Workers' Compensation Claims and the Medicare Secondary Payer Act

Meeting Reporting Requirements, Satisfying Liens, and Establishing Set-Asides in Settlements

Recording of a 90-minute CLE webinar with Q&A


Conducted on Wednesday, February 1, 2017
Recorded event now available


This CLE webinar will provide workers’ compensation counsel with a review of the MSP Act, Section 111, and Medicare set-aside arrangements. The panel will discuss the differences between workers’ comp and other personal injury claims—and how to protect the client’s and Medicare’s interests during settlement. The panelist will also cover recent developments, including CMS’ Workers’ Compensation Medicare Set-Aside Arrangement Reference guide, issued in April 2016, so attendees will receive the most up-to-date information to address these compliance issues at the lowest cost to the client.

Description

Workers’ compensation settlements require satisfaction of Medicare’s lien interests if Medicare made conditional payments for an injured plaintiff. Both parties’ counsel may be held liable to satisfy the lien if Medicare’s interest is not properly protected in the settlement.

The MMSEA Section 111 mandates proper reporting of workers’ comp settlements to the government. Failing to timely report a settlement of a workers’ comp claim can result in steep, daily fines.

Certain workers’ comp claim settlements are required to contemplate Medicare set-aside agreements to ensure protection of Medicare’s interests. Counsel must know how to determine if a Medicare set-aside is needed, how to determine the proper amount, and then how to properly establish these arrangements.

Listen as our authoritative workers’ compensation panelist reviews the requirements for lien satisfaction, reporting of settlements, and use of Medicare set-asides. You will learn how recent administrative guidance changes the way you think about Medicare set-asides. The program will also discuss special considerations when settling workers’ compensation claims.

Outline

  1. Medicare Secondary Payer
    1. Statutory analysis of conditional payments
    2. Statutory analysis of MSAs
    3. Statutory analysis of MMSEA Section 111 reporting
  2. MMSEA Section 111
    1. What triggers MMSEA Section 111?
    2. Reporting nuts and bolts
    3. Low dollar thresholds
  3. Conditional payments
    1. The CRC – a new process for E/Cs
    2. CPNs vs. CPLs – a distinction with a difference
  4. Future medicals and MSAs
    1. MSAs in accepted WC claims
    2. MSAs in denied WC claims
  5. MSP changes in 2017
    1. New WCMSA review contractor

Benefits

The panelist will review these and other key issues:

  • What are the responsibilities for counsel regarding Medicare’s interests when settling a workers’ comp case?
  • What are the new reporting requirements of Section 111—and who is responsible for compliance?
  • When is a Medicare set-aside agreement needed? How should it be established?

Faculty

John V. Cattie, Jr., Founding Member
Cattie, Charlotte, N.C.

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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