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Medicare Secondary Payer Compliance: Today, Tomorrow And Beyond

Webinar: ID# 1026199
Recorded CD
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Medicare Secondary Payer Compliance: Today, Tomorrow And Beyond
About This Course:
Medicare Secondary Payer (MSP) compliance is evolving and this webinar will provide an update on current MSP compliance processes.

We will go in-depth and look at where Section 111 Mandatory Insurer Reporting stands today, what the future may hold in consideration of the ever-changing CMS review process, with the potential for review of Liability Medicare Set-Asides and No Fault Medicare Set-Asides, coupled with advancements in medicine and cost drivers that in consideration as a whole, may affect your ability to obtain resolution for your claims.

The material will provide an easy-to-digest review of where MSP compliance stands today, tomorrow, and beyond.

AGENDA

Mandatory Insurer Reporting
  • MIR Landscape Today, and Challenges
  • Reporting and Conditional Payment Recovery Working Hand in Hand
  • 2017 Reporting and Recovery Thresholds
  • The Significance of ICD Diagnosis Codes
  • The Role of the Recovery Agent
WCMSAs Today
  • CMS WCMSA Review Contractor Status
  • WCMSA Revised Reference Guide/Internal Rules (If Issued)
  • Challenges With CMS Review Today
  • Where We Stand in Consideration of New Contractor
  • Re-Review Process, as It Stands Today
Medicare Secondary Payer Compliance Regarding Liability Insurance and No-Fault Insurance Settlements
  • Statute/Memo/Publication
  • 42 U.S.C. § 1395Y(B)(2)(a)(II)
  • CMS Memo, Dated September 30, 2011
  • CMS Publication MLN Matters Article, Dated February 3, 2017
  • Liability Insurance and No-Fault Insurance Settlements
  • When Might an MSA Be Appropriate?
  • Liability MSAs (LMSA)/NoFault MSAs (NFMSA)
  • WCRC RFP Possible Expansion of Review to Include Liability Settlements
  • Matters to Consider Regarding Liability Settlements and Future Medical Expenses
  • Settlement for Less Than Full Value
  • Policy Limits, Statutory Tort Caps, Negligence Rules
  • Determining the Amount to Be SetAside, If Any
  • CMS Guidance Coming in October 2017?
Advancements in Medicine and Potential Cost-Drivers in Workers' Compensation Claims
  • Surgical Advancements
  • Technological Advancements
  • Pharmaceutical Advancements
  • Coming Soon to an MSA Near You
About The Presenters

Jennifer A. Alvarez, MBA, JD, LL.M, RN
  • Director of Client Risk Assessment & Compliance Programs
  • Licensed Attorney admitted to practice in the State of Maryland and Registered Nurse with more than 20 years combined legal/medical experience in the areas of MSP Compliance, Estates Planning, Trust Administration, Asset Protection, and Disability Planning
  • Director of Client Risk Assessment & Compliance Programs at MEDVAL
  • For the last 10 years, has provided consultation services to plaintiffs' attorneys, defense attorneys, self-insureds, and insurance companies regarding liability settlements and MSP compliance
Jean S. Goldstein, JD
  • Legal & Corporate Affairs Manager at MEDVAL
  • Licensed attorney admitted to practice in the State of Maryland, with a diverse legal background in class action litigation, estate planning, elder law, social security disability, and administrative proceedings
  • Invited speaker at the 2017 NAMSAP Annual Meeting
  • Year to date responsible for savings for clients of nearly $4 million dollars in re-review responses/appeals from the Centers for Medicare and Medicaid Services (CMS)
  • With a keen understanding of Medicare Secondary Payer compliance, she is often consulted to offer insight, direction, and training to insurance carriers and outside counsel, on topics ranging from CMS’ voluntary review program, CMS policies, practice tips, and general Medicare Secondary Payer compliance, including conditional payment resolution
Erin L. O'Neill, PA-C, JD
  • Senior managing attorney/clinical director-Complex Claims Division at MEDVAL
  • More than 20 years of a unique combination of medical and legal experience as a Nationally Certified Physician Assistant and Licensed Attorney admitted to practice in the state of Pennsylvania
  • Invited speaker at 2016 NAMSAP Annual Meeting
  • Invited speaker at California Self-Insurers Association 2017 annual Meeting and Educational Conference
  • Frequent provider of training in Medicare Secondary Payer Act Compliance and Medicare-Set-Asides to outside counsel and insurance companies
Jessica M. Wingenroth, JD
  • Director of Operations at MEDVAL
  • Licensed attorney admitted to practice in the state of Pennsylvania
  • More than 13 years of experience in Medicare Secondary Payer compliance, as applicable to both workers’ compensation and general liability claims
  • MEDVAL’s dedicated consultant in the area of policy as related to Mandatory Insurer Reporting, assisting insurers of various sizes with building, implementing, and auditing in-house reporting programs to ensure compliance
  • Frequently invited to provide in-house seminars and training related to MSP compliance, including Mandatory Insurer Reporting, Conditional Payments and the role of Medicare Set-Aside Arrangements in settlements
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Medicare Secondary Payer Compliance: Today, Tomorrow And Beyond
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