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 Thursday, September 27, 2018

Recorded event now available

or call 1-800-926-7926

This CLE course 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.

Description

Parties resolving workers’ compensation claims must adhere to the MSP Act in order to ensure Medicare cannot seek potential reimbursement of paid medical expenses or impose penalties for non-compliance. The three (3) parts of MSP compliance (Section 111 reporting, conditional payment reimbursement for past medicals, and addressing Medicare’s potential right to not pay future medicals) can all create roadblocks to what would otherwise be a perfectly valid settlement agreement. Counsel must know how these 3 MSP compliance parts interact, and what is the best way to achieve compliance at the lowest possible cost.

Listen as our authoritative speaker reviews the requirements for conditional payment satisfaction, reporting of settlements under Section 111, and when/how to use Medicare Set-Asides. You will learn how recent administrative guidance changes the way you think about Medicare set-asides, including alternatives to Medicare Set-Asides in 2018.

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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 Commercial Repayment Contractor (CRC) – an entity Employers/Carriers (E/Cs) should get to know
    2. Conditional Payment Notices (CPNs) vs. Conditional Payment Letters (CPLs)
  4. Future medicals and Medicare Set-Asides (MSAs)
    1. MSAs in accepted WC claims
    2. MSAs in denied WC claims
  5. MSA Alternatives in 2018
    1. Medical Review vs. Legal Analysis
    2. 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

Cattie, John
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

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