HANS Agreement with Emerging Therapy Solutions (ETS) for Gene Therapy Products
by Angela Blue, Director Member and Community Relations

The Hemophilia Alliance is excited to share details of the newest HANS opportunity available to our members for gene therapy products! The agreement is available through a new addendum to the Hemophilia Alliance Networks Services (HANS) agreement. We are asking all of our member HTCs to consider signing onto HANS to access this new agreement in order to be in-network to provide gene therapy infusions to your patients.

The Hemophilia Alliance presented a webinar on May 14th in collaboration with Emerging Therapy Solutions (ETS). The webinar provided information and answered questions about the new agreement. A recording of the webinar can be found here.

Emerging Therapy Solutions (ETS) is a national entity connected to the Synergie Medication Collective. ETS focuses on high-cost services, cell and gene therapy, transplants, and other complex healthcare cases. ETS has relationships with national payers and currently has over 2,000 plan/payer contracts. Their client base currently includes 27 of the 32 Blue Cross and Blue Shield Plans across the country and they are aspiring to expand their client base over the next several years. ETS helps Providers by providing a simplified contracting process, efficiency in claims processing, and promotion of provider programs, like HTCs, within their payer networks.

To review, the Hemophilia Alliance Network Services (HANS) is a legal entity established in 2017 to enable the Hemophilia Alliance to contract on behalf of participating members on a national level. Hemophilia Alliance member HTCs can participate at no cost and are able to opt-in or opt-out of specific contracts as they wish. To access the new addendum including specific details about pricing and reimbursement, an HTC must be signed on to the HANS agreement. If you would like details about participating in HANS or the new addendum, please contact the Member and Community relations team.
The goal of the new agreement that went into effect Jan. 1, 2024, is to provide our member HTCs assistance and greater assurance of payment for Gene Therapies beyond a prior authorization and even a single case agreement. The agreement between HANS and ETS currently covers Roctavian and Hemgenix, and we are working on expanding to add the newly approved Hemophilia B gene therapy, Beqvez.

The process for using the agreement is triggered when an HTC submits a Prior Authorization to a plan working with ETS, then the payer submits a patient referral to ETS, ETS notifies HANS, and HANS then notifies the HTC that the patient is covered by the ETS agreement. ETS does not take a cut of the reimbursement, their reimbursement comes directly from separate agreements they have with payers.

The process on the HTC side is relatively simple. First, the HTC needs to confirm that they received the referral notice and schedule of administration date. Second, the HTC needs to confirm that the therapy was administered as planned and submit the claim to ETS for re-pricing. ETS will then submit the claim to the payer for payment to the HTC. One of the benefits of signing the agreement is that ETS can help resolve any billing disputes with payers and the HTC will be paid within 30 days of submitting a clean claim.

If a HTC’s home institution already has a direct agreement with ETS, the rates in the HANS agreement supersede existing agreements. It’s important to note that agreements that overlap are a result of ETS having broad agreements with institutions before hemophilia gene therapy existed.

In addition to the link to the recording of the recent webinar, we also have more detailed information including notes from the detailed Q & A discussion we can provide to anyone who is interested if you have questions about the ETS agreement or HANS contact your primary Member and Community Relations contact. Please take the time to learn about this new opportunity through HANS and sign onto HANS to access these newly negotiated gene therapy contracts.