Expertise

Brian Abraham

Senior Director,​ Market Access & Patient Services

Expertise:

Digital Medicine, Revenue Management

Brian Abraham, Director of Revenue Management Solutions at EVERSANA™ helps medical technology and biopharma companies develop and execute strategies around coding, coverage, and payment for innovative medical technology products. He has 20 years of experience in various therapeutic areas inside companies such as MedImmune (now part of AstraZeneca), IBA Molecular, and Nuo Therapeutics, as well consulting to them. Brian has built reimbursement strategies and teams from early stage through commercialization and worked closely with the Centers for Medicare and Medicaid Services (CMS) on technical and policy issues, including during his time at the Medical Imaging Technology Alliance (MITA). Throughout his career, he has successfully built strategies and teams for market access and reimbursement. Brian earned a bachelor’s degree in Government from the College of William & Mary and a master’s degree in Public Administration from the George Washington University.

Articles by Brian Abraham

TOP NEWS: CMS Proposes Repeal on Medicare Coverage of Innovative Technologies Initiative

In a reversal of its upcoming policy to cover breakthrough designated medical devices, the Centers for Medicare and Medicaid Services (CMS) on Monday issued a proposed rule that would completely repeal the Medicare Coverage of Innovative Technologies (MCIT) initiative, and it would not go into effect in December of this year. Their reasoning is as […]

American Medical Association Discusses New CPT Codes to Identify Digital Health Services

In our last update, we discussed the proposed rule that the Centers for Medicare and Medicaid Services (CMS) issued regarding the addition of certain Current Procedural Terminology (CPT®) codes to identify remote therapeutic monitoring (RTM) in parallel to the existing remote physiological monitoring (RPM) codes and their expected payment rates. Now we’re looking at what […]

CMS Releases Remote Therapeutic Monitoring Codes for 2022

The Centers for Medicare and Medicaid Services (CMS) released the proposed Medicare physician fee schedule regulation for 2022, which includes an analysis and payment calculations for the new Remote Therapeutic Monitoring (RTM) CPT codes issued by the American Medical Association (AMA) late last year. As announced in earlier this year, these codes may enable indirect […]

News Alert: MCIT Program Delayed Until December

The Centers for Medicare and Medicaid Services (CMS) again delayed implementation of the Medicare Coverage of Innovative Technology (MCIT) program, now until December 15, 2021. The program, as described in the current and preceding rules, will provide automatic Medicare coverage for four years to medical devices designated as breakthrough and authorized for marketing by the […]

News Alert: MCIT Implementation Delayed

On Friday, March 12, the Centers for Medicare and Medicaid Services (CMS) issued an Interim Final Rule with Comment (IFC) delaying the effective date of the Medicare Coverage of Innovative Technologies (MCIT) initiative from March 15 to May 15, 2021. In postponing the implementation date, CMS cited the President’s Executive Order of January 20, 2021, […]

Webinar: Drug Pricing and Reporting Regulatory Updates Part 1

Pharmaceutical companies in the U.S. are navigating President Biden’s new administration and legislative changes that are affecting pricing and regulatory actions.   One of these changes includes the regulatory freeze ordered for actions made in the final two months of the Trump administration, which has paused Medicare Part B and Medicare Part D legislation as well.  In part one of our drug pricing and reporting […]

Reimbursement May Be on the Way for Remote Therapeutic Monitoring

The American Medical Association (AMA) manages the procedure code set that physicians and other healthcare professionals use to identify the services for which they bill. These codes are commonly known as the CPT® code set, which stands for Current Procedural Terminology, and are the standard billing lexicon for medical services. Currently, four CPT codes identify […]

Drug Pricing And Drug Price Reporting Regulatory Update

As the new president and Congress begin their terms, EVERSANA would like to provide an update on recent legislative and regulatory actions that affect drug pricing and price reporting. The Centers for Medicare and Medicaid Services (CMS) issued this interim final rule on November 20, 2020 (85 Fed Reg 76180-76259), requiring a revised calculation of […]

CMS Adopts Automatic Medicare Coverage of Breakthrough Devices

The Centers for Medicare and Medicaid Services (CMS) on January 12 finalized its proposal of Medicare Coverage of Innovative Technology (MCIT), an additional pathway of coverage for breakthrough-designated medical devices, providing timelines and clarifying definitions of eligible items. CMS initially proposed this rule on August 31, 2020, and EVERSANA’s initial analysis is provided here. The […]

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