2026 Knowledge Series
Solving the Mysteries of MSP Compliance

During these complimentary sessions, you’ll hear from our experienced team on a variety of forward-looking Medicare Secondary Payer (MSP) related topics with a focus on offering insights that help you stay informed and stay ahead of compliance requirements.

Webinars are held on the second Thursday of the month at 2:00 pm ET / 11:00 am PT.

Post-settlement considerations are often left to the end of settlement discussions, which can lead to golden opportunities being left on the table. Join us as we investigate processes for funding and administration, detect potential pain points, and explore solutions for success.

Key takeaways:

• Examine how considering funding and post-settlement administration earlier in the process can lead to quicker settlements
• Uncover the possible savings and benefits of using structured settlement annuities as part of your settlement
• Identify when it may be best to use an annuity and examine how customizing the settlement can reveal savings while meeting the needs of both the claimant and the insured

Join us as we discuss the impacts of ORM reporting and conditional payment reimbursement requests from Medicare, Medicare Advantage, or Prescription plans including identifying and unraveling the conundrum of U.S. Treasury collections based on past conditional payment demands. Medicare Advantage and Prescription plans reimbursement processes are different, and this session will cover these differences and how they can impact negotiation and resolution.

Key take aways:

• Explore means of identifying outstanding conditional payment debt with U.S. Treasury
• Discover potential defenses to conditional payment requests, including circumstances where a Medicare Advantage Plan or Prescription Plan asserts a subrogation right to reimbursement
• Investigate factors that may assist in determining whether to appeal or pay conditional payments

Have you ever been shocked by the cost of a Medicare Set Aside because it does not represent the medical situation as you know it? We will explore the practical steps that can be taken to align the MSA with probable future treatment. Attendees will examine how treatment patterns, pharmacy utilization, clinical projections, and jurisdictional nuances directly influence MSA values – and how to strategically intervene before costs lock in. By the end, participants will understand not just what shrinks an MSA, but why those strategies work and how to apply them consistently across claims.

Key Takeaways

• Examine how treatment trends, pharmacy drivers, and clinical documentation shape MSA projections—and where reduction opportunities typically hide
• Identify strategies for influencing future medical exposure through early intervention, provider engagement, and evidence‑supported recommendations
• Discover practical techniques for achieving defensible reductions that withstand CMS review and improve overall claim outcomes

Every claim situation is unique, and therefore a one-size-fits-all approach is not optimal. Join us as we review the spectrum of future medical allocation options and explore the distinctions between CMS‑submitted MSAs, non‑submit MSAs, and broader medical cost projections that account for both Medicare‑covered and non‑covered items. By walking through practical decision points and real‑world scenarios, participants will gain a clearer framework for selecting the right allocation strategy for each claim.

Key Takeaways

• Learn how CMS‑submitted MSAs, non‑submit MSAs, and comprehensive cost projections differ—and when each option is most effective
• Investigate what sets a Certified Non‑Submit MSA apart from a standard non‑submit allocation
• Discover a practical decision framework for choosing the most defensible and cost‑effective future medical allocation path

We will take a deep look at the two primary pathways for challenging and changing CMS‑approved MSA amounts: Re‑Review and Amended Review. Attendees will examine real‑world data showing when each option is most effective, what triggers CMS to reconsider its original determination, and how documentation and claim strategy influence outcomes. We will use real case examples to highlight the patterns behind successful challenges that lead to revised approvals. Participants will leave with a clearer understanding of how to navigate these processes.

Key Takeaways

• Explore how Re‑Review and Amended Review differ – and the specific criteria that make each pathway viable
• Gain insights from real‑world examples showing what drives CMS to adjust previously approved MSA amounts
• Review practical strategies and documentation approaches that increase the likelihood of a successful challenge

Join us as we discuss how settlement and reporting the settlement to Medicare or Medicare Advantage/Prescription plans can impact conditional payment reimbursement requests. We will also explore topics including U.S. Treasury collection against the Medicare beneficiary, Medicare Advantage Plan’s tactics in seeking reimbursement, and potential options for negotiating and resolving these liens. The differences between traditional Medicare (Part A and B) and Medicare Advantage Plans processes will also be covered.

Key takeaways:

• Examine the impacts reporting settlements will have on Medicare or Medicare Advantage/Prescription Plans and identify means to confirm resolution
• Investigate potential options for negotiating and resolving conditional payments by Medicare Advantage Plans based on subrogation or settlement reporting
• Gain a better understanding of Medicare’s recent announcement regarding Part D plan benefit coordination
• Reveal factors that can assist you in solving the quandary of whether to appeal or pay conditional payments

Join us as we search for answers on the CMP process. The Final Rule for Civil Money Penalties for untimely Section 111 Mandatory Insurer Reporting was announced in 2023, with the first audits happening in 2026. We will examine what is currently known about the audit process and review the early quarterly results. Don’t miss this session where we will explore whether “the truth is out there”… and perhaps more importantly, is it attainable?

Key takeaways:

• Review the audit process for Civil Money Penalties for Section 111 Mandatory Insurer Reporting
• Examine what is known from the first two quarters of audit implementation, including the ratio of Non-Group Health Plan (NGHP) records to Group Health Plan (GHP) records (i.e., the number of records pulled from our reporting areas).
• Study any changes or clarifications that CMS has made to the audit process this year.

Legacy claims can develop into mysteries that contribute to higher costs for employers and insurers and impact the bottom line of any organization. Join us as we discuss overcoming obstacles to settlement on your most pending claims, positioning those claims for resolution, and finally closing the book on these challenging cases.

Key takeaways:

• Discover how settlement projects can efficiently lower your overall pending numbers
• Investigate the parameters of a settlement project and explore which cases offer the best potential for cost savings
• Identify how to choose the best cases to include in the settlement project to achieve optimal outcomes

Do I need to have an MSA on this case? Does this case need to be submitted to CMS? How do I get (insert body part/condition here) removed from the MSA? Medicare Secondary Payer (MSP) compliance can be a confusing part of settling your claims. Join our team as we address the most common MSP compliance questions that we receive.

Key Takeaways:

• Explore the most common MSP compliance questions that the IMPAXX team has received over the past year
• Offer insights and answers for common questions (Section 111 Reporting, Conditional Payments, Allocations) and provide resources for learning more
• Get answers to your top questions – we will be taking questions in advance (submit yours here) and will be responding live to questions from attendees

What we know – submitting WCMSAs to CMS is (and always has been) a voluntary process. What is sometimes a mystery – how CMS will interpret and apply medical records and doctor’s recommendations for allocation determinations once an MSA is submitted. Join us as we open the book on the CMS submission process and share insights from our experiences working with CMS.

Key Takeaways:

• Explore the WCMSA Reference Guide through summaries of the main content (sections of the Guide) and the most often referenced portions
• Analyze the strengths of the Guide and reveal where a clear map can be followed for a successful submission journey
• Expose some weaknesses of the Guide and reveal where additional pointers may hold the keys to achieving most cost effective MSAs and obtaining faster determinations

January 22
2:00 pm ET

Tracking the Trail of MSP Compliance: Reviewing 2025 and Previewing 2026

Join the IMPAXX team as we explore key 2025 MSP compliance news and trends and offer tips and predictions about what’s to come in 2026. From the implementation of Section 111 Civil Monetary Penalties and outstanding questions surrounding TPOC reporting requirements for Workers’ Compensation Medicare Set-Asides (WCMSAs) to Conditional Payment puzzles and solutions, we will share the new year’s resolutions you can make now to uncover and address your potential MSP exposure and risks in 2026.

Key takeaways:

• Examine TPOC reporting requirements for Workers’ Compensation Medicare Set-Asides (WCMSAs) and explore any quandaries about the process.
• Reveal changes announced in April 2025 to Zero-Dollar MSAs and Amended Review and their potential impact on your compliance program.
• Investigate changes made to Section 111 Reporting, MSAs, Conditional Payments, and more (including important milestones), and explore how you can stay informed, reduce your risk, and start 2026 on the right foot.

2025 was a suspenseful year for Section 111 Mandatory Insurer Reporting. Join our Settlement Consulting team as we navigate through the questions we get asked most frequently about Section 111 Reporting.

Key takeaways:

• Investigate the base reporting requirements and reveal the most recent changes and clarifications from CMS
• Unveil the most asked reporting questions, delve into the answers and explore resources to uncover the truth… it’s out there
• Discover best practices for avoiding CMPs and ways to confirm you are compliant with Section 111 reporting requirements

Jennifer Shymanski
Vice President,
Implementation and Strategy

Mark Heberling
Vice President,
Settlement Consulting

Patrick Czuprynski
Vice President,
Lien Solutions

Dawn Dietz
Assistant VP,
Settlement Consulting