2023 Knowledge Series
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 both compliance requirements and your competition.
Please email us for the password needed to access each recorded session.
|Section 111 Reporting: Expansion of TPOC Reporting to include MSA Data
The Centers for Medicare & Medicaid Services recently held a webinar to discuss an upcoming expansion of Section 111 TPOC reporting to include submitted and non-submitted Workers’ Compensation Medicare Set-Aside (WCMSA) information. Join our team to learn more as they share highlights from the webinar and take a deeper dive into this change and how it may impact your organization. We will explore:
|Civil Money Penalties: Examining the Final Rule
Yesterday, the Centers for Medicare & Medicaid Services issued an alert that it finalized the rule specifying how and when it will calculate and impose Civil Money Penalties. Join us tomorrow to learn more as our team takes a deep dive into CMPs, with a particular focus on the final rule. We will explore:
|The (Mixed) Reviews Are In: Simplifying Mandatory Insurer Reporting
Section 111 Mandatory Insurer Reporting is on everyone’s mind these days. New Non-Group Health Plan User Guides seem to be coming out more frequently, Civil Monetary Penalties are anticipated in 2024 and what is an “Unsolicited Response File” anyway? Join us as we explore all things Section 111. Key takeaways:
|That’s a Wrap: Finalizing the Settlement
Just getting to settlement on cases involving Medicare considerations can be challenging enough, but that is only one piece of the puzzle. Join us as we discuss the elements of finalizing the settlement including completing the CMS submission process, finishing documentation, securing funding, and providing administration. Key takeaways:
|Plot Twist: Considering Medicare’s Interests in Liability Settlements
Who Saw That Coming? While Medicare Secondary Payer for Workers’ Compensation has some structure to it (i.e., WCMSA Reference Guide), parties often find it more challenging to consider Medicare’s interests in liability settlements. This webinar will provide an overview of the various aspects of Medicare Secondary Payer (MSP) compliance as related to liability cases. We will also discuss Section 111 Mandatory Insurer Reporting and Conditional Payments for liability cases and how they may require more cooperation between the settling parties. Will we walk through Reporting and Lien Resolution on liability cases and review the importance of the settling parties’ agreement on the MSP pieces of the settlement. Key takeaways:
|It Starts with a Script: Building a Cost-Effective Allocation
While the story continues to evolve, it is critical for you to stay informed to remain compliant and minimize risk in the rapidly changing Medicare Secondary payer compliance landscape. Join us as we explore the importance of pre-allocation mitigation, settlement consulting services, MSA options, understanding CMS trends and more. Key takeaways:
|Finding the Right Talent: Establishing Medicare & Social Security Status
Determining whether a Medicare Set-Aside is appropriate is often linked to a claimant’s entitlement status. This webinar will explore the pathways to obtaining Social Security Disability and how that status relates to Medicare entitlement. We will also discuss the importance of evaluating CMS workload review thresholds and discuss the basics of Part A, Part B, Part C, and Part D. Key takeaways:
|Lights, Camera, Action: Exploring Conditional Payment Litigation
Join us as we review cases related to Conditional Payments with a particular focus on recent litigation involving LifeWallet (formerly MSP Recovery). We will discuss the elements of each case including arguments made to the Court, the court’s decision, and any impact those decisions may have on your Conditional Payment program. Key takeaways:
|Is CMS Still Approving Zero Waiver MSAs?
In this webinar, we will explore considerations for Zero Waiver MSAs including examining the language and documentation required by CMS, discussing clean cases where no loss payments were made, and assessing the best methods for disputing Zero Waiver MSAs. Key takeaways:
|Is It True That Non-Submit MSAs Can No Longer Be Used?
In January of 2022, CMS released a new version of the WCMSA Reference Guide (version 3.5), adding section 4.3 The Use of Non-CMS-Approved Products to Address Future Medical Care. Some in the industry interpreted section 4.3 to mean you could no longer opt out of the CMS submission process. However, that is not the case. CMS followed with an updated version of the WCMSA Reference Guide, version 3.6, which confirmed that submission remains voluntary. We will walk through the facts and discuss where we stand on the age-old question – To Submit or Not Submit? Key takeaways:
|Can I Do Anything About My Result from CMS or am I Stuck?
So, you submitted an MSA to CMS for review and received an unfavorable result, possibly impacting your settlement indefinitely. Are you stuck with their decision, or do you have options to pursue? Join us to explore the tools available for post-CMS review and how to set yourself up for success when requesting a Re-Review or Amended Review from CMS. Key takeaways:
|Exploring Different Processes for Medicare Liens: Parts A, B, C, and D
For traditional Medicare (Parts A and B), a specific process is used for conditional payment search and collections through Section 111 reporting information. However, the process may differ if a Medicare Part C or Part D plan is involved. Since Medicare has updated its query response system to include information from Medicare Part C and D plans, carrier/self-insureds now have a great opportunity to identify and resolve Medicare Part C and D liens prior to recovery litigation. Key takeaways:
|This Case Won’t be Able to Settle: How Can I Lower MSA Costs?
Future settlement values are too often overinflated due to unclear documentation, inclusion of unwanted treatment(s), inclusion of high-dollar medications, and a variety of other reasons. We will discuss CMS’ policies, review claim mitigation strategies, and explore how to achieve mutually agreeable resolutions for you and the opposing party. We will provide several examples of ways to lower future medical projections and/or reduce the risks associated with the CMS submission process. Key takeaways:
|What Do I Need to Know About Section 111 Reporting?
Section 111 Reporting is a central part of Medicare Secondary Payer compliance. Mistakes in reporting ORM, ORM Termination, TPOC, ICD-Coding and other data can not only impact conditional lien exposure, but also may soon subject you, or your customers, to Civil Monetary Penalties. Key takeaways:
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