Don’t miss your chance to get the latest developments in mandatory insurer reporting, conditional payments, Medicare set-asides, and Medicare Secondary Payer at the 7th Annual Medicare Secondary Payer Master Class, February 23-25, at the Kimpton Hotel Monaco in Washington, D.C.
The in-person, live event, designed for mid- to senior-level management professionals responsible for all aspects of Medicare secondary payer compliance, will feature a three-part preconference workshop, more than 25 expert speakers, and 20 sessions. The popular conference requires proof of COVID-19 vaccination to attend.
Take a look at a few of the topics we’ll cover:
Recent MSP class action litigation
We’ll provide a comprehensive analysis on recent MSP class action litigation during a half-day, three-part preconference workshop, moderated by conference chair and MSP expert Rafael Gonzalez, Esq., partner, Cattie & Gonzalez, PLLC, will take place in the afternoon of Wednesday, Feb. 23.
- Jennifer Jordan, an MSP consultant, will provide an introduction to MSP recovery as the MSP enforcer during the first part of the workshop. Attendees will identify the litigants involved in MSP recovery efforts, assess who these litigants represent, understand their objectives, and explore where they are receiving their funding.
- The second part will focus on early case law review leading to current class action litigation. Heather Schwartz Sanderson, Esq., president, Sanderson Firm PLLC, will discuss what was learned from early U.S. District Court case law, and will explore U.S. Courts of Appeals adaptations that initiated private causes of action.
- The third section will provide an in-depth look at amended Qui Tam complaint for violations under the MSP Act and state False Claims Act. Rachel LaMontagne, partner, Shutts & Bowen LLP, will assess the background information of the Qui Tam lawsuits, evaluate the “whistleblower” concept and how it could impact the industry, and explore all the documentation needed to submit a civil complaint under the seal of the court to ensure accuracy and compliance.
Learn everything you need to know about the new Provide Accurate Information Directly (PAID) Act on Thursday, Feb. 24, the first day of the main conference. Well explore the law in three parts:
- First, Suzanne Jordan, compliance manager, Broadspire, will lead a discussion on the PAID Act, including its importance, why it was initially introduced, how it will improve the industry, and strategies to maximize components of the law.
- The second part will assess the differences of the PAID Act for key stakeholders. Susan Montoya, R.N., managing director, Medicare & debt resolution,
Travelers, will assess the benefits of the PAID Act for No fault and how it is administered, the advantages of the law for workers compensation, and the benefits of the law for liability claim.
- Finally we'’ll evaluate the immediate and long-term impacts of the law. Brian Bargender, internal consultant, Humana, and Heather Schwartz Sanderson, Sanderson Firm PLLC, will assess the processes from a payer related to the PAID Act when seeking reimbursement, discuss the information that should be and should not be shared with the plaintiff counsel and why; and will review the immediate impacts the PAID Act has had on the industry, and speculate the future impacts over the next three to five years.
The afternoon of the first day of the main conference will explore best practices for Medicare Set-Asides.
- Nancy Harple, claims supervisor, Chesapeake Employers’ Insurance Company, and Monica Williams, RN, CEO and president, Medicare and Workers Compensation Consultants, will explore the traditional Medicare Set-Aside System. They’ll discuss allocation and submission, the documentation needed for a successful claim, and best practices when dealing with Medicare to achieve desired outcomes.
- Next, we’ll examine alternative Medicare Set-Asides to assure Medicare’s future interests. Amy Bilton, J.D., shareholder, Nyhan Bambrick Kinzie & Lowry, will dissect medical guidelines to understand the process, and explain the documentation that is necessary and unnecessary. She’ll also analyze legally based Medicare Set-Asides to identify legal issues, case law, and statute that are valuable to the case.
- Rasa Fumagalli, J.D., director of MSP compliance, Synergy Settlement Services, will explain how to protect Medicare’s future interest without a set structure. She’ll analyze the differences between Liability and Workers Compensation Medicare Set-Asides; assess how to prepare accurately with lack of structure, including the no set process, reference manual, or guidelines.
- Next, we’ll explore alternative Medicare Set-Aside approaches with John V. Cattie, Jr., managing attorney, Cattie & Gonzalez, PLLC. He’ll go over the process of self-allocation based on individuals’ medical needs for life and explain the pitfalls when utilizing a medical opinion related to future medical needs. Cattie will also explain how to capitalize on medical cost projection created from advice from multiple professionals to ensure an accurate assessment. We’ll also learn how to utilize traditional legally based Medicare Set-Asides that are created based on medial recommendations.
No-Fault Conditional Payment
The second day of the main conference will take place Friday, Feb. 25 and will include topics related to no-fault condition payments.
- Steven Shaw, attorney and certified Medicare Secondary Payer professional, Shaw Legal Solutions, and Ryan Weiner, chief operating officer, MASSIVE: Medical and Subrogation Specialists, will explain the obligations of the plaintiff/lawyer. They’ll go over the plaintiff’s responsibility related to liens in no-fault cases, explain the process and the information that needs to be provided to Medicare, and process and documentation needed for the Commercial Repayment Center.
- Cattie will return for a session on the obligation of the defendant. He’ll analyze the process to identify the total financial exposure in the policy related to the claim. Attendees will also learn to assess the breakdown of payments related to loss of wages, medical care, and reimbursement to Medicare, including documentation and providing proof of expenses. Cattie will also discuss the timing involved in the claim that potentially can create a responsibility to reimburse Medicare.
- Charles R. Medlin, COO and founder, LitPRO, will go over the responsibilities of the plaintiff/lawyer in worker compensation claims. He’ll discuss processes to follow if the employer accepts responsibility for medical, and the expectations of Medicare; the plaintiff’s role post settlement, including timelines and documentation; and the processes of working with both the Commercial Repayment Center and the Benefits Coordination & Recovery Center to assure compliant processes and timelines.
- Next, we’ll evaluate the responsibility of the defendant for conditional payments related to workers compensation. Michelle A. Allan, Esquire, principal,
Allan Koba Compliance Solutions, will explore strategies to calculate anticipated payments to Medicare to avoid costly miscalculations. He’ll also help attendees prepare to manage critical information sharing between the injured party and Medicare related to the claim. Attendees will also learn how to identify payments not related to the claim that should be disputed, and prepare for the process including dispute, redetermination, and reconsideration.