Dr. Bien-Willner is the Medical Director of the MolDX program at Palmetto GBA, a Medicare Administrative Contractor (MAC). MolDX seeks to understand the molecular testing landscape to implement payer controls, coverage, and to set policy for affiliated MACs, which currently cover 28 states. He is a leader in the Precision Medicine space and practices as a Board-certified Anatomic Pathologist and Molecular Genetic Pathologist. Throughout his career, he has been active in research, development, and advancement of molecular diagnostic services, specifically next generation sequencing. Read his full bio.
Interview with Gabriel Bien-Willner, Medical Director, Palmetto GBA
Q: What does your role entail as the director of the MolDX program at Palmetto GBA?
A: The job directing MolDX is multifaceted; first and foremost the MolDX program is responsible for assessing molecular diagnostic tests on the market and makes coverage and pricing determinations for such tests and technology. This is usually done through local coverage determination policies or technical assessments. This involves direct interactions with the providers performing these services and subject matter experts (SMEs) who help provide feedback and insight to utility of these tests. Secondly, we must communicate these findings with the provider community to make sure they understand the policies and how to comply with them to reduce provider burden and lower improper payments from CMS. I am also used as a SME by different branches of the government regarding molecular diagnostics.
Q: What implications the recent coverage decisions may have for the future CMS decision seekers?
A: I am not sure I understand this question- which coverage decisions, local vs. national? Who are the “decision seekers”? Providers?
Q: What challenges oncologists face in the genomic era and how molecular pathologists could help?
A: As cancer care adopts precision medicine and clinicians employ more and more sophisticated genomic tests, they will become more and more dependent on SMEs to explain the results within a clinical context. Molecular Pathologists can help by becoming more conversant on the clinical use and utility of these tests, the associated pharmacology, and of course the underlying genetic principles and how they can be used to guide the oncologists’ hands.
Q: What advice can you give hospitals and health networks that are planning to implement precision medicine programs that will successfully use genetic testing and gene sequencing in support of clinical care?
A: Having run precision medicine programs outside my role at Palmetto GBA I may be able to provide some helpful suggestions. First, ensure there is administrative support for such a project and that funds are available to enact it. Implementing such a program is not as simple as sending tests out; it requires significant education and expertise to ensure staff adapt to changing processes, technology, and science. Secondly, there have to be leadership in the staff that support the initiative and recruit or have access to molecular pathologists who have expertise in molecular genomics and their clinical applications. These individuals must be able to educate staff about molecular pathways and genetic principles in Molecular Tumor Boards and other educational sessions; they should feel comfortable being part of the treatment decision process. Third, IT infrastructure may become a significant hurdle and it is important to have IT support for this process as data do not often travel freely from clinician workflows to vendor laboratories.
The Precision Medicine World Conference (PMWC), in its 17th installment, will take place in the Santa Clara Convention Center (Silicon Valley) on January 21-24, 2020. The program will traverse innovative technologies, thriving initiatives, and clinical case studies that enable the translation of precision medicine into direct improvements in health care. Conference attendees will have an opportunity to learn first-hand about the latest developments and advancements in precision medicine and cutting-edge new strategies and solutions that are changing how patients are treated.
See 2019 Agenda highlights:
- Five tracks will showcase sessions on the latest advancements in precision medicine which include, but are not limited to:
- AI & Data Science Showcase
- Clinical & Research Tools Showcase
- Clinical Dx Showcase
- Creating Clinical Value with Liquid Biopsy ctDNA, etc.
- Digital Health/Health and Wellness
- Digital Phenotyping
- Diversity in Precision Medicine
- Drug Development (PPPs)
- Early Days of Life Sequencing
- Emerging Technologies in PM
- Emerging Therapeutic Showcase
- FDA Efforts to Accelerate PM
- Gene Editing
- Genomic Profiling Showcase
- Immunotherapy Sessions & Showcase
- Implementation into Health Care Delivery
- Large Scale Bio-data Resources to Support Drug Development (PPPs)
- Microbial Profiling Showcase
- Microbiome
- Neoantigens
- Next-Gen. Workforce of PM
- Non-Clinical Services Showcase
- Pharmacogenomics
- Point-of Care Dx Platform
- Precision Public Health
- Rare Disease Diagnosis
- Resilience
- Robust Clinical Decision Support Tools
- Wellness and Aging Showcase
See 2019 Agenda highlights:
- Five tracks will showcase sessions on the latest advancements in precision medicine which include, but are not limited to:
- AI & Data Science Showcase
- Clinical & Research Tools Showcase
- Clinical Dx Showcase
- Creating Clinical Value with Liquid Biopsy ctDNA, etc.
- Digital Health/Health and Wellness
- Digital Phenotyping
- Diversity in Precision Medicine
- Drug Development (PPPs)
- Early Days of Life Sequencing
- Emerging Technologies in PM
- Emerging Therapeutic Showcase
- FDA Efforts to Accelerate PM
- Gene Editing / CRISPR
- Genomic Profiling Showcase
- Immunotherapy Sessions & Showcase
- Implementation into Health Care Delivery
- Large Scale Bio-data Resources to Support Drug Development (PPPs)
- Microbial Profiling Showcase
- Microbiome
- Neoantigens
- Next-Gen. Workforce of PM
- Non-Clinical Services Showcase
- Pharmacogenomics
- Point-of Care Dx Platform
- Precision Public Health
- Rare Disease Diagnosis
- Resilience
- Robust Clinical Decision Support Tools
- Wellness and Aging Showcase
- A lineup of 450+ highly regarded speakers featuring pioneering researchers and authorities across the healthcare and biotechnology sectors
- Luminary and Pioneer Awards, honoring individuals who contributed, and continue to contribute, to the field of Precision Medicine
- 2000+ multidisciplinary attendees, from across the entire spectrum of healthcare, representing different types of companies, technologies, and medical centers with leadership roles in precision medicine