10th Annual Workshop for Transplant Financial Coordinators
September 17th to 19th, 2014
DoubleTree by Hilton Hotel
San Diego-Mission Valley, California
TFCs: Ensuring we provide accurate financial information to our patients and their families in a compassionate and
tactful manner, while maximizing reimbursement for our transplant centers.
~~ Registration Opens Tuesday, September 16 – 5:00 to 7:00 pm, South Foyer ~~
Day 1: Wednesday, September 17
7:30 am-4:00 pm
REGISTRATION OPEN
South Foyer
7:30 am-4:00 pm
EXHIBIT AREA OPEN
Great Room 1 - 4
7:30 am-8:15 am
BREAKFAST
Great Room 1 - 4
Generously sponsored by National Foundation for Transplant (NFT)
GENERAL SESSIONS
~~ please sit with your transplant specialty - signs on tables~~
8:15 am-8:45 am
Great Room 5 - 8
8:45 am-9:45 am
Great Room 5 - 8
WELCOME
Debbie Mast, TFCA President, Database Administrator/Financial Manager,
Solid Organ Transplant/MCS Program, Stanford Health Care, Palo Alto, CA
The Pivotal Role of the Transplant Financial Coordinator in the Era of
Accountable Health
Jennifer Milton, BSN, CCTC, MBA, Administrative Director, Clinical Assistant
Professor University of Texas Transplant Center, San Antonio, TX
The landscape of healthcare has undergone sweeping changes over the last few
years that have had a dramatic impact on transplant centers. Accountable Health
Care initiatives combined with coverage expansions through the affordable care
legislation have had a particular impact on transplantation. This talk will focus on
the critical role of the transplant financial coordinator in patient and program
management in this era of change.
At the end of the session attendees will be able to:
1. Describe the impact of Affordable Care Act on transplant patients and
centers.
2. Summarize key issues facing transplant financial coordinators related to
coverage expansion and accountable health care.
3. Discuss key issues related to the expanding managed Medicare and
Medicaid programs.
Moderator: John Waldon, Transplant Financial Coordinator,
St. Vincent Transplant Services, Indianapolis, IN
9:45 am-10:00 am
Great Room 1 - 4
BREAK with EXHIBITORS
Day 1: Wednesday, September 17 - continued
10:00 am-11:00 am
Great Room 5 - 8
Changing Organ Allocation:
Where Have We Been and Where Might We Be Going?
Carl Berg, MD., UNOS President, Medical Director of Abdominal Transplantation,
Duke University Health System, Durham, NC
After this session participants will be able to:
1. Understand the principles that serve as the foundation for the development
of organ allocation.
2. Recognize the process by which changes to the organ allocation system
can be developed, approved and implemented.
3. Review impending changes to the kidney allocation system, and potential
changes to the liver allocation system.
Moderator: Daryl Battin, MSW, LICSW, TFC & Social Worker,
Department of Transplantation, Lahey Hospital & Medical Center, Burlington, MA
11:00 am-12:00 pm
Great Room 5 - 8
LEGOLAND in the TFC World: Building Blocks of Best Practices
Different Programs: Same Patient Concerns & Dynamics
♦ Communicating and collaborating
♦ Sharing resources and networking
Moderators:
Lisa McDermott, Transplant Operations Analyst,
Methodist University Hospital, Memphis, TN
Lisa Donovan, Transplant Financial Coordinator,
SUNY Upstate University Hospital, Syracuse, NY
12:00 pm-1:15 pm
LUNCH – table signs to sit with your transplant specialty
Great Room 1 - 4
GENERAL SESSION
1:15 pm-2:15 pm
Great Room 5 - 8
Transplant Financial Success for Everyone – Fundraising Can Be Key!
Rick Lofgren, CFRE, President & CEO, Children’s Organ Transplant Association-COTA
Rebecca Carr, MSW, Co-Manager- Patient Services, HelpHOPELive
Connie Gonitzke, President & CEO, National Foundation for Transplants-NFT
Rent or meds? Electric bill or hospital bill? Why should anyone have to choose?
Fundraising with HelpHOPELive, National Foundation for Transplants (NFT), or COTA
opens a world of opportunity for a successful transplant, reducing monetary stress and
giving patients and families another partner in their transplant journey. Reducing
financial stress increases patient readiness and positive outcomes - benefiting both
patients and transplant centers. With more than 85 combined years of fundraising and
volunteer experience with thousands of patients across the country, these 3 nonprofit
organizations partner with families and communities to conduct fundraising campaigns
and overcome financial hurdles. With fundraising, each family’s transplant stress is
lessened as they seek to meet the mounting financial burden of pre- and posttransplant medical costs, high deductibles, lifetime costs of medications, time off from
work, and transportation and lodging costs. Learn the advantages of fundraising, tips
and tools for TFCs working through financial issues with families, helpful ideas for
raising funds in a challenging economy, and how “crowd” fundraising could impact your
patients.
Moderator: Daryl Battin, MSW, LICSW, TFC & Social Worker,
Department of Transplantation, Lahey Hospital & Medical Center, Burlington, MA
2:15 pm-2:30 pm
Great Room 1 - 4
BREAK with EXHIBITORS
Generously Sponsored by Stanford Health Care
CONCURRENT BREAKOUT SESSIONS I
2:30 pm-4:00 pm
2 topics - choose one to attend
More than elementary –
Patient & Transplant
Finances -Pre through Post
More than elementary – Needing the TFC to be Sherlock Holmes in the World
of Transplant Insurance and Patient Finances
Tracy Giacoma, RN, MSN, MBA, FACHE, Vice President Transplant Services,
Methodist Dallas Medical Center, Dallas, TX
Great Room 5 - 8
The world of transplant insurance and finances is like no other in medicine. We
often have to search with a magnifying glass through insurance, Medicare, and
UNOS policies and protocols. Knowing the language and many facets of the TFC
financial world [including transplant funding, contracting, and SRTR] are key to this
search and for the success of our transplant patients and programs. This session
presentation and case study discussion will enhance our TFC work, pre through
post transplant.
Moderator: Daryl Battin, MSW, LICSW, TFC & Social Worker, Department of
Transplantation, Lahey Hospital & Medical Center, Burlington, MA
BMT:
Healthcare Reform
& Resources
Shutters West 1 - 2
Healthcare Reform and Resources for Stem Cell Transplantation
Alicia Silver, MPP, Research Analyst, Payor Policy and Legislative Relations,
National Marrow Donor Program, Minneapolis, MN
Heather James, BA, CHTC, National Marrow Donor Program, Minneapolis, MN
This presentation will focus on lessons learned from the first year of
implementation of the Affordable Care Act and how the new legislation impacted
the Stem Cell Transplant community.
Session will also allow attendees to:
 Describe the purpose of Be The Match Patient and Health Professional
Services
 Discover programs and resources available to support transplant patients,
families and caregivers
Moderator: Bethany Fountain, Transplant Financial Counselor-Senior Financial
Counselor, Spectrum Health Hospital Group Solid Organ and Blood & Marrow
Transplant Programs, Grand Rapids, MI
~~ TFCA Welcome ~~
Light Reception
5:00 pm to 6:00 pm
Great Room 1-4 with Exhibitors
Day 2: Thursday, September 18
7:30 am-4:30 pm
REGISTRATION OPEN
South Foyer
7:30 am-2:15 pm
EXHIBIT AREA OPEN
Great Room 1 - 4
7:30 am-8:15 am
BREAKFAST
Great Room 1 - 4
8:15 am-9:30 am
Great Room 5 - 8
KEYNOTE ADDRESS
Generously sponsored by HeartWare
The Unspoken Needs of Patients – Lessons Learned in the Journey from
Surgeon to Transplant Patient
Kevin Anderson, MD, Department of Urology, Kaiser Permanente,
Sacramento, CA; Heart Transplant Recipient
The unspoken needs of patients are essential to understand and address in any
patient with a chronic or life-threatening disease. In this presentation we will
discover how to:
1. Name the fear
2. Become the advocate
3. Engender hope at every encounter
Moderator: Debbie Mast, Database Administrator/Financial Manager,
Solid Organ Transplant/MCS Program, Stanford Health Care, Palo Alto, CA
GENERAL SESSION
9:30 am-10:30 am
Great Room 5 - 8
TFC Detective Work in the World of Transplant Meds – Prescription
Assistance Programs (PAPs) & Medicare B vs. D
Judy Maltz, CPC, President-Transplant Reimbursement Analytics,LLC, Phoenix, AZ
Getting the most out of manufacturer’s Assistance Programs means understanding
and managing your patients’ use of their benefits and the programs that are
available for additional assistance. This module will cover benefit determination for
transplant medications through Medicare and commercial payers and how to use
the various assistance programs offered by pharmaceutical manufacturers from
vouchers and copay programs to free medication through Patient Assistance
Programs.
Moderator: Amellia Gay, Transplant Financial Coordinator,
Transplant Surgery, Scott & White Memorial Hospital, Temple, TX
10:30 am-10:45 am
BREAK with EXHIBITORS
Great Room 1 - 4
CONCURRENT BREAKOUT SESSIONS II
10:45 am-11:45 am
3 topics – choose one to attend
Kidney Paired Donations
That was easy…. NOT!
Financial Considerations of Paired Kidney Donation Events
Gwen McNatt, MS, RN, CNN, FNP-BC, Director, Kovler Organ Transplantation
Center, Northwestern Memorial Hospital, Chicago, IL
Great Room 5 - 8
This presentation will contain information about the complicated (and confusing)
finances around Kidney Paired Donation.
Learning Objectives:
 Describe the different components of KPD
 Describe a standard acquisition charge in transplantation
 Discuss inconsistencies in Medicare’s policy on KPD billing
 Discuss pros and cons of various financial models (SAC,
National SAC, departmental charges, etc…)
Moderator: Lisa Donovan, Transplant Financial Coordinator,
SUNY Upstate University Hospital, Syracuse, NY
BMT
Shutters East 1 - 2
Umbilical Cord Transplantation – Quo Vadis (Where are we going?)
John Lister, MD, Chief, Division of Hematology and Cellular Therapy, Director,
Allegheny Health Network Cancer Institute, West Penn Hospital, Pittsburgh, PA
Allogeneic hematopoietic stem cell transplantation can be performed from marrow,
peripheral blood or umbilical cord blood sources. Donors can be related,
unrelated, matched or mis-matched. Each donor source presents unique
characteristics with relative advantage the one compared to the other. This
presentation will provide an overview of umbilical cord blood transplantation,
specifically discussing five topics of concern. These topics are: engraftment, posttransplant immunocompetency, propensity for GVHD, relapse risk and cost.
Recent advances in the field will be discussed that address these topics and a
comparison with other sources will be described.
Moderator: Michelle Dodson, Transplant Financial Coordinator,
Cell Transplantation Program, Allegheny Health Network Cancer Institute,
West Penn Hospital, Pittsburgh, PA
Patient Compliance/
Communication
Session with Heart
Social Worker &
Liver & Kidney TFC
Shutters West 1 - 2
But no one ever told me! - do our patients really “hear” what we tell them?
Jan Hart, MSW, LCSW, CCTSW, Heart & MCS Social Worker,
St. Vincent Hospital, Indianapolis, IN
Amy Hackney, BSW, MBA, Manager, Transplant Finance & Data
Tulane Medical Center-Tulane Transplant Institute, New Orleans, LA
This session will enable participants to:




Describe critical areas for patient communication
Identify why information is often forgotten or missed
Consider learning styles and patterns of adherence
Strategize with colleagues
Interactive conversation between speakers and participants will allow sharing of
best practices.
Moderator: Suzanne Tegio, Heart Transplant Financial Coordinator, MCS
Program, Stanford Health Care, Palo Alto, CA
11:45 am-1:00 pm
LUNCH
Generously sponsored by Walgreens
Great Room 1 – 4
CONCURRENT BREAKOUT SESSIONS III
1:00 pm-2:00 pm
2 topics – choose one to attend
Medicare Advantage
Plans
The ABCs of Medicare Advantage Plans
Laura J. Aguiar, Senior Consultant, Guidry & East LLC–Transplant Consulting
Solutions, Phoenix, AZ
Great Room 5 - 8
At the end of the Medicare Advantage Plans session, attendees will have a better
understanding of these plans, including enrollment and coverage issues specific to
transplant patients. Attendees should also have a better understanding of why
these plans are often referred to as ‘disAdvantage’ plans for the transplant
population.
Moderator: Debbie Mast, Database Administrator/Financial Manager,
Solid Organ Transplant/MCS Program, Stanford Health Care, Palo Alto, CA
Day 2: Thursday, September 18 - continued
Pediatrics Session:
Patient Adherence
Shutters West 1 - 2
Adherence to Treatment Among Youth with Chronic Illness:
Striving to Understanding Behavior (or Lack Thereof)
Christopher Fitzgerald, PhD, Pediatric Psychology Fellow, The Children’s Hospital
of Philadelphia, Solid Organ Transplant Center, Philadelphia, PA
The presentation will review general correlates of non-adherence among
adolescents and their families. Additionally, there will be a discussion of the ways
that adherence is typically assessed in clinical practice and research with particular
emphasis on various interventions that have been shown to be effective in
improving youth self-management.
Moderator: Amellia Gay, Transplant Financial Coordinator,
Transplant Surgery, Scott & White Memorial Hospital, Temple, TX
2:00 pm – 2:15 pm
Great Room 1 – 4
BREAK with EXHIBITORS
Generously sponsored by Walgreens
~~ Exhibitor Bingo Drawing at 2:10 p.m. – You must be present to win ~~
CONCURRENT BREAKOUT SESSIONS IV
2:15 pm-3:15 pm
3 topics – choose one to attend
Medicare 101
Medicare Basics for New TFCs
Ruth Wilhelm, Transplant Financial Coordinator, The Virginia Transplant Center,
Henrico Doctors’ Hospital, Henrico, VA
Shutters West 1 – 2
This session will briefly cover transplant history, terms and definitions, Medicare
entitlement and eligibility, COB/MSP (Coordination of Benefits/Medicare
Secondary Payer), and other Medicare topics that the new TFC may encounter.
Moderator: Lisa McDermott, Transplant Operations Analyst,
Methodist University Hospital, Memphis, TN
BMT - PharmD
Shutters East 1 - 2
Cost Saving Measures Impacting the Transplant Program:
BMT and PharmD Collaboration
Ashley Dalton, PharmD, Inpatient Pharmacy Manager, University of California San
Diego Medical, San Diego, CA
Sam Martinez, Pharm D, University of California San Diego Medical, San Diego, CA
The positive outcomes associated with pharmacist collaboration in patient care are
well documented in literature. This presentation will outline the role of the
pharmacist within the Bone Marrow Transplant Team at the UC San Diego HealthSystem and Pharmacy lead initiatives within the service that have had a positive
impact for the organization and our patients.
Moderator: Michelle Dodson, Transplant Financial Coordinator,
Cell Transplantation Program, Allegheny Health Network Cancer Institute,
West Penn Hospital, Pittsburgh, PA
Reimbursement for
Organ Acquisition Costs
Great Room 5 - 8
Overview of Reimbursement for Organ Acquisition Costs:
Understanding the Medicare Cost Report, Standard Acquisition Charge, and
Monitoring Reimbursement
Robert Howey, CPA, Revenue Cycle Manager, Mayo Clinic, Jacksonville, FL
The presentation will provide an overview of reimbursement for organ acquisition
costs. It will discuss the Medicare cost report methodology as well as obtaining
reimbursement from non-Medicare payers.
After the session, the participant will be able to:
 Understand the Medicare cost report methodology, areas of risk, and
areas of opportunities
 Understand the preparation of the cost report and types of cost
included/excluded
 Understand how non-Medicare payers reimburse for organ acquisition
costs
Moderator: Debbie Mast, Database Administrator/Financial Manager,
Solid Organ Transplant/MCS Program, Stanford Health Care, Palo Alto, CA
CONCURRENT BREAKOUT SESSIONS V
3:15 pm-4:30 pm
2 topics – choose one to attend
Live Donor Billing Solid Organ & BMT
Billing Practices and Policies for Living Transplant Donors
William P. Vaughan, Chief Operating Officer, Guidry & East LLC–Transplant
Consulting Solutions, Tampa, FL
Laura J. Aguiar, Senior Consultant, Guidry & East LLC–Transplant Consulting
Solutions, Phoenix, AZ
Michelle Dodson, Transplant Financial Coordinator, Cell Transplantation Program,
Allegheny Health Network Cancer Institute, West Penn Hospital, Pittsburgh, PA
Great Room 5 - 8
This session will help attendees understand the complex processes in place to bill
for complications associated with living organ donation, including the ‘clarifications’
issued by CMS in 2012. These clarifications specify the coverage the recipient
must have at the time of transplant as well as the party responsible for the donor’s
complications.
In addition this session will


Introduce the audience to Cell Transplantation and how donor testing is
billed for related and unrelated donors.
Compare and identify distinct similarities and difference between related
and unrelated stem cell transplant donors.
Moderator: Bethany Fountain, Transplant Financial Counselor-Senior Financial
Counselor, Spectrum Health Hospital Group Solid Organ and Blood & Marrow
Transplant Programs, Grand Rapids, MI
Heart
Shutters West 1 - 2
Authorizations & Reimbursement for VADs and Heart Transplants:
Policies, Protocols, Issues
Frederick M. McNeil, DNP, ACNP-BC, RN, CCRN, Government Policy and Health
Outcomes, HeartWare, Framingham, MA
Suzanne Tegio, Heart Transplant Financial Coordinator, MCS Program, Stanford
Health Care, Palo Alto, CA
Session will
 Provide overview of authorization process and procedures for
reimbursement conditions for mechanical circulatory support devices as
bridge-to-transplantation, bridge-to-recovery/determination and permanent
or destination therapy.
 Better define financial clearance and information to/from payers as it
relates to securing authorization for services regarding different phases of
care.
 Outline one approach to financial clearance for Transplant and MCS
(Mechanical Circulatory Support).
Discussion of best practices amongst centers will enhance attendee learning.
Moderator: John Waldon, Transplant Financial Coordinator,
St. Vincent Transplant Services, Indianapolis, IN
Day 3: Friday, September 19
7:30 am-1:00 pm
REGISTRATION OPEN
South Foyer
7:30 am-9:00 am**
Great Room 1 - 4
8:00 am-9:30 am
Great Room 5 - 8
BREAKFAST
** Note** TFCA Business Meeting starts at 8:00 a.m. for all TFCA Members
14th Annual TFCA (Transplant Financial Coordinators Association)
Business Meeting [Session Attendance Limited to TFCA MEMBERS]
The TFCA Business Meeting is for active TFCA members only. In this meeting the
TFCA governing body is charged with disseminating association business
information. Officer Reports, Financial Reporting along with Election Committee,
Credentialing Committee, Planning Committee and Fundraising Committee
Updates. Following committee updates, will be open discussion for members to
ask questions and seek clarification on subjects and topics pertinent to our
organization.
9:30 am-9:45 am
BREAK
Great Room 1 – 4
GENERAL SESSIONS
9:45 am-11:00 am
Great Room 5 - 8
Medicare and the World of Transplant & Disability: Current Policies & Policy
Changes to Watch For (and where to find them)
David P. Santana, Health Insurance Specialist/Lead Trainer, Centers for Medicare
& Medicaid Services, Baltimore, MD
This session will provide a detailed overview of Medicare program rules and
structure, including eligibility based on ESRD and Disability, coverage for
transplant services, and coordination of benefits. In addition will provide updated
information on the programs administered by the Centers for Medicare & Medicaid
Services (CMS), including Medicare, Medicaid, and the Children’s Health
Insurance Program (CHIP).
Moderator: Ruth Wilhelm, Transplant Financial Coordinator, The Virginia
Transplant Center, Henrico Doctors’ Hospital, Henrico, VA
11:00 am-11:30 am
BREAK
Great Room 1 – 4
11:30 am-12:45 pm
Great Room 5 - 8
Health Care Marketplace
♦ 2014 Review
♦ What to expect for 2015
This session will provide an update on the implementation of new provisions under
the Affordable Care Act currently impacting the private health insurance market;
including new Marketplace, eligibility, enrollment, benefits, tax credits, and share
responsibility. New Medicaid eligibility group, new preventive benefits, and new
consumer protections.
David P. Santana, Health Insurance Specialist/Lead Trainer, Centers for Medicare
& Medicaid Services, Baltimore, MD
Moderator: Debbie Mast, Database Administrator/Financial Manager, Solid Organ
Transplant/MCS Program, Stanford Health Care, Palo Alto, CA
12:45 pm-1:00 pm
Great Room 5 - 8
Wrap-Up & Evaluations
Debbie Mast, TFCA President, Database Administrator/Financial Manager,
Solid Organ Transplant/MCS Program, Stanford Health Care, Palo Alto, CA
Lisa McDermott, Transplant Operations Analyst, Methodist University Hospital,
Memphis, TN, TFCA Workshop Planning Co-Chair
Lisa Donovan, Transplant Financial Coordinator, SUNY Upstate University
Hospital, Syracuse, NY, TFCA Workshop Planning Co-Chair