Learn about the latest issues impacting future medical expenses and Medicare.
This topic will focus on Medicare compliance in workers' compensation and liability cases in which future medical expenses are likely to be incurred. Explore the legal obligations of injured persons, insurers, and employers in compliance with the Medicare Secondary Payer Act when settling workers' compensation and liability cases. Explore alternatives to submission for CMS approval as a means of compliance. This information advocates a reasoned approach to allocating for the Medicare Set-Aside and to deciding whether submission for approval is advisable considering anecdotal evidence of MSA overfunding.
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General Medicare Considerations
The Legal Basis for Medicare Compliance in Workers' Compensation and Liability Cases
Medicare Compliance Areas
Consequences of Noncompliance
Advantages of Medicare Approval
Considerations When Submitting Cases for Medicare Approval
Medicare Approval Horror Stories
The High Cost of the Overfunding Problem
Conclusion: the Goal
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This course was last revised on May 14, 2020.
Call 1-866-352-9540 for further credit information.
- AK CLE 1.5
- Alaska attorneys may receive 1.5 hours of continuing legal education for completing this program. Please contact the Alaska Bar Association or go to www.alaskabar.org for details regarding reciprocity with other states.
- AL CLE 1.5
- This course or a portion thereof has been approved by the Alabama State Mandatory Continuing Legal Education Commission for a maximum of 1.5 hours credit.
- AR CLE 1.5
- This course has been approved for 1.5 hours of CLE by the Arkansas CLE Board.
- Arizona CLE 1.5
- The Arizona State Bar does not pre-approve or pre-certify MCLE programs. However, records of this program and attendance will be maintained by Lorman Education Services for auditing purposes. This activity may qualify for up to 1.5 hours toward your annual CLE requirement for the State Bar of Arizona.
- CA MCLE 1.5
- Lorman Business Center, LLC. is a State Bar of California approved MCLE sponsor and this course qualifies for 1.5 CLE hours of participatory credit.
- CT CLE 1.5
- Neither the Connecticut Judicial Branch nor the Commission on Minimum Continuing Legal Education approve or accredit CLE providers or activities. This course has been approved for CLE credit in jurisdictions aside from CT and therefore it automatically meets the content and delivery requirements in Connecticut. Credit is based on a 60 minute credit hour and shall be awarded as follows: 1.5 CLE credit(s).
- HI CLE 1.5
- This program was approved by the Hawaii State Board of Continuing Legal Education for 1.5 CLE credit hours.
- IL CLE 1.5
- This course was approved for a total of 1.5 hours of MCLE Credit by the Illinois MCLE Board.
- ME CLE 1.5
- This course has been approved by the State of Maine Board of Overseers of the Bar. Lawyers who complete this course shall receive 1.5 hours of CLE credit under M. Bar R. 5.
- ND CLE 1.5
- North Dakota CLE policy does not allow for pre-approval of any self-study courses. This course may qualify for up to 1.5 hours of CLE credit.
- NH MCLE 1.5
- NH MCLE does not approve or accredit CLE activities for the NH Minimum CLE requirement. Lorman Education Services believes this Ondemand course meets the requirement of NH Supreme Court Rule 53 and may qualify for CLE credit(s). Program Length: 91 Minutes.
- NY CLE 1.5 including Areas of Professional Practice 1.5
- This course has been approved in accordance with the requirements of the New York Continuing Legal Education Board for up to a maximum of 1.5 credit hours in the area(s) of Areas of Professional Practice for 1.50 hours. Each hour may be counted only as satisfying one category of credit. Duplicate credit for the same hour of instruction is not permitted. This course qualifies for both established and newly admitted attorneys. Lorman Business Center, LLC. has a financial hardship guideline. Please contact customer service at 1.866.352.9539 for instructions on how to apply.
- PA CLE 1.5
- This Distance Learning program has been approved by the Pennsylvania Continuing Legal Education Board for 1.5 hours of substantive law, practice and procedure CLE credit.
- RI CLE 1.5
- This program has been approved by the Rhode Island Mandatory Continuing Legal Education Commission for 1.5 hours of CLE credit.
- VT CLE 1.5
- This self-study program has been approved by the Mandatory Continuing Legal Education Board of Vermont for 1.5 hour(s) of CLE credit. Please note: Attorneys may only claim 6 credits per compliance period in this format. This course is considered "Non-Moderated Programming without Interactivity".
- WA CLE 1.5
- This program has been approved by the Washington State Board of Continuing Legal Education for 1.5 hours of A/V credit under the Law & Legal Procedure category.
- WV MCLE 1.8
- This program has been approved by the West Virginia State Bar MCLE Commission for 1.8 MCLE hours.
- HR Certification Institute 1.5
- This E-Learning program has been approved for 1.5 (General) recertification credit hours toward aPHR(TM), aPHRi(TM), PHR®, PHRca®, SPHR®, GPHR®, PHRi(TM) and SPHRi(TM)recertification through HR Certification Institute® (HRCI®). For more information about certification or recertification, please visit the HR Certification Institute website at www.hrci.org.
- SHRM 1.5
- Lorman Education Services is recognized by SHRM to offer Professional Development Credits (PDCs) for the SHRM-CPSM or SHRM-SCPSM. This program is valid for 1.5 PDC(s) for the SHRM-CP or SHRM-SCP.
To earn each credit Lorman offers through the OnDemand learning platform, you need to watch 100% of the program. Also, for certain credits you will need to fulfill additional requirements which will be displayed on the "credits" tab when viewing the course.
- Those applying for AIA and HRCI must view 100% of the program and answer the questions following the program.
This program does NOT qualify, nor meet the National Standard for NASBA accreditation.
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MSP Compliance Solutions, LLC
- Legal practice experience in the areas of workers’ compensation, personal injury, and Medicare/Medicaid compliance
- A health insurance professional that brings a passion to educating his peers
- Licensed to practice law in Minnesota since 2002, as well as Wisconsin starting in 2008
- Has litigated countless cases and founded a compliance consulting firm where he helped numerous individuals from diverse backgrounds across the United States
- Passions include assisting low income persons via pro bono legal representation
- J.D. degree, William Mitchell College of Law, St. Paul, MN; B.A. degree, St. Cloud State University
- Can be contacted at 651-485-7036 or [email protected]
Deborah Robinson Stewart
GENEX Services, Inc
- National manager of Medicare Set-Aside Services (MSA) at GENEX Services, Inc and is responsible for the daily operations and oversight of the MSA department
- Experienced in handling Medicare Secondary Payer Compliance matters and stays on top of legal and regulatory developments and emerging policy changes that impact the workers' compensation, managed care, and Medicare fields
- Routinely consults with clients on medically and legally challenging cases and provides guidance on compliance issues stemming from settlement of workers’ compensation and liability claims
- Prior experience includes working as a CMS contractor adjudicating health care disputes involving Medicare services and Medicare Secondary Payer matters
- Was also engaged in the practice of law representing clients in personal injury, medical negligence, workers’ compensation, insurance coverage, and estate matters
- Member of the Pennsylvania bar, a volunteer with Neighborhood Meals on Wheels, and a member of the board of the Neighborhood Bike Works
- J.D. degree, Villanova University School of Law; B.A. degree, University of Virginia
- Can be contacted at 610-964-5264 or [email protected]
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