Wednesday,
June 25, 2003,
Afternoon Session 2:00 p.m. – 5:00 p.m.
Title:
Mandated Benefits
A number of states have long mandated coverage of
a variety of health care services, including certain
pharmaceuticals. How prevalent are these mandates?
Which benefits are most and least widely mandated?
What are the effects of these mandates? To what
extent do these mandates increase the cost of health
insurance coverage? To what extent would these benefits
be available in the private coverage market, absent
the mandate? For example, are these benefits typically
provided by self-funded employee benefit plans,
which are not subject to these mandates? What factors
explain why certain states choose to mandate certain
benefits?
Panelists:
Thursday, June 26, 2003
Morning Session 9:15 a.m. – 12:15 p.m.
Title: Pharmaceuticals:
Formulary Issues
Pharmacy benefit managers (PBMs) have emerged as
major factors in the marketing and distribution
of pharmaceuticals. How do PBMs work? What information
do PBMs disseminate about their operations? What
factors enter into PBM formulary listing decisions
and how transparent are those decisions? What tools
do PBMs employ, and how effective are these tools?
What are the effects of PBMs on the cost of pharmaceuticals?
What state and federal laws affect how PBMs operate?
What, if any, are the barriers to entry for potential
competitors to existing PBMs? What consumer information,
consumer protection, and antitrust issues are raised
by the presence of PBMs in the market?
Panelists:
Thursday,
June 26, 2003
Afternoon Session 2:00 p.m. – 5:00 p.m.
Title: Prospective
Guidance
To provide prospective guidance to requesting parties
and to the public, the FTC provides advisory opinions
and the DOJ provides business review letters. Over
the past decade, the FTC and DOJ have each generated
approximately a half dozen such opinions and letters
relating to health care per year. Does this modest
volume reflect the true demand for prospective guidance,
or are parties discouraged from obtaining advisory
opinions and business review letters? Is prospective
guidance helpful or unhelpful in the health care
context? Is prospective guidance too costly or too
slow? What changes would make prospective guidance
more useful? How does the prospective guidance provided
by the FTC and DOJ compare to that provided by other
federal agencies?
Panelists
- Jeff
Brennan, Federal Trade Commission
- William Cohen, Federal Trade Commission
- Ellen
S. Cooper, Maryland Office of the Attorney
General
- Claudia
H. Dulmage, Department of Justice Antitrust
Division
- Warren
Grimes, Southwestern University School
of Law
- Clifton E. Johnson, Hall, Render, Killian,
Heath & Lyman, P.S.C.
- Jeff Miles, Ober, Kaler
- Vicky Robinson, Office of the Inspector
General, Department of Health & Human
Services
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