Medicare Secondary Payer Act - Protecting Medicare's Interest in Insurance Settlements

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 109 Min. Audio MP3 - No shipping cost
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Benefits

Pursuant to 42 USC Section 1395y(b)(2), commonly known as the Medicare Secondary Payer Act, Medicare may not make payment for medical benefits where 'payment has been made or can reasonably be expected to be made under a workmen's compensation law or plan of the United States or a state or under an automobile or liability insurance policy or plan (including a self-insured plan) or under no fault insurance.' By law, Medicare has a priority right of recovery from the primary payer as well as from parties in receipt of third-party payments, such as a beneficiary, provider, supplier, physician, attorney, state agency or private insurer (42 CFR 411.24(g)). Accordingly, it is essential that all parties to personal injury insurance settlements ensure that Medicare's interests are protected and therefore of the utmost importance for all attorneys, insurance company personnel and medical billing professionals to fully understand how and when the MSP applies in any given personal injury situation.

You will benefit from an overview of all pertinent statutes and regulations, as well as CMS interpretation in its manuals and policies. We'll address individual areas of law separately as to the manner in which the MSP applies in each. Most significantly, you'll learn about workers' compensation settlements, as CMS is most actively monitoring them and has established policies with respect to addressing past and future medical expenses in the settlement of claims. We'll address liability settlements as a hot topic since there is no established CMS guidance as there is in workers' compensation, yet it's rumored to be CMS' next target. You'll walk away with valuable insight and a better understanding of Medicare's role in insurance claims settlement.


Agenda

Overview
Medicare as Secondary Payer
  • The Law
  • The Regulations
  • The Policy
Medicare Liens – The Past
  • Conditional Payments
  • Repayment Required by Statute
  • Compromise of Conditional Payments
  • Coordination of Benefits Contractor
  • Medicare Secondary Payer Recovery Contractor
Medicare Set-Aside Allocations – The Future
  • When Must Medicare Be Protected in a Settlement?
  • Calculating a MSA
  • CMS Procedures for Workers' Compensation Settlements
  • MSAs in Liability Settlements
  • Annuities – A CMS-Approved Method of Funding MSAs at Present Value
  • Post-Settlement MSA Administration
  • Medicaid, and Other State and Federal Benefits Eligibility
  • Ethical and Legal Considerations for Attorneys
  • Legislative Activities
Settlement Tips

Faculty

Jennifer C. Jordan, Medval, LLC

Jennifer C. Jordan
  • General counsel for Medval, LLC
  • Resident expert on the Medicare Secondary Payer Act and its application in personal injury insurance settlements
  • Certified by the Commission on Health Care Certification as a Medicare set-aside certified consultant
  • J.D. and M.B.A. degrees, University of Baltimore
  • B.A. degree in economics, Virginia Polytechnic Institute and State University
  • Contact her at jjordan@medval.com





These Materials are Designed For

Attorneys, workers' compensation administrators, benefits professionals, insurance and claims professionals, business owners and managers, and other legal professionals

CD & Manual - CD Set with bound 24 page manual
Podcast - 109 Minute MP3 with 24 page electronic manual - Immediate Access and No Shipping Cost