advances access to quality health care. She provides analysis of law, regulation, and legislation, as well as manages advocacy initiatives by providing policy analysis and overseeing coalition-building efforts. Ms. Worthy is also a partner at DCBA Law & Policy where she counsels members of the health care industry, small businesses, and not-for-profits. She earned her Juris Doctorate degree from the George Mason School of Law, and graduated magna cum laude from Boston’s Suffolk University.
For more details, contact Aimed Alliance at firstname.lastname@example.org or (202) 559-0380.
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