Course Description
Strategies to Simplify Medicare Set-Asides
There's
no question that worker's compensation and liability Medicare
set-asides create headaches for many attorneys. Nonetheless, it is
imperative that attorneys know the ins and outs of MSAs, both so they
can protect Medicare's interests and secure more advantageous
settlements for their clients. Strategies to reduce allocation amounts,
knowing how the workers' compensation review contractor reviews
settlement proposals, and simply understanding the pros and cons of
structured settlements vs. lump sums can all put more money in your
client's pocket. Don't miss out on this valuable overview of MSAs -
register today!
- Determine what Medicare's reimbursement rights are when they make a conditional payment on an outstanding medical bill.
- Effectively protect Medicare's interests, even in cases that do not meet the minimum review thresholds for a WCMSA.
- Ensure
the allocation amount of a WCMSA is not too high by using strategies to
reduce future prescription drug costs, future medical costs and more.
- Avoid lag time when submitting a set-aside to CMS by recognizing submission pitfalls that lead to delays.
- Calculate
whether a lump sum or a structured settlement is more advantageous for
funding a workers' compensation Medicare set-aside.
- Ethically handle settlement funds in a dispute.
Who Should Attend
This basic-to-intermediate level course will provide
guidance in Medicare Set-Aside compliance and will benefit attorneys.
It could also benefit in-house counsel, insurance claims professionals,
and paralegals.
Course Content
- Government and Third Party Liens: Beyond Medicare
- Ethics
- Liability Medicare Set-Asides and Conditional Payments: A Case Example
- Workers' Comp Medicare Set-Asides (WCMSA) and Conditional Payments: A Case Example
Agenda / Content Covered
MORNING SESSION: THIRD PARTY AND GOVERNMENT LIENS SIMPLIFIED
- GOVERNMENT AND THIRD PARTY LIENS: BEYOND MEDICARE
9:00 - 10:45, Paul K. Isaac and Paul Loudenslager - Medicaid Liens and Other Liens of the Commonwealth
- Workers' Compensation Leins
- ERISA Liens
- U.S. Medical Care Recovery Act Liens (FMCRA)
- TRICARE Claims
- Medicare Part D/Medicare Advantage
- ETHICS
11:00 - 12:00, Paul K. Isaac and Paul Loudenslager - What to do When a Client Ignores Medicare's Interests
- Avoiding Other Conflicts of Interest
AFTERNOON SESSION: MEDICARE ISSUES IN LIABILITY AND WORKERS' COMP CLAIMS
- LIABILITY MEDICARE SET-ASIDES AND CONDITIONAL PAYMENTS: A CASE EXAMPLE
1:00 - 2:30, Paul K. Isaac and Paul Loudenslager - MMSEA Section 11 Mandatory Insurer Reporting Requirements
- The SMART Act and New Reporting Requirements
- Discretionary Fines for Noncompliance
- Sample Reporting Cheat Sheet
- Which Entities and Information are Required to be Reported?
- Tips for Attorneys and Insurance Professionals
- Handling Conditional Payments
- The SMART Act and New Conditional Payment Resolution Process
- Changes to Threshold Amounts
- Statute of Limitation Changes
- Forms, Sample Letters and Communication
- Calculating Amounts for Conditional Payments
- Medicare Set-Asides
- The SMART Act's Impact on LMSA's
- Considerations in Determining Whether to Set up a Medicare Set Aside to Cover Future Medical Expenses
- Calculating MSA Amounts
- Approval/Submission Process
- Tips for Getting a Quick Response From Medicare
- Structuring a Set-Aside
- MSA Administration: Practical Pointers
- Practical Tips for Working with CMS
- Measures to Minimize Liability and Penalties for Incomplete Submissions/Non-Compliance
- Dealing with Medicare Set Asides That Don't Require CMS Pre-Approval
- Innovative Ways to Settle a Case: Thinking Outside the Box
- WORKERS' COMP MEDICARE SET-ASIDES (WCMSA) AND CONDITIONAL PAYMENTS: A CASE EXAMPLE
2:45 - 4:30, Paul K. Isaac and Paul Loudenslager - MMSEA Section 111 Mandatory Insurer Reporting Requirements
- New Reporting
- Sample Reporting Cheat Sheet
- Which Entities and Information are Required to be Reported?
- Tips for Attorneys and Insurance Professionals
- Handling Conditional Payments
- The SMART Act and the New Conditional Payment Resolution Process
- Thresholds
- Timelines
- Statute of Limitations
- Forms, Sample Letters and Communication
- Calculating Amounts for Conditional Payments
- WCMSAs
- The SMART Act's Impact on WCMSAs
- Considerations in Determining Whether to Set up a Medicare Set Aside to Cover Future Medical Expenses
- Calculating MSA Amounts
- Approval/Submission Process
- Tips for Getting a Quick Response From Medicare
- Structuring a Set-Aside
- MSA Administration: Practical Pointers
- Practical Tips for Working with CMS
- Measures to Minimize Liability and Penalties for Incomplete Submissions/Non-Compliance
- Dealing with WCMSAs That Don't Require CMS Pre-Approval
- Innovative Ways to Settle a Case: Thinking Outside the Box
*Because
the rules regarding Medicare set-asides are in a state of flux, the
above agenda may not reflect the latest developments. However, faculty
will present up-to-date information at the seminar. As this material is
presented in various jurisdictions throughout the county, relevant
statutes, case law, opinion, etc. will be incorporated so as to reflect
current guidelines and law in the jurisdiction where the program is
being presented.
Agenda
MORNING SESSION: THIRD PARTY AND GOVERNMENT LIENS SIMPLIFIED
- GOVERNMENT AND THIRD PARTY LIENS: BEYOND MEDICARE
9:00 - 10:45, Paul K. Isaac and Paul Loudenslager - Medicaid Liens and Other Liens of the Commonwealth
- Workers' Compensation Leins
- ERISA Liens
- U.S. Medical Care Recovery Act Liens (FMCRA)
- TRICARE Claims
- Medicare Part D/Medicare Advantage
- ETHICS
11:00 - 12:00, Paul K. Isaac and Paul Loudenslager - What to do When a Client Ignores Medicare's Interests
- Avoiding Other Conflicts of Interest
AFTERNOON SESSION: MEDICARE ISSUES IN LIABILITY AND WORKERS' COMP CLAIMS
- LIABILITY MEDICARE SET-ASIDES AND CONDITIONAL PAYMENTS: A CASE EXAMPLE
1:00 - 2:30, Paul K. Isaac and Paul Loudenslager - MMSEA Section 11 Mandatory Insurer Reporting Requirements
- The SMART Act and New Reporting Requirements
- Discretionary Fines for Noncompliance
- Sample Reporting Cheat Sheet
- Which Entities and Information are Required to be Reported?
- Tips for Attorneys and Insurance Professionals
- Handling Conditional Payments
- The SMART Act and New Conditional Payment Resolution Process
- Changes to Threshold Amounts
- Statute of Limitation Changes
- Forms, Sample Letters and Communication
- Calculating Amounts for Conditional Payments
- Medicare Set-Asides
- The SMART Act's Impact on LMSA's
- Considerations in Determining Whether to Set up a Medicare Set Aside to Cover Future Medical Expenses
- Calculating MSA Amounts
- Approval/Submission Process
- Tips for Getting a Quick Response From Medicare
- Structuring a Set-Aside
- MSA Administration: Practical Pointers
- Practical Tips for Working with CMS
- Measures to Minimize Liability and Penalties for Incomplete Submissions/Non-Compliance
- Dealing with Medicare Set Asides That Don’t Require CMS Pre-Approval
- Innovative Ways to Settle a Case: Thinking Outside the Box
- WORKERS' COMP MEDICARE SET-ASIDES (WCMSA) AND CONDITIONAL PAYMENTS: A CASE EXAMPLE
2:45 - 4:30, Paul K. Isaac and Paul Loudenslager - MMSEA Section 111 Mandatory Insurer Reporting Requirements
- New Reporting
- Sample Reporting Cheat Sheet
- Which Entities and Information are Required to be Reported?
- Tips for Attorneys and Insurance Professionals
- Handling Conditional Payments
- The SMART Act and the New Conditional Payment Resolution Process
- Thresholds
- Timelines
- Statute of Limitations
- Forms, Sample Letters and Communication
- Calculating Amounts for Conditional Payments
- WCMSAs
- The SMART Act's Impact on WCMSAs
- Considerations in Determining Whether to Set up a Medicare Set Aside to Cover Future Medical Expenses
- Calculating MSA Amounts
- Approval/Submission Process
- Tips for Getting a Quick Response From Medicare
- Structuring a Set-Aside
- MSA Administration: Practical Pointers
- Practical Tips for Working with CMS
- Measures to Minimize Liability and Penalties for Incomplete Submissions/Non-Compliance
- Dealing with WCMSAs That Don’t Require CMS Pre-Approval
- Innovative Ways to Settle a Case: Thinking Outside the Box
*Because
the rules regarding Medicare set-asides are in a state of flux, the
above agenda may not reflect the latest developments. However, faculty
will present up-to-date information at the seminar. As this material is
presented in various jurisdictions throughout the county, relevant
statutes, case law, opinion, etc. will be incorporated so as to reflect
current guidelines and law in the jurisdiction where the program is
being presented.
Audience
This basic-to-intermediate level course will provide
guidance in Medicare Set-Aside compliance and will benefit attorneys.
It could also benefit in-house counsel, insurance claims professionals,
and paralegals.