Reimbursement Specialist Customer Support

ROBERT G. DASH

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EXECUTIVE PROFILE

Highly self-motivated Market Access and Reimbursement Professional within the Biopharmaceutical, Biotech, Medical foods and formula, Medical Devices, and Life Science areas. Expert knowledge regarding Healthcare Policy/CMS interface, and product knowledge impacting therapeutic/patient access and strategic launch activities. Proven pricing negotiating skills with all payer segments via rebates, fee-for-service and value-based contracting execution. Highly patient centric Individual with the compassion and fortitude to always strive to “Win the Hearts and Minds of the patient experience”.

Acute business acumen along with a unique insight to challenges facing payer’s reimbursement and barriers to patient access. Extensive Managed Market knowledge across MCO payers, Medicare Part B/DMERC carriers

(MACs), Pharmacy Benefit Managers (PBMs), Medicare Part D, State Medicaid, Specialty Pharmacy (SPP), IDN’s, Wholesaler’s, Hospital, and infusion clinics.

Collaborative team player, impactful insights to access strategies, acting as key resource to colleagues and health professionals (HCP) for reimbursement healthcare economics.

Twenty three (23) years creating tactical and strategic market access and reimbursement initiatives affecting US market and manufacturers products. Continue to provide patient and consumer group educational workshops on reimbursement and payer issues, supporting all field sales teams with customer reimbursement strategies/tactics. In depth knowledge of State Medicaid, Medicare, and private payer reimbursement modalities for many therapeutics and devices. Coordinated direct meetings with over 40 State Medicaid pharmacy directors and staff, related to negative access to company therapies, as well as gathering utilization data for sales and marketing teams. Co- chaired Plasma Protein Therapeutic Association’s (PPTA's) State Reimbursement Task Force Committee. CAREER ACHIEVEMENTS

Obtained medical policy coverage for human amniotic membrane (HAM) skin graft ; Point32 Health Plan, BCBS RI, BCBS MA, Excellus, Fidelis Care, Horizon BCBS, Cigna, IBX, Capital Blue, UPMC Health Plan, Optima Health.

Obtained formulary status with 12 state WIC Programs and 3 major state Metabolic Programs. Established formulary presence for key formula therapies within 30 states under DME state and commercial payer’s.

Successfully obtained new HCPCS Code for von Willebrand factor complex prior to launch of new indication

Obtained coverage of ZLB Behring's A1PI, IVIG, and Rh(D) therapies under Texas Medicaid program (TDVP)

Received Business Excellence Award, 1998, 2000 and 2001. QUALIFICATION HIGHLIGHTS

Expert in field of Medicaid, Medicare, and private payer reimbursement with all provider channels, an emphasis on

“Buy & Bill” reimbursement complexities

Contract expertise with major PBMs (Express Scripts, OptumRx, CVS Caremark, Prime Therapeutics, Humana Pharmacy Solutions)

Spearheaded State Medicaid Pharmacy Directors strategy for CSL and Baxter, Medicaid reimbursement. Created database insights to customer PDL inclusion / business strategies, State Medicaid reimbursement rates/methods, prior authorization requirements (PAs), and State contacts

Successfully worked for inclusion of desmopressin acetate and A1PI therapies on PDL for NY State Medicaid, AmeriChoice/United Healthcare, and Florida State Medicaid formularies

Developed and administered Patient Assistance Program (PAP)/Reimbursement Hot-line

Started and managed Reimbursement HUB at CSL Behring PROFESSIONAL BACKGROUND

Market Access Manager – Northeast January 2022 – January 2023 HeartFlow, Inc. Mountain View, CA

Payer account responsibility for Cigna, Point32Health, Excellus, Fidelis Care, BCBS RI, BCBS MA, CDPHP, Horizon BCBS, UPMC Health Plan, Highmark, IBX, Capital Blue, Medicare MAC’s – NGS, Palmetto, Novitas, Maryland – All Payer Model, Optima Health/Sentara. Medicaid FFS/MCO as needed.

Engage with all levels within payer system to achieve clinical policy coverage for FFRct (Fraction Flow Reserve Computed Tomography). Achieve prior authorization removal, rate setting per category 3 CPT codes.

Work with internal HeartFlow stakeholders (Sales, Marketing, Medical Affairs, Finance) to align proper payer messaging and reimbursement pull-through activities with all providers. Head of Market Access and Reimbursement July 2020 – December 2021 Nobelpharma America, LLC. Bethesda, MD

Responsible for all Market Access and Reimbursement activities within the US for our Pharmacy therapeutic awaiting FDA approval.

Completed Market Access/Reimbursement due diligence related to Orphan Drug pre-licensure approval

Developed value messaging proposition for therapeutic candidate

SWOT analysis completed based on price sensitivity and potential payer obstacles

Payer research with respect to coverage and pharmacy tier ongoing (CVS Health – Aetna, United Health, Cigna, Humana, UPMC, Optima Health, IBX, Capital Blue of PA, Geisinger Health Plan)

Medicare MAC, State Medicaid FFS and MCO reimbursement landscape completed

Application responsibility for CMS level II HCPCS Code upon FDA approval

Proficient in PBM and Payer contracting models, including Value-Based contracting

Responsible for cultivating relationships with patient foundation (TS Alliance)

Working with internal Medical Affairs staff to develop clinical value dossier for payers and AMCP

Responsible for reimbursement HUB, Patient Assistance Program, Rx-Savings Program

Developed initial list and meetings with Specialty Pharmacy partnership opportunities Regional Account Manager – Market Access and Reimbursement November 2017 – December 2019 Osiris Therapeutics, Inc., Columbia, MD

East Territory responsibility for approx. 30mm covered lives

Obtaining Medical Policy coverage for all advanced wound care therapies

Provide reimbursement in-services with accounts to ensure proper billing, coding, reimbursement

Work with all regional payers within territory

Provide pull-through activities with sales force

Work with providers on all claim appeals and provide guidance on proper paper and electronic claims submission Director, Reimbursement April 2015 – October 2017

Cambrooke Therapeutics, Inc., Ayer, MA

Responsible for all reimbursement strategy for US & Canadian markets

Obtaining coverage for all US distributed medical foods and formulas through public and private payors

Work directly with PBM’s to contract for formulary tier status within US

Manage internal reimbursement HUB process as it relates to Prior Authorizations and patient communication

Work with provincial Ministries of Health in Canada to obtain formulary status

Lead reimbursement initiatives with all internal/external customers

Obtain coverage for all therapies with state WIC and Medicaid Programs Director, Health Policy and Reimbursement

American Society of Clinical Oncology (ASCO) - VA December 2014 – March 2015 Director of Health Policy and Reimbursement within ASCO's North America operations

Direct evaluation and impact analysis of statutory, regulatory, and other public policy initiatives affecting oncology reimbursement and practice

Develop strategic relationships and networking with policymakers, professional organizations, and other stakeholders affecting clinical practice and reimbursement policy for oncology

Direct preparation of formal comments, position papers, and other content communicating ASCO positions and priorities relating to oncology practice and reimbursement in a timely manner

Direct support for Clinical Practice Committee

Independent Consultant within Biopharmaceutical and Biotech Industry October 2010 - October 2014

Market Access and Reimbursement Consulting projects

Client List: Vertex Pharma, Celegene, NHF Chapters, IDF Chapters Associate Director, Health Care Economics June 2006 – October 2010 Baxter Health Care Corporation (BioSciences Division) Deerfield, IL Associate Director within Biosciences Division for Mid-West and East Coast area, 18 State Medicaid agencies, all Medicare Part B/DMERC carriers within region, and private payors (UnitedHealthcare, Cigna, BC/BS – affiliates, First Health, Coventry, Geisinger Health, Aetna – specialty, WellPoint, Ohio Mutual.

Ensured all BioScience therapies received adequate reimbursement and favorable payor policy guidelines.

Responsible for field coordination and assistance with both Hospital and Hemophilia sales representatives within territory. Reimbursement/Payor presentation responsibility for key Hospital, Specialty Pharmacy Provider (SPP), and Hemophilia Treatment Center (HTC) accounts.

Training responsibility for all new hires for both Hospital and Hemophilia business units.

Patient advocacy coordination within Hemophilia community and Baxter's business goals.

Key note speaker for all patient educational programs within region (over 20 programs per year).

Health Economics Liaison between Marketing/Sales/National Accounts/Medical Affairs departments CSL Behring, King of Prussia, PA January 2001 – May 2006 Manager, Reimbursement

Managed CSL's reimbursement department for all US based products. Developed and managed reimbursement answerline, patient assistance program, departmental presentations, reimbursement materials for internal / external use, CSL's reimbursement resource center for website, company newsletter (Reimbursement Alert), and all pertinent standard operating procedures (SOPs) for department.

Obtained higher reimbursement outcome for all intravenous immune globulin (IVIG) therapies under Medicare in CY2000 and 2001 through CMS contacts by demonstrating reimbursement policy and having discontinued products deleted from calculation. Successfully worked to differentiate antihemophilic FIX, purified, human products from antihemophilic FIX, complex, human products with all Medicare Part B carriers resulting in higher reimbursement for HCPCS Code J 7193 (antihemophilic factor IX, purified, human, per IU).

Demonstrated ability to self initiate projects and strategies geared towards positive reimbursement outcomes for all CSL therapies, as well as garnering consumer group’s allegiance to ZLB Behring's reimbursement department for expertise and accomplishments.

Developed close relationships with CSL customers, patients, and consumer groups. Coordinated reimbursement workshops for all HTCs within Region 1 and 2 for 3 consecutive years. Requested to present at Hemophilia Alliance meetings throughout the country for the past four (4) years. Collaborated with all National Hemophilia Foundation

(NHF), immune deficiency foundation (IDF), and guillain barre foundation syndrome (GBSF) associations/foundations to present at local and national meetings on healthcare policy and insurance issues. CSL Behring King of Prussia, PA

Reimbursement Analyst January 1998 - January 2001

Lead reimbursement specialist for all CSL Behring therapies, internal / external reimbursement communications within company. Managed department’s reimbursement answerline, newsletter formation and dissemination, and website content. Coordinated with internal and external Sales & Marketing teams as it relates to provider and consumer group presentations

Exponentially developed departments’ outreach to all Hemophilia Treatment Centers’ (HTCs), Home healthcare companies (HHC), and consumer groups as leader in the reimbursement and healthcare policy field.

Attained CSL Behring's Business Excellence Award in CY2000.

Recognized with Impact Award in December 2001, for exceptional contribution to the North America Sales. CSL Behring King of Prussia, PA

Customer Account Representative May 1996 – January 1998 Telesales responsibilities for IVIG and Albumin therapies. Developed quarterly, monthly, and year-end sales promotions to all Centeon wholesalers and distributors. Customer account representative responsible for entire North East sales region. Handled all customer ordering, price negotiations, and field representative coordination with accounts.

Initiated incremental sales of IVIG and Albumin to all Wholesale and Distributor Classes of Trade. Responsible for key hemophilia accounts (i.e., NY Blood Consortium)

Developed increased knowledge of plasma industry and therapies manufactured to treat bleeding disorder and immune compromised patient populations.

Presented with special recognition Award within Customer Support Department – 1998 EDUCATION BACKGROUND

B.A., Business Management Graduated June 1993

Temple University – Fox School of Business, Philadelphia, PA

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