Workers' Compensation Claims and the Medicare Secondary Payer Act

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

This program has been cancelled

A live 90-minute CLE video webinar with interactive Q&A

This program is included with the Strafford CLE Pass. Click for more information.
This program is included with the Strafford All-Access Pass. Click for more information.

Tuesday, September 27, 2022 (Tomorrow)

1:00pm-2:30pm EDT, 10:00am-11:30am PDT


This CLE course will review 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 the nuanced differences between workers' compensation and other personal injury claims--and how they affect how MSP compliance takes shape during the workers' comp settlement process. The panelist will also cover recent developments and best strategies to extinguish all potential MSP exposure going forward.

Description

Parties resolving workers' compensation claims must adhere to the MSP Act to ensure Medicare cannot seek potential reimbursement of paid medical expenses or impose penalties for noncompliance. The three 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 three MSP compliance parts interact and what is the best way to achieve compliance at the lowest possible cost.

Listen as John V. Cattie, Jr., Founding Member at Cattie & Gonzalez, reviews the requirements for conditional payment satisfaction, reporting of settlements under Section 111, and when/how to use MSAs. You will learn how recent administrative guidance changes the way you think about MSAs, including alternatives to MSAs.

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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. Commercial repayment contractor--an entity employers/carriers should get to know
    2. Conditional payment notices vs. conditional payment letters
  4. Future medicals and MSAs
    1. MSAs in accepted WC claims
    2. MSAs in denied WC claims
  5. MSA alternatives currently available
    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' compensation case?
  • What are the reporting requirements of Section 111--and who is responsible for compliance?
  • When is an MSA agreement needed? How should it be established? What alternatives to MSAs 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