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Honing in on the Appeal Process to Improve Access to Anti-VEGF Therapy for Patients with AMD

Premiere Date: Thursday, November 21, 2019

This activity offers CE credit for:

1. Physicians (CME)
2. Pharmacists (ACPE)
3. ABO (MOC)
4. Other

All other clinicians will receive a Certificate of Attendance stating this activity was certified for AMA PRA Category 1 Credit™

Credit Expiration Date:
Thursday, December 31, 2020
Note: Credit Is No Longer Available

Faculty

Darius M. Moshfeghi, MD (Moderator) Professor and Chief, Retina Division Horngren Family Vitreoretinal Center, Byers Eye Institute Department of Ophthalmology Stanford University School of Medicine Stanford, CA

Derek van Amerongen, MD, MS  Vice President and Medical Officer Humana of Ohio Springdale, OH

Statement of Need

Step therapy requirements have limited patient access to FDA-approved, anti-VEGF agents for the treatment of AMD. Prior authorization requests for these therapies are commonly denied. Hence, it is important that clinicians be aware of the approaches to overcome these barriers and implement systemic and clinically supported appeals that ensure uninterrupted anti-VEGF therapy for patients with AMD.

In the third module of this CME Outfitters Snack series, expert faculty focus on developing and implementing strategies for appeals in order to reduce treatment delays.

Learning Objectives

At the end of this CE activity, participants should be able to:

• Develop and implement approaches for a systematic and clinically supported appeal to ensure uninterrupted anti-VEGF therapy for patients with AMD.

The following learning objectives pertain only to those requesting CNE or CPE credit:

• Describe approaches for a systematic and clinically supported appeal to ensure uninterrupted anti-VEGF therapy for patients with AMD.

Financial Support

This activity is supported by an independent medical education grant from Regeneron Pharmaceuticals, Inc.

Target Audience

Retina specialists, physician assistants, nurse practitioners, nurses, pharmacists, and patients.

Credit Information

CME Credit (Physicians):
CME Outfitters, LLC, is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

CME Outfitters, LLC, designates this enduring material for a maximum of 0.5 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

CPE Credit (Pharmacists):
CME Outfitters, LLC, is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education. 0.5 contact hours (0.05 CEUs) Universal Activity Number:
Enduring: 0376-0000-19-067-H01-P

Type: Knowledge-based

ABO MOC Credit: Successful completion of this CME activity, which includes participation in the evaluation component, enables the learner to satisfy the Lifelong Learning and Self-Assessment requirements for the American Board of Ophthalmology's Maintenance of Certification program. It is the CME activity provider's responsibility to submit learner completion information to ACCME for the purpose of granting MOC credit.

Learning Format:
Enduring Material

Royal College MOC: Through an agreement between the Accreditation Council for Continuing Medical Education and the Royal College of Physicians and Surgeons of Canada, medical practitioners participating in the Royal College MOC Program may record completion of accredited activities registered under the ACCME’s “CME in Support of MOC” program in Section 3 of the Royal College’s MOC Program.

MIPS Improvement Activity: This activity counts towards MIPS Improvement Activity requirements under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). Clinicians should submit their improvement activities by attestation via the CMS Quality Payment Program website.

Note to Physician Assistants: AAPA accepts certificates of participation for educational activities certified for AMA PRA Category 1 Credit™ from organizations accredited by the Accreditation Council for Continuing Medical Education.

Note to Nurse Practitioners: Nurse Practitioners can apply for AMA PRA Category 1 Credit™ through the American Academy of Nurse Practitioners (AANP). AANP will accept AMA PRA Category 1 Credit™ from organizations accredited by the Accreditation Council for Continuing Medical Education. Nurse practitioners can also apply for credit through their state boards.

Post-tests, credit request forms, and activity evaluations must be completed online (requires free account activation), and participants can print their certificate or statement of credit immediately (75% pass rate required). This website supports all browsers except Internet Explorer for Mac. For complete technical requirements and privacy policy, visit https://www.cmeoutfitters.com/privacy-and-confidentiality-policy/.

Disclosure Declaration

It is the policy of CME Outfitters, LLC, to ensure independence, balance, objectivity, and scientific rigor and integrity in all of their CE activities. Faculty must disclose to the participants any relationships with commercial companies whose products or devices may be mentioned in faculty presentations, or with the commercial supporter of this CE activity. CME Outfitters, LLC, has evaluated, identified, and attempted to resolve any potential conflicts of interest through a rigorous content validation procedure, use of evidence-based data/research, and a multidisciplinary peer review process. The following information is for participant information only. It is not assumed that these relationships will have a negative impact on the presentations.

Dr. Moshfeghi reports that he receives research support from Apellis Pharmaceuticals and Genentech, Inc. He is on the advisory committee for Alcon; Bayer Corporation; Iconic Therapeutics, Inc.; and Regeneration Pharmaceuticals, Inc. He is a consultant for Alcon; Congruence Medical Solutions, LLC; Iconic Therapeutics, Inc.; Novartis Pharmaceuticals Corporation; Regeneron Pharmaceuticals, Inc.; and Visunex Medical Systems, Inc. He is a stock shareholder (directly purchased) of dSentz Inc.; Grand Legend Technologies, Ltd; Linc; Pr3vent; PromiSight Inc.; Pykus Therapeutics, Inc.; Versl, Inc.; and Visunex Systems, Inc.

Dr. van Amerongen has no disclosures to report.

Jeffrey Helfand, DO (peer reviewer) has no disclosures to report.

Mae Ochoa, RPh (peer reviewer) has no disclosures to report.

Kavitha Ramachandran, PhD (planning committee) has no disclosures to report.

Susan Perry (planning committee) has no disclosures to report.

Jan Perez (planning committee) has no disclosures to report.

Sharon Tordoff (planning committee) has no disclosures to report.

Disclosures were obtained from the CME Outfitters, LLC staff: No disclosures to report.

CME Outfitters, LLC and the faculty do not endorse the use of any product outside of the FDA labeled indications. Medical professionals should not utilize the procedures, products, or diagnosis techniques discussed during this activity without evaluation of their patient for contraindications or dangers of use.

Questions about this activity? Call us at 877.CME.PROS (877.263.7767).