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Medicare's Role In The Personal Injury Case  

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This basic-to-intermediate level course will provide guidance in Medicare Set-Aside compliance and will benefit: Attorneys, In-House Counsel, Insurance Claims Professionals, Paralegals

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Seminar Summary:

This engaging legal course includes in-depth discussions on mandatory insurer reporting, Medicare conditional payments, and Medicare Set-Asides. (see full course description)

 

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Training Course Syllabus:


Proactively Address Medicare Liens to Prevent Follow-up Litigation

Medicare has redoubled the enforcement of its right of lien recovery under the Medicare Secondary Payer Act in injury claims and settlements. Do you know exactly when and how litigants must take Medicare's interests into account to ensure compliance and minimize its impact on settlement? This engaging legal course includes in-depth discussions on mandatory insurer reporting, Medicare conditional payments, and Medicare Set-Asides. Get practical guidance in resolution of Medicaid liens and the creation and administration of special needs trusts. Don't let the MMSEA derail your injury settlements - register today!

  • Explore the latest mandatory reporting requirements and lien resolution tactics under the MMSEA.
  • Learn how to effectively communicate with the Centers for Medicare and Medicaid Services.
  • Understand how settlement award monies can jeopardize the plaintiff's SSI and Medicaid eligibility and how to address it in settlement negotiations.
  • Find new ways of encouraging plaintiff/defense cooperation in ensuring lien compliance.
  • Get seasoned attorneys' guidance on effective introduction of liens at trial.
  • Make the best use of supplemental needs trusts to structure settlements and preserve your clients' government benefits eligibility.


  1. Welcome and Program Overview
    9:00 - 9:15, Paul K. Isaac
  2. What Defines Medicare's Interest
    9:15 - 10:45, Benjamin M. Basista
    1. Brief Explanation of the Medicare Secondary Payer Act
    2. Mandatory Reporting For Insurers and Self-Insurers
      1. The SCHIPP Extension Act
      2. Penalty For Failure to Notify Medicare
    3. The Delay In Payment Arising Out Ambiguity
      1. Confusing Conditional Payment Rules with Medicare Set Aside Rules
      2. Distinguishing the Obligations
  3. When Do You Need to Consider Medicare's Future Interests?
    11:00 -12:00, Paul K. Isaac and Benjamin M. Basista
    1. Workers' Compensation Cases
    2. Liability Cases
  4. What To Do When The Defendant/Insurer Insists On An MSA?
    1:00 - 2:15, Paul K. Isaac
    1. What Are Your Options?
      1. The Medicare Manual
      2. New York State CPLR Section 5003-a
      3. Caselaw
  5. Getting Paid Faster (The Proper Methods For Interacting with CMS)
    2:30 - 3:00, Robert R. Schweers
    1. Phone, Fax, or Third Party Private Contractor?
    2. The CMS Website (www.MSPRC.info)
  6. Challenging The Conditional Payment
    3:00 - 3:30, Robert R. Schweers
  7. Appeals
    3:30 - 4:00, Robert R. Schweers
  8. Litigation Regarding Medicare Conditional Payments (Frequently Called Medicare Liens)
    4:00 - 4:30, Paul K. Isaac
    1. Merryfield v. United States, 2008 WL 906263 [D.N.J., 2008]
    2. United States v. Harrs, 2009 WL 89191 [N.D.W.Va., 2009]
    3. Big R. Towing, Inc v. Benoit, 2011 WL 43219 [W.D.La., 2011]
    4. Bradley v. Sebelius, 2010 WL 3769132 [11th Cir 2010]
    5. U.S. v. Stricker, US Dist Ct, ND Ala, CV-09-PT-2423-E, 2009
    6. Parra v. PacificCare of Arizona, Inc, US Dist Ct, D Az, CV-10-008-DCB, 2011

Seminar Summary:

This engaging legal course includes in-depth discussions on mandatory insurer reporting, Medicare conditional payments, and Medicare Set-Asides. (see full course description)

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