Medicare Liens: Obtaining and Appealing Medicare Final Demands; Navigating the Five Levels of Medicare Appeals
Recording of a 90-minute CLE video webinar with Q&A
This CLE course will provide personal injury counsel for both plaintiffs and defendants, as well as adjusters, with practical tips and considerations for obtaining a final demand using the Medicare portal and for appealing a post-final demand.
Outline
- Using the Medicare Portal
- Appeals
- Redeterminations by a Medicare Administrative Contractor
- Reconsiderations by a Qualified Independent Contractor
- ALJ appeals to the Office of Medicare Hearings and Appeals
- Medicare Appeals Council appeals
- District Court
Benefits
The panel will review these and other pivotal issues:
- When using the Medicare Portal, what mistakes cannot be corrected?
- What are the most common types of mistakes Medicare makes when issuing a final demand?
- Is the Portal form and AI driven?
- What types of appeals are most likely to succeed?
- How soon should appeals be made?
- Who decides appeals?
Faculty
John V. Cattie, Jr.
Managing Partner
Cattie & Gonzalez
Mr. Cattie focuses his law practice exclusively on MSP and MSA issues, providing legal opinions regarding reporting and... | Read More
Mr. Cattie focuses his law practice exclusively on MSP and MSA issues, providing legal opinions regarding reporting and repayment obligations as well as assessing a client’s future medical exposure under the MSP Act. In the MSA area, he has personally reviewed or overseen the review of over 10,000 distinct fact patterns. Federal and state court opinions such as Smith v. Marine Terminals of Arkansas, Tye v. Upper Valley Medical Center, and Doe v. Company X cite his analysis favorably.
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David L. (Dave) Place, JD
Owner
The Place Firm
Mr. Place exclusively assists personal injury victims and plaintiff counsel with complex lien resolution problems using... | Read More
Mr. Place exclusively assists personal injury victims and plaintiff counsel with complex lien resolution problems using his vast knowledge of the other side’s techniques. Mr. Place spent fourteen years representing large private group health insurance plans, self-funded ERISA groups, FEHBA plans, Medicare Advantage plans, state Medicaid plans, as well as stop-loss and disability plans in their subrogation/recovery programs. He asserted subrogation/reimbursement rights for those groups in all fifty states, personally recovering nearly one hundred million dollars for the insurance industry.
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