2022 Agenda

Wednesday - February 23, 2022

1:00 PM 6:15 PM

12:00 PM 5:15 PM

11:00 AM 4:15 PM

10:00 AM 3:15 PM

Registration

2:00 PM 5:15 PM

1:00 PM 4:15 PM

12:00 PM 3:15 PM

11:00 AM 2:15 PM

Pre-Conference Workshop

A Comprehensive Analysis of Recent MSP Class Action Litigation


Moderator
Rafael Gonzalez, Esq., Partner
Cattie & Gonzalez, PLLC


Part 1: An Introduction to MSP Recovery as the MSP Enforcer

  • Identify the litigants involved in the MSP Recovery efforts
  • Assess who these litigants represent
  • Understand their objectives, including what they are claiming, the end goal they are targeting, and the information they are requesting
  • Explore where litigants are receiving their funding to cover up front costs of litigation

Jennifer Jordan,
MSP Consultant


Part 2: Early Case Law Review Leading to Current Class Action Litigation

  • Analyze early case law to identify key areas for change for MSP Recovery
  • Discuss early US District Court case law to examine what was learned
  • Explore US Courts of Appeals adaptations that Initiated private causes of action

Heather Schwartz Sanderson, Esq., President,
Sanderson Firm PLLC


Part 3: Emerging Details of Filed Qui Tam Class Action Lawsuit
A Deep Dive Into the Amended Qui Tam Complaint for Violations Under the MSP Act and State False Claims Act.

  • Assess the background information of the Qui Tam lawsuits to gain an understanding
  • Evaluate the “whistleblower” concept and how it could impact the industry
  • Explore the process and all documentation needed to submit a civil complaint under the seal of the court to ensure accuracy and compliance

Rachel LaMontagne, Partner,
Shutts & Bowen LLP

5:15 PM 6:15 PM

4:15 PM 5:15 PM

3:15 PM 4:15 PM

2:15 PM 3:15 PM

Networking Cocktail Reception

Thursday - February 24, 2022

7:30 AM 8:20 AM

6:30 AM 7:20 AM

5:30 AM 6:20 AM

4:30 AM 5:20 AM

Registration and Networking Breakfast

8:20 AM 8:30 AM

7:20 AM 7:30 AM

6:20 AM 6:30 AM

5:20 AM 5:30 AM

Welcome Remarks

Rafael Gonzalez, Esq., Partner
Cattie & Gonzalez, PLLC

8:30 AM 9:15 AM

7:30 AM 8:15 AM

6:30 AM 7:15 AM

5:30 AM 6:15 AM

A Deep Dive into the Proposed Civil Money Penalties Rules

  • Examine the proposed CMPs which were published in 2020 and discuss changes that need to be made once finalized 
  • Assess the probability that the proposed rules will be consistent with the final ruling 
  • Interpret the public comments that were made and distinguish any suspected changes based off of industry specialist comments 

9:15 AM 10:00 AM

8:15 AM 9:00 AM

7:15 AM 8:00 AM

6:15 AM 7:00 AM

Part 1: Industry Leader Discussion on the PAID Act

  • Examine the importance of the PAID Act and why the Bill was introduced initially 
  • Interpret the goal of the PAID Act and how it will improve the industry 
  • Discuss the best strategies to maximize components of the PAID Act for your advantage  

Suzanne Jordan, SCHIP Compliance Manager,
Broadspire

10:00 AM 10:15 AM

9:00 AM 9:15 AM

8:00 AM 8:15 AM

7:00 AM 7:15 AM

Networking Break

10:15 AM 11:00 AM

9:15 AM 10:00 AM

8:15 AM 9:00 AM

7:15 AM 8:00 AM

Part 2- An Assessment of the Differences of the PAID Act for Key Stakeholders

  • Assess the benefits of the PAID Act for No Fault as well as how it is administered 
  • Examine the advantages of the PAID Act for Workers Compensation 
  • Discuss the pros of the PAID Act for liability claims 
  • Gain valuable insight from payers from all three stakeholders as well as health plans on the anticipated changes related to the PAID Act 

Susan Montoya RN, Managing Director, Medicare & Debt Resolution,
Travelers

11:00 AM 11:45 AM

10:00 AM 10:45 AM

9:00 AM 9:45 AM

8:00 AM 8:45 AM

Part 3- Evaluate the Immediate and Long-Term Impacts of the PAID Act

  • Assess the processes from a payer related to the PAID Act when seeking reimbursement 
  • Explore the information that should be and should not be shared with the plaintiff counsel and why 
  • Discuss the immediate impacts the PAID Act has had on the industry, and speculate the future impacts over the next 3-5 years  

Brian Bargender, Internal Consultant
Humana

 

11:45 AM 12:30 PM

10:45 AM 11:30 AM

9:45 AM 10:30 AM

8:45 AM 9:30 AM

Understand the Traditional Medicare Set-Aside System- Allocation and Submission

  • Discuss the traditional system for allocation and submission and any recent changes that may have occurred
  • Understand which documentation needs to be sent versus not sent to Medicare for a successful claim
  • Assess best practices when dealing with Medicare to achieve desired outcomes


Nancy Harple, CMSP, MSCC, Claims Supervisor,
Chesapeake Employers’ Insurance Company

Monica Williams, RN, CCM, CRRN, LNC, MSCC, CMSP, CEO & President,
Medicare and Workers Compensation Consultants

12:30 PM 1:15 PM

11:30 AM 12:15 PM

10:30 AM 11:15 AM

9:30 AM 10:15 AM

Networking Lunch

1:15 PM 2:00 PM

12:15 PM 1:00 PM

11:15 AM 12:00 PM

10:15 AM 11:00 AM

Examine Alternative Medicare Set-Asides to Assure Medicare’s Future Interests

  • Dissect Medical Guidelines Based MSA’s to understand the process, and what documentation is necessary v’s unnecessary  
  • Analyze Legally Based MSA’s to identify legal issues, case law, and statute that are valuable to the case 
  • Realize the importance of leaving out certain documentation to improve probability of success  

Amy Bilton, JD, MSCC, CMSP-F, Shareholder,  
Nyhan Bambrick Kinzie & Lowry 

 

2:00 PM 2:45 PM

1:00 PM 1:45 PM

12:00 PM 12:45 PM

11:00 AM 11:45 AM

You Are on Your Own! Protecting Medicare’s Future Interest Without a set Structure

  • Analyze the important differences between Liability and Workers Compensation Medicare Set-Asides 
  • Assess how to prepare accurately with lack of structure, including no set process, reference manual, or guidelines 
  • Explore best practices and proven strategies to achieve success 

Rasa Fumagalli JD, MSCC, CMSP-F, Director of MSP Compliance,
Synergy Settlement Services

 

2:45 PM 2:55 PM

1:45 PM 1:55 PM

12:45 PM 12:55 PM

11:45 AM 11:55 AM

Networking Break

2:55 PM 3:40 PM

1:55 PM 2:40 PM

12:55 PM 1:40 PM

11:55 AM 12:40 PM

Explore Alternative Medicare Set- Aside Approaches

  • Understand the process of self-allocation based on individuals’ medical needs for life 
  • Prepare for pitfalls when utilizing a medical opinion related to future medical needs 
  • Capitalize on Medical Cost Projection created from advice from multiple professionals to ensure an accurate assessment 
  • Utilize traditional legally based MSA’s that are created based on medial recommendations 

John V. Cattie, Jr., Managing Attorney, 
Cattie & Gonzalez, PLLC

 

3:40 PM 4:45 PM

2:40 PM 3:45 PM

1:40 PM 2:45 PM

12:40 PM 1:45 PM

Industry Wrap Up: Panel Discussion Review of Medicare Secondary Payer

  • Hear from industry leaders on expectations, potential impact, and future changes related to the CMPs Proposed Rule and the PAID Act 
  • Delve into MSP Recovery Lawsuits filed across the country to identify similarities and changes to the industry 
  • Dissect Medicare Set-Aside issues related to both Workers Compensation and Liability 

Moderator
Rafael Gonzalez, Esq., Partner
Cattie & Gonzalez, PLLC

Panelists
Heather Schwartz Sanderson, Esq., President,
Sanderson Firm PLLC

John V. Cattie, Jr., Managing Attorney,
Cattie & Gonzalez, PLLC

Amy Bilton, JD, MSCC, CMSP-F, Shareholder
Nyhan Bambrick Kinzie & Lowry

Brian Bargender, Internal Consultant
Humana

4:45 PM 5:00 PM

3:45 PM 4:00 PM

2:45 PM 3:00 PM

1:45 PM 2:00 PM

Chairperson Closing Remarks


Rafael Gonzalez, Esq., Partner
Cattie & Gonzalez, PLLC

5:00 PM 6:00 PM

4:00 PM 5:00 PM

3:00 PM 4:00 PM

2:00 PM 3:00 PM

Networking Cocktail Reception

Friday - February 25, 2022

8:00 AM 8:50 AM

7:00 AM 7:50 AM

6:00 AM 6:50 AM

5:00 AM 5:50 AM

Networking Breakfast

8:50 AM 9:00 AM

7:50 AM 8:00 AM

6:50 AM 7:00 AM

5:50 AM 6:00 AM

Opening Remarks & Review of Day 1

Rafael Gonzalez, Esq., Partner
Cattie & Gonzalez, PLLC

9:00 AM 9:45 AM

8:00 AM 8:45 AM

7:00 AM 7:45 AM

6:00 AM 6:45 AM

Understand the Obligations of Plaintiff/Lawyer Related to No-Fault Conditional Payments

  • Examine the plaintiff’s responsibility related to liens in No-Fault cases 
  • Understand the process, and the information that needs to be provided to Medicare 
  • Analyze the process and documentation needed for the Commercial Repayment Center 

Steven Shaw, Attorney & Certified Medicare Secondary Payer Professional,
Shaw Legal Solutions

Ryan Weiner, Chief Operating Officer,
MASSIVE: Medical and Subrogation Specialists 

9:45 AM 10:30 AM

8:45 AM 9:30 AM

7:45 AM 8:30 AM

6:45 AM 7:30 AM

Analyze the Responsibilities of Plaintiff/Lawyer in Workers Compensation Claims

  • Discuss processes if employer accepts responsibility for medical, and the expectations of Medicare 
  • Understand the plaintiff’s role post settlement, including timelines and documentation 
  • Explore the processes of working with both the Commercial Repayment Center and the Benefits Coordination & Recovery Center to assure compliant processes and timelines 

Charles R. Medlin, COO & Founder,
LitPRO

 

10:30 AM 10:45 AM

9:30 AM 9:45 AM

8:30 AM 8:45 AM

7:30 AM 7:45 AM

Networking Break

10:45 AM 11:30 AM

9:45 AM 10:30 AM

8:45 AM 9:30 AM

7:45 AM 8:30 AM

Evaluate the Obligation for Plaintiff/Lawyer with Liability Conditional Payment Cases

  • Calculate the documentation needed to notify Medicare of the claim 
  • Prepare for conditional payment letters and final demand from the BCRC 
  • Analyze the requirements necessary to appeal BCRC, Qualified Independent Contractor, and US Treasury decisions

Jason Lazarus, J.D., LL.M., MSCC, CSSC, Founder, Chief Executive Officer,
Synergy Settlements

11:30 AM 12:15 PM

10:30 AM 11:15 AM

9:30 AM 10:15 AM

8:30 AM 9:15 AM

Grasp the Obligation of the Defendant Related to No-Fault Conditional Payment

  • Analyze the process to identify the total financial exposure in the policy related to the claim 
  • Assess the breakdown of payments related to loss of wages, medical care, and reimbursement to Medicare, including documentation and providing proof of expenses 
  • Explore the timing involved in the claim that potentially can create a responsibility to reimburse Medicare  

John V. Cattie, Jr., Managing Attorney,
Cattie & Gonzalez, PLLC

12:15 PM 1:10 PM

11:15 AM 12:10 PM

10:15 AM 11:10 AM

9:15 AM 10:10 AM

Networking Lunch

1:10 PM 1:55 PM

12:10 PM 12:55 PM

11:10 AM 11:55 AM

10:10 AM 10:55 AM

Evaluate the Responsibility of the Defendant for Conditional Payments Related to Workers Compensation

  • Explore strategies to calculate anticipated payments to Medicare to avoid costly miscalculations 
  • Prepare to manage critical information sharing between the injured party and Medicare related to the claim 
  • Identify payments not related to the claim that should be disputed, and prepare for the process including dispute, redetermination, and reconsideration 

Michelle A. Allan, Esquire, Principal,
Allan Koba Compliance Solutions

1:55 PM 2:40 PM

12:55 PM 1:40 PM

11:55 AM 12:40 PM

10:55 AM 11:40 AM

Discover the Obligation of Defendant for Conditional Payment Related to Liability Claims

  • Ensure specific party reimburse Medicare to avoid costly long-term complications 
  • Analyze documentation, including proof of reimbursement to ensure compliance if claimant is represented 
  • Create and implement best practices to ensure that all settled cases are correctly maintained to evade future problems if claimant is unrepresented 

Catherine E. Goldhaber, Partner in Charge,
Hawkins Parnell

2:40 PM 2:50 PM

1:40 PM 1:50 PM

12:40 PM 12:50 PM

11:40 AM 11:50 AM

Networking Break

2:50 PM 3:55 PM

1:50 PM 2:55 PM

12:50 PM 1:55 PM

11:50 AM 12:55 PM

Overall Review of Conditional Payments, CRC and BCRC, and Case Law

  • Analyze strategies for success when working with the CRC and BCRC and potential changes on the horizon 
  • Assess cases that have been sent to the Department of Treasury, and anticipate if we will see an increase or decrease in cases in the future 
  • Explore different mechanisms utilized by Medicare to claim reimbursement 

Moderator
Rafael Gonzalez, Esq., Partner
Cattie & Gonzalez, PLLC

Panelists
Steven Shaw, Attorney & Certified Medicare Secondary Payer Professional,
Shaw Legal Solutions

Michelle A. Allan, Esquire, Principal,
Allan Koba Compliance Solutions

John V. Cattie, Jr., Managing Attorney,
Cattie & Gonzalez, PLLC

Catherine E. Goldhaber, Partner in Charge,
Hawkins Parnell

 

3:55 PM 4:00 PM

2:55 PM 3:00 PM

1:55 PM 2:00 PM

12:55 PM 1:00 PM

Closing Remarks

Rafael Gonzalez, Esq., Partner
Cattie & Gonzalez, PLLC