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
This CLE webinar will provide attendees with a comprehensive review of the Medicare Secondary Payer (MSP) Act and its various reporting and reimbursement obligations (including Section 111 reporting, conditional payments and future medical/Medicare Set-Aside (MSA) issues). The speaker will discuss in detail the nuanced differences between workers’ comp and other personal injury claims—and how affect how MSP compliance takes shape during the WC settlement process. The panelist will also cover recent developments and MSA alternatives in 2018, so attendees will receive the most up-to-date information to address these compliance issues at the lowest cost to the client in a way that will extinguish all potential MSP exposure going forward.
Outline
- Medicare Secondary Payer
- Statutory analysis of conditional payments
- Statutory analysis of MSAs
- Statutory analysis of MMSEA Section 111 reporting
- MMSEA Section 111
- What triggers MMSEA Section 111?
- Reporting nuts and bolts
- Low dollar thresholds
- Conditional payments
- The Commercial Repayment Contractor (CRC) – an entity Employers/Carriers (E/Cs) should get to know
- Conditional Payment Notices (CPNs) vs. Conditional Payment Letters (CPLs)
- Future medicals and Medicare Set-Asides (MSAs)
- MSAs in accepted WC claims
- MSAs in denied WC claims
- MSA Alternatives in 2018
- Medical Review vs. Legal Analysis
- Submission vs. Non-Submission
Benefits
The panelist will review these and other relevant issues:
- What are the responsibilities for counsel regarding Medicare’s interests when settling a workers’ comp case?
- What are the reporting requirements of Section 111—and who is responsible for compliance?
- When is a Medicare set-aside agreement needed? How should it be established? What alternatives to Medicare Set-Asides exist today?
Faculty

John V. Cattie, Jr.
Founding Member
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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