Medicare's interests in the settlement of workers' compensation claims has become one of the most critical areas facing everyone who is involved in handling and settling workers' compensation claims today. Employers who want to protect themselves from the potential of Medicare setting aside a settlement of a serious claim needs to keep themselves familiar with the current provisions and applications to their claims. This seminar will provide information needed by all parties to a workers' compensation settlement, including the employer, the insurer and the representatives of injured workers.
This seminar will cover the effect of applicable statutes and provisions, as well as the mechanics of addressing these concerns. No one wants to have a settlement carefully negotiated between the parties set aside, nor do they want the uncertainty that will result from not adequately addressing the concerns of Medicare.
- Learn the impact of prescription drug benefits on workers' compensation
- Avoid the penalties for failure to comply
- Learn how to create a Medicare Set Aside Fund and what to consider
9:00 a.m. - 9:10 a.m.
I. Opening Comments
9:10 a.m. - 9:35 a.m.
II. What Is Medicare's Interest In Your
Workers' Compensation Claim?
A. Overview Of Medicare System
9:35 a.m. - 10:00 a.m.
III. When Do You Need To Consider
A. Medicare's Criteria In Law, Regulation, Memorandum And Practice
B. Specific Examples Of When It Is Necessary And When It Is Not
10:00 a.m. - 10:50 a.m.
IV. What Will Be The Effect Of The
Medicare Prescription Drug Benefit
On Your Workers' Compensation
10:50 a.m. - 11:05 a.m.
11:05 a.m. - 12:15 p.m.
V. How Do You Create A Medicare
Set-Aside Trust? An Overview Of
Medicare's Recovery Claim For Past
A. Use Of Consultants
B. The MMA Of 2003 (Medicare Modernization Act)
C. Preparing A Medicare Set-Aside Allocation (MSA)
D. Medicare's Recovery Claim Against The WC Settlement
E. Overview Of The CMS Policy Memos
F. Administration Of The Trust
12:15 p.m. - 1:15 p.m.
Lunch (On Your Own)
1:15 p.m. - 1:45 p.m.
VI. How Does The Process Work When
Medicare Is Involved?: From
Catastrophic Injury To Settlement
B. Reasons For Delays
C. Resolving The Catastrophic Claim
1:45 p.m. - 2:15 p.m.
VII. What Are The Alternatives To A
Medicare Set-Aside Trust?
A. Why You Might Not Prepare A Trust
B. Risks Of Not Preparing A Trust
C. Examples Of Alternatives To A Trust
2:15 p.m. - 2:45 p.m.
VIII. What are the Ethical Considerations
And Penalties For Not Considering
A. Undoing A Settlement
B. Double Damages
2:45 p.m. - 3:00 p.m.
3:00 p.m. - 3:30 p.m.
IX. How Do You Address Medicaid
Liens Before And After Settlement?
A. How Medicaid's Interests Differ From Medicare's Interests
B. Obligations Of Medicaid
C. How The Process Works In Georgia
D. Penalties For Not Addressing Medicaid Liens
3:30 p.m. - 4:30 p.m.
X. Panel Discussion
A. Leonard and Michael Rosetti
A. Ethical Issues In Protecting Medicare's Interests
B. Recent Updates Regarding What Is Covered Under Medicare
C. Self-Administered vs. Guardian Administered Trust For Future Medical Expenses
D. Rated-Age Implications For Set-Aside Trusts