View the Agenda | MSP World | A RISE Health Conference

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MSP World
March 29-30, 2024
A Virtual Event

Agenda

Wednesday - May 29, 2024

11:00 AM 11:10 AM

10:00 AM 10:10 AM

9:00 AM 9:10 AM

8:00 AM 8:10 AM

Chairperson’s Opening Remarks

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

11:10 AM 11:55 AM

10:10 AM 10:55 AM

9:10 AM 9:55 AM

8:10 AM 8:55 AM

Defining Untimely Reporting Under the Final Rule Issued by CMS

  • Understand the reporting time frames to avoid costly mistakes 
  • Assess the financial penalty for reporting outside of the required time frames 
  • Best practices and timelines to ensure timely and compliant reporting 

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

Panelists
Susan Lin, Assistant Vice President,
Travelers

Suzanne Jordan, SCHIP Compliance Manager,
Broadspire

Paul McLaughlin, President,
APP Technologies

Shelley Wisniewski, Medicare Lead Consultant,
Allstate

11:55 AM 12:05 PM

10:55 AM 11:05 AM

9:55 AM 10:05 AM

8:55 AM 9:05 AM

Break

12:05 PM 12:50 PM

11:05 AM 11:50 AM

10:05 AM 10:50 AM

9:05 AM 9:50 AM

Preparation and Best Practice Techniques for Random Sample Audit

  • Understand the process of CMS randomly selecting 1,000 cases per year to audit 
  • Prepare your team for quarterly audits of 250 files to ensure compliance and successful timely reporting 
  • Identify strategies to confirm that all cases meet the new CMS regulations to avoid hefty penalties 

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

Panelists
Susan Lin, Assistant Vice President,
Travelers

Suzanne Jordan, SCHIP Compliance Manager,
Broadspire

Paul McLaughlin, President,
APP Technologies

Shelley Wisniewski, Medicare Lead Consultant,
Allstate

 

12:50 PM 1:00 PM

11:50 AM 12:00 PM

10:50 AM 11:00 AM

9:50 AM 10:00 AM

Break

1:00 PM 1:45 PM

12:00 PM 12:45 PM

11:00 AM 11:45 AM

10:00 AM 10:45 AM

Assess CMS New Tiered Approach to Civil Monetary Penalties

  • Understand the new penalties based on tardiness of submission 
  • Evaluate the potential penalties in your case load resulting from late reporting 
  • Best practices to manage your cases to ensure timely submission and avoid crippling penalties 

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

Panelists
Susan Lin, Assistant Vice President,
Travelers

Suzanne Jordan, SCHIP Compliance Manager,
Broadspire

Paul McLaughlin, President,
APP Technologies

Shelley Wisniewski, Medicare Lead Consultant,
Allstate

1:45 PM 1:55 PM

12:45 PM 12:55 PM

11:45 AM 11:55 AM

10:45 AM 10:55 AM

Break

1:55 PM 2:55 PM

12:55 PM 1:55 PM

11:55 AM 12:55 PM

10:55 AM 11:55 AM

Understand the CMP Informal Dispute Process for a Successful Challenge & Evaluate the CMP Formal Dispute Process to Win Your Appeal

Part 1
Understand the CMP Informal Dispute Process for a Successful Challenge

  • Analyze the informal dispute process and timeline to better for your dispute
  • Gather pertinent information that supports, strengthens and validates your dispute
  • Identify valid reasons that explain, mitigate, or excuse late submission 

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

Panelists
Susan Lin, Assistant Vice President,
Travelers

Suzanne Jordan, SCHIP Compliance Manager,
Broadspire

Paul McLaughlin, President,
APP Technologies

Shelley Wisniewski, Medicare Lead Consultant,
Allstate

 

Part 2
Evaluate the CMP Formal Dispute Process to Win Your Appeal

  • Engage in a deep dive of the event(s) that triggered the imposition of CMP
  • Analyze the CMP amount proposed to better understand the reasoning for the potential penalty
  • Assess the value, costs, and reasoning for of requesting a hearing before an administrative law judge

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

Panelists
Susan Lin, Assistant Vice President,
Travelers

Suzanne Jordan, SCHIP Compliance Manager,
Broadspire

Paul McLaughlin, President,
APP Technologies

Shelley Wisniewski, Medicare Lead Consultant,
Allstate

2:55 PM 3:05 PM

1:55 PM 2:05 PM

12:55 PM 1:05 PM

11:55 AM 12:05 PM

Break

3:05 PM 3:50 PM

2:05 PM 2:50 PM

1:05 PM 1:50 PM

12:05 PM 12:50 PM

Understand the Regulation’s Five-Year Statute of Limitations

  • Examine the case timeline to confirm or disprove the date and event of any alleged violation 
  • Identify with specificity when and why your responsibility to report begins and ends 
  • Confirm when the government’s five-year SOL period ends and can no longer request CMP 

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

Panelists
Susan Lin, Assistant Vice President,
Travelers

Suzanne Jordan, SCHIP Compliance Manager,
Broadspire

Paul McLaughlin, President,
APP Technologies

Shelley Wisniewski, Medicare Lead Consultant,
Allstate

 

3:50 PM 4:00 PM

2:50 PM 3:00 PM

1:50 PM 2:00 PM

12:50 PM 1:00 PM

Break

4:00 PM 4:45 PM

3:00 PM 3:45 PM

2:00 PM 2:45 PM

1:00 PM 1:45 PM

Identity “Safe Harbor” Components Which May Do Away with CMPs

  • Explore which technical or system issues exist that could potentially forgive CMPs
  • Discuss possible CMS or contractor errors which could result in an exemption of CMPs
  • Examine facts regarding lack of cooperation by the beneficiary which may have hindered timely submission which could excuse CMPs

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

Panelists
Susan Lin, Assistant Vice President,
Travelers

Suzanne Jordan, SCHIP Compliance Manager,
Broadspire

Paul McLaughlin, President,
APP Technologies

Shelley Wisniewski, Medicare Lead Consultant,
Allstate

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

 

Thursday - May 30, 2024

11:00 AM 11:10 AM

10:00 AM 10:10 AM

9:00 AM 9:10 AM

8:00 AM 8:10 AM

Chairperson’s Opening Remarks

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

11:10 AM 11:55 AM

10:10 AM 10:55 AM

9:10 AM 9:55 AM

8:10 AM 8:55 AM

Plaintiff and Defendant Perspective on Resolving Conditional Payments with CMS

  • Understand the specific Benefits Coordination Recovery Center (BCRC) process for plaintiffs to ensure resolution of conditional payments  
  • Assess the Commercial Repayment Center (CRC) procedures for defendants to reimburse Medicare the appropriate amount 
  • Evaluate the differences between the liability, no-fault, and workers compensation conditional payment resolution process at the BCRC and CRC 

Shawn Deane, Esq., General Counsel & Vice President Claims Solutions,
J29 Inc.

Shannon P. Metcalf, Esq., Partner,
Hedrick Gardner Kinchelow & Garofalo, LLP

 

11:55 AM 12:05 PM

10:55 AM 11:05 AM

9:55 AM 10:05 AM

8:55 AM 9:05 AM

Break

12:05 PM 12:50 PM

11:05 AM 11:50 AM

10:05 AM 10:50 AM

9:05 AM 9:50 AM

Litigants Perspectives on Resolving Conditional Payments with Private Plans

  • Dissect the Medicare Advantage Plan process for plaintiffs and defendants to resolve outstanding conditional payments  
  • Delve into the Prescription Drug Plans methodology for plaintiffs and defendants to resolve conditional payments  
  • Compare and contrast the differences between liability, no-fault, and workers compensation private plans’ conditional payment resolution process  

 

Barrye Panepinto Miyagi, Esq., Partner,
Taylor Porter

Robert Finley, Esq., Partner,
Hinshaw & Culbertson LLP

12:50 PM 1:00 PM

11:50 AM 12:00 PM

10:50 AM 11:00 AM

9:50 AM 10:00 AM

Break

1:00 PM 1:45 PM

12:00 PM 12:45 PM

11:00 AM 11:45 AM

10:00 AM 10:45 AM

An Overview on Resolution of Medicaid/VA/Tricare/ACA Liens

  • Identify if Medicaid is the payer, assess the amount paid, and confirm its relation to the claim
  • Explore if VA or Tricare made initial payment, assess the amount paid, and verify if the payment is related to the claim
  • Distinguish if ACA Marketplace is the payer, identify the plan and the amount paid, to determine appropriate reimbursement

Meghan Tiernan, Director of Lien Resolution,
Cattie & Gonzalez, PLLC

Speaker to be anounced

1:45 PM 1:55 PM

12:45 PM 12:55 PM

11:45 AM 11:55 AM

10:45 AM 10:55 AM

Break

1:55 PM 2:40 PM

12:55 PM 1:40 PM

11:55 AM 12:40 PM

10:55 AM 11:40 AM

An Analysis of Workers Compensation and Liability Legally Based MSA Allocations

  • Explore differences between medically based and legally based MSA allocations
  • Discuss the various components of a legally based MSA allocation
  • Analyze how MSA legal opinions protect Medicare and litigants, without CMS approval

John Cattie, Esq., Managing Partner,
Cattie & Gonzalez, PLLC

Speaker to be announced

2:40 PM 2:50 PM

1:40 PM 1:50 PM

12:40 PM 12:50 PM

11:40 AM 11:50 AM

Break

2:50 PM 3:35 PM

1:50 PM 2:35 PM

12:50 PM 1:35 PM

11:50 AM 12:35 PM

Deep Dive Into Workers Compensation and Liability Medically Based MSA Allocations

  • Explore trends and patterns in $0 submitted Workers Compensation MSA allocations
  • Examine issues and concerns with non-submitted WC MSA allocations
  • Discuss reporting details of WC MSA to CMS via Mandatory Insurer Reporting Total Payment Obligation to Claimant process commencing Q1 2025
  • Understand plaintiff v. defense mindset differences on need for creation of Liability MSA allocations
  • Assess post settlement issues to determine whether given the liability MSA, Medicare will pay/deny future injury related bills
  • Discuss post settlement benefit and recovery process when Medicare Advantage Plans and Prescription Drug Plans intersect with Liability MSAs

Vanessa De Rosa Lipsky, Esq., Partner,
Eraclides Gelman

Steven Shaw, Esq., Principal,
Shaw Legal Solutions

3:35 PM 3:45 PM

2:35 PM 2:45 PM

1:35 PM 1:45 PM

12:35 PM 12:45 PM

Break

3:45 PM 4:30 PM

2:45 PM 3:30 PM

1:45 PM 2:30 PM

12:45 PM 1:30 PM

A Panel Conversation with Industry Leaders on MSP Issues and Concerns

  • In-depth discussion of the latest issues and concerns on all aspects of mandatory insurer reporting
  • A comprehensive conversation about the procedural and substantive challenges of reimbursement and recovery of conditional payments
  • Compare and contrast plaintiff/defense, medical/legal, workers compensation/liability set aside allocation differences, mindsets, methodologies, complications, and responsibilities

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

Panelists
Barrye Panepinto Miyagi, Esq., Partner,
Taylor Porter

John Cattie, Esq., Managing Partner,
Cattie & Gonzalez, PLLC

Shannon P. Metcalf, Esq., Partner,
Hedrick Gardner Kinchelow & Garofalo, LLP

Steven Shaw, Esq., Principal,
Shaw Legal Solutions

4:30 PM 4:40 PM

3:30 PM 3:40 PM

2:30 PM 2:40 PM

1:30 PM 1:40 PM

Chairperson Closing Remarks

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

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