Training Course Syllabus:

Strategies to Simplify Medicare Set-Asides
There's no question that workers' compensation and liability Medicare set-asides create headaches for many attorneys. Nonetheless, it is imperative that attorneys know the ins and outs of MSAs, both so they can protect Medicare's interests and secure more advantageous settlements for their clients. Strategies to reduce allocation amounts, knowing how the workers' compensation review contractor reviews settlement proposals, and simply understanding the pros and cons of structured settlements vs. lump sums can all put more money in your client's pocket. Don't miss out on this valuable overview of MSAs - register today!

• Determine what Medicare's reimbursement rights are when they make a conditional payment on an outstanding medical bill.
• Effectively protect Medicare's interests, even in cases that do not meet the minimum review thresholds for a WCMSA.
• Ensure the allocation amount of a WCMSA is not too high by using strategies to reduce future prescription drug costs, future medical costs and more.
• Avoid lag time when submitting a set-aside to CMS by recognizing submission pitfalls that lead to delays.
• Calculate whether a lump sum or a structured settlement is more advantageous for funding a workers' compensation Medicare set-aside.
• Ethically handle settlement funds in a dispute.

MORNING SESSION: THIRD PARTY AND GOVERNMENT LIENS SIMPLIFIED

1. GOVERNMENT AND THIRD PARTY LIENS: BEYOND MEDICARE
   9:00 - 10:00 and 10:15 - 11:30, Paul K. Isaac and Paul Loudenslager
1. Medicaid Liens and Other Liens of the Commonwealth
2. Workers’ Compensation Liens
3. ERISA Liens
4. U.S. Medical Care Recovery Act Liens (FMCRA)
5. TRICARE Claims
6. Medicare Part D/Medicare Advantage
2. ETHICS
   11:30 - 12:30, Paul K. Isaac and Paul Loudenslager
   1. What to do When a Client Ignores Medicare’s Interests
   2. Avoiding Other Conflicts of Interest
   3. Medical Records Treatment Under HIPAA

AFTERNOON SESSION: MEDICARE ISSUES IN LIABILITY AND WORKERS’ COMP CLAIMS

3. LIABILITY MEDICARE SET-ASIDES AND CONDITIONAL PAYMENTS: A CASE EXAMPLE
   1:30 - 2:30, Paul K. Isaac and Paul Loudenslager
1. MMSEA Section 11 Mandatory Insurer Reporting Requirements
1. The SMART Act and New Reporting Requirements
2. Discretionary Fines for Noncompliance
3. Sample Reporting Cheat Sheet
4. Which Entities and Information are Required to be Reported?
5. Tips for Attorneys and Insurance Professionals
2. Handling Conditional Payments
   1. The SMART Act and New Conditional Payment Resolution Process
   2. Changes to Threshold Amounts
   3. Statute of Limitation Changes
   4. Forms, Sample Letters and Communication
   5. Calculating Amounts for Conditional Payments
3. Medicare Set-Asides
   1. The SMART Act’s Impact on LMSA’s
   2. Considerations in Determining Whether to Set up a Medicare Set-Aside to Cover Future Medical Expenses
   3. Calculating MSA Amounts
   4. Approval/Submission Process
   5. Tips for Getting a Quick Response From Medicare
   6. Structuring a Set-Aside
   7. MSA Administration: Practical Pointers
   8. Practical Tips for Working with CMS
   9. Measures to Minimize Liability and Penalties for Incomplete Submissions/Non-Compliance
4. Dealing with Medicare Set-Asides That Don’t Require CMS Pre-Approval
5. Innovative Ways to Settle a Case: Thinking Outside the Box
4. WORKERS’ COMP MEDICARE SET-ASIDES (WCMSA) AND CONDITIONAL PAYMENTS: A CASE EXAMPLE
   2:45 - 4:30, Paul K. Isaac and Paul Loudenslager
   1. MMSEA Section 111 Mandatory Insurer Reporting Requirements
1. New Reporting
2. Sample Reporting Cheat Sheet
3. Which Entities and Information are Required to be Reported?
4. Tips for Attorneys and Insurance Professionals
2. Handling Conditional Payments
1. The SMART Act and the New Conditional Payment Resolution Process
2. Thresholds
3. Timelines
4. Statute of Limitations
5. Forms, Sample Letters and Communication
6. Calculating Amounts for Conditional Payments
3. WCMSAs
1. The SMART Act’s Impact on WCMSAs
2. Considerations in Determining Whether to Set up a Medicare Set-Aside to Cover Future Medical Expenses
3. Calculating MSA Amounts
4. Approval/Submission Process
5. Tips for Getting a Quick Response From Medicare
6. Structuring a Set-Aside
7. MSA Administration: Practical Pointers
8. Practical Tips for Working with CMS
9. Measures to Minimize Liability and Penalties for Incomplete Submissions/Non-Compliance
4. Dealing with WCMSAs That Don’t Require CMS Pre-Approval
5. Innovative Ways to Settle a Case: Thinking Outside the Box

*Because the rules regarding Medicare set-asides are in a state of flux, the above agenda may not reflect the latest developments. However, faculty will present up-to-date information at the seminar.

Seminar Summary:

 (see full course description)

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