In this Issue…

Notes from Joe
· Halfway There

Legal Update
· Program Income Rules Still Apply During a Public Health Emergency

Payer Update

Alliance Update

Notes from the Community
· News from the International Community

Team Alliance Contact Information

Halfway There
By Joe Pugliese

Wouldn’t it be wonderful if zoom fatigue was our biggest problem? We hope you are all safe and well. It is the middle of what has been a most challenging year. I know I find it hard to stay focused on the job at hand but I think we need to take the approach that things will get back to a good normal.

The middle of the year is typically a time to look back and see how you are doing against the goals you set for the year. This gives you the opportunity to refocus on the things you want to have done by year end. One goal we set for 2020 was to have three new participating members and I’m pleased to report that year to date we have four. Alaska and University Health System, Cleveland were layups since they had both signed on before the end of 2019 and were awaiting registration on the OPA website. The other two are Connecticut Children’s and University of California San Diego. I think we have an excellent opportunity to have three additional participating members before the end of the year.

As a reminder, there is nothing preventing non-participating members from joining. All you need is to be a federally-qualified hemophilia treatment center listed on the Office of Pharmacy Affairs website with an HM designation. If you have questions about how to join, drop me a line.

There are an ever-growing number of reasons to be a member of the Alliance. Our group purchasing contracts are the most obvious. However, the work of our payer team in building out a national PPO (preferred provider organization) has quickly emerged as another tangible and compelling benefit of Alliance membership. Through our collaborative efforts with members, NHF and insurance brokers and plans across the country, we are capturing business for our members across the country. This is a classic win, win, win: patients enjoy better outcomes at a lower cost; HTCs are able to fund the staffing they need to provide outstanding clinical care; and the health system saves money.

We are presently at 31.5 HTCs who have signed the PPO agreement. I think the tipping point is somewhere north of 60, at that point we have sufficient reach in addition to the outstanding clinical results to compel national and large regional plans to include us in their networks.

You may recall that the end of March we were going to Washington for our annual Hill Day. It was particularly exciting because after years of effort we seemed to have found a solution for the skilled nursing facility (SNF) issue that has represented a significant access to care issue for the community. The events of the last 90 days have obviously slowed our progress on that front. We are moving forward with a virtual Hill Day later this summer and hope that you’ll join us in that effort. 

There are still six months to go in 2020, which provides lots of opportunity for us to make significant progress in securing the future of comprehensive care for the bleeding disorders community.

Program Income Rules Still Apply During a Public Health Emergency
By Elizabeth 'Issie' Karan

The COVID-19 epidemic has placed unprecedented challenges on the U.S. economy and healthcare system. In the coming weeks and months, many institutions and organizations may find themselves in unexpected positions, financially and otherwise. As hemophilia treatment centers (HTCs) and their host institutions assess budgetary impacts, we wanted to remind Hemophilia Alliance members of resources describing restrictions on spending federal funds.

First, the Maternal and Child Health Bureau (MCHB) has stated that all factor replacement revenue, whether or not the HTC is a 340B covered entity, is program income and subject to the applicable rules and guidance. (See MCHB, Hemophilia Treatment Center Manual for Participating in the Drug Pricing Program Established by Section 340B of the Public Health Service Act, 2005). As such, regardless of how your HTC obtains factor under the 340B program (i.e. through a hospital versus a grantee designation), all savings must be treated as program income.

Second, host institutions may charge for indirect costs (e.g. overhead) associated with the HTC’s operations but still must comply with 45 CFR Part 75 in doing so. The Hemophilia Alliance Legal Team described these requirements in detail in this letter. Importantly, any costs charged to a federal grant must be allocable, reasonable, and allowable.

If you have questions regarding the use of program income, particularly to support activities outside of the HTC, please contact us.

By Jeff Blake

The last few years has been very busy for the Payer Team. We have accomplished a lot, but there is so much more that we can do. Through our relationships and marketing efforts and collaboration with HTC members we have been able to bring 30m-40m units of new business to HTCs. This added volume in factor distribution has allowed HTCs to develop and fund new programs, support workforce retention and recruitment and continue to sustain the comprehensive clinical model of care. Revenue from this new business can fund approximately 75 – 100 HTC employees, maintaining and enhancing the care and services provided by HTCs.

To continue our success and bring more business to HTC pharmacy programs will require teamwork. Payers are contacting us daily to discuss potential solutions to better manage and contain the cost of bleeding disorders care. As you know, we tell payers the best solution is to have an integrated model of care that our member HTCs provide that includes medical and pharmacy services. Payers are listening to our message and bringing more potential opportunities to us. We currently have payer opportunities of more than 60m units, which could generate substantial program income to help support HTCs. We plan to share more details of the financial impact of our work on HTC programs on an upcoming webinar.

So, what do we need you to do to bring more business to HTC pharmacy programs? Two things come to mind.

1. We must be responsive to payers to finalize potential opportunities. We typically have 7 – 10 business days to respond to payer opportunities. How can you help? When a member of the Hemophilia Alliance team contacts you about an opportunity to grow your pharmacy business, please be responsive so we can respond in a timely manner to payers.
    
2. Review and sign the Hemophilia Alliance Network Services (HANS) PPO Agreement. We will work with you and your contracting/legal teams to finalize this agreement. This agreement will provide you the opportunity to participate in payer contracts that we have negotiated. We currently have 30 members that have signed the HANS PPO Agreement. To have an effective national network of HTCs and their pharmacy programs we need at least 60 members to sign the HANS PPO Agreement. To have a larger national presence we need at least 80 HTCs to participate.

To learn more about our payer activities, please contact me or a member of the Hemophilia Alliance Team.

By Sean Singh

I’m happy to provide quick updates about a number of Alliance activities this summer and fall. As always, remember WE WORK FOR YOU and please contact me with any ideas or concerns.

Summer Webinar Series

We hope that you will join us this summer for our popular webinar series. We’ve moved it to every other week and we will continue to update you on changes in healthcare that affect HTCs and the bleeding disorders community. We continue to look at solutions for every aspect of your program from manufacturers issues to helping you with payors to providing updates from our team in Washington DC about changes that might affect you from a legal or regulatory perspective. We encourage you to let us know what might be affecting you and how we can help.

The dates for the summer series are:

July 9th – with special guest speaker, Dr. Leonard Valentino, President and CEO of NHF who will present on their Blue Sky initiative; July 23rd; and August 20th.

Fall Members Meeting and New HTC Staff Meeting

Due to uncertainty over the COVID situation this fall, the Alliance has made the sad but necessary decision to cancel the fall members meeting and the new HTC staff meeting.  We look forward to seeing everyone in person in 2021 and virtually via webinars this year.  

Virtual Meetings

We will be participating in both NHF and HFA annual meetings virtually. We are looking for ways to support our members and to help tell their story at the meetings. This can include stories about your center and the work you have been doing, or how you are preparing for the future. The meetings are rapidly approaching. If you are interested in helping us share your story, please contact Sean Singh at sean@hemoalliance.org.

Website Additions

Recorded Webinars – We have been recording our webinars this spring and you can find the slides and recordings in the member section of the website. The summer series is also being uploaded to the website. Please let us know if you are unable to access these presentations. The webinars are the proprietary and are for Alliance members only.

Contact Form – A new Center Contact Update form has been added to the www.hemoalliance.org website. The form is a way for you to update us on changes to personnel within your HTC at your convenience. The form is located in the members section of our website. Once you have logged in, click on the Alliance Members tab, then select Center Contact Update.

Email Notification – An email notification recently went out regarding entering in your purchase data. In an effort to help you, help us we will send out reminder emails on the 1st, 6th and 9th of the month. If you did not receive a reminder email and you are the person entering data, please contact theresa@hemoalliance.org.

Primary Contact Map – A Contact Map has just been added. You can find it under Alliance Members/Alliance Contact Map. This will show you what team member is your main person of contact for your center.

News from the International Community
By Jennifer Laliberte, WFH USA National Director

The first ever #WFHVirtualSummit featured a number of inspiring medical and multidisciplinary sessions, WFH educational sessions and free papers. In case you missed it, all sessions will be available for a whole year for registered participants. It’s not too late to register!

Notable announcements included the publication of the 3rd Edition of the WFH Guidelines for the Management of Hemophilia, soon available in Haemophilia as well as on the WFH eLearning platform, an update on the development of the WFH Gene Therapy Registry, and a call to action for the global community to move from Compassion to Action.

Click here to find out how you can help the WFH support its national member organizations through the global pandemic and continue to deliver life-changing programs and services. Learn more at www.wfh.org/give.

Team Alliance Contact Information

We work for you! Please don’t hesitate to contact any of us with any questions or concerns: