
NAMSAP is proud to feature the following line-up of industry experts for this year's conference.
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John P. Albert Senior Technical Advisor, Division of Medicare Secondary Payer Operations Office of Financial Management, CMS
CMS Fireside Chat, Wednesday, October 7, 2020, 4:15 p.m.
John
Albert has worked for the Centers for Medicare and Medicaid Services
(CMS) for 31 years, primarily on Medicare Secondary Payer (MSP) and
Coordination of Benefits & Recovery policy and opertions. Mr. Albert is currently serving as the Contracting Officer Representative for the Commercial Repayment Center (CRC) contract with Performant Financial, Inc. within the Division
Medicare Secondary Payer Operations, which is responsible for oversight of the all MSP coordination of benefits and recovery policy and operations for CMS. In addition to the CRC, other contracts overseen by the
Division include the Benefits Coordination & Recovery Center contract and the Workers Compensation Review Contract.
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Michelle Allan
Partner, Gordon & Rees
WCRC + Documentation and Evidence, Wednesday, October 7, 2020, 8:00 a.m.
Michelle A. Allan is a Partner in the Pittsburgh office of Gordon & Rees and is a member of the Medicare Compliance practice group. She focuses on Medicare issues that arise in the resolution of workers’ compensation, longshore, Jones Act, and general liability claims.
Allan has been instrumental in successfully settling tens of thousands of cases nationwide involving Medicare Secondary Payer issues. Her work includes preparing Medicare Set-Aside Arrangements and having the same approved by the Centers for Medicare and Medicaid Services. Allan makes recommendations on how best to consider and protect Medicare’s interests while also balancing her clients’ interests in claims not requiring Medicare approval. In addition, Allan negotiates Medicare conditional payments and has saved her clients millions of dollars in conditional payment reimbursements.
Allan is a recognized national presenter on Medicare Secondary Payer issues, and frequently lectures on the topic of Medicare compliance to insurance carriers, self-insured businesses, third-party administrators, law firms, and other professional organizations. She is also a 2011 inductee to The Legal Intelligencer’s prestigious class of Lawyers on the Fast Track.
While attending law school, Allan served as an extern for the United States Magistrate Judge Ila Jeanne Sensenich in the United States District Court for the Western District of Pennsylvania. Prior to attending law school, Allan worked as a journalist, reporting daily news for the Pittsburgh Tribune-Review.
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Daniel M. Anders, Esq., MSCC, CMSP-F
Chief Compliance Officer, Tower MSA Partners
Reference Guide Lesser Known Facts and Fallacies, Wednesday, October 7, 2020, 12:15 p.m.
Daniel
M. Anders, Esq., is the Chief Compliance Officer for Tower MSA Partners
where he oversees the Medicare Secondary Payer (MSP) compliance
program. In this position, Anders is responsible for ensuring the
integrity and quality of all MSP compliance services and products.
Based
upon his 14 years of experience in working with employers, insurers,
TPAs, attorneys and claimants, Anders provides education and
consultation to Tower MSA clients on all aspects of MSP compliance. He
also regularly offers expert guidance on Tower MSA’s MSP Compliance
Blog, has been featured in “Leaders Speak” on WorkCompWire and is
regularly quoted on WorkCompCentral in regard to MSP matters.
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Brian Bargender, CSRP
Internal Consultant, Humana
MAO Panel, Tuesday, October 6, 2020, 11:30 a.m.
Brian Bargender is an internal consultant with Humana, one of the country’s largest Medicare Advantage organizations. In recent years, he has helped to lead Humana’s efforts to clarify and enforce the Medicare Secondary
Payer (MSP) rules that pertain to Medicare Advantage and Medicare Prescription Drug plans. He is also responsible for monitoring trends that may impact subrogation and MSP recovery efforts, developing new cost
avoidance and payment recovery projects and advising operational leaders regarding subrogation and MSP issues.
Bargender has 16 years of experience in leading and improving health benefit subrogation and MSP operations. He holds a Certified Subrogation Recovery Professional (CSRP) designation from the National Association
of Subrogation Professionals and has served as both a co-chair of NASP’s Wisconsin chapter and a health subrogation education track leader for NASP’s annual national conference.
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Adriana Begley, MSCC Quality Manager/WCRC Litigation Contact, Capitol Bridge
WCRC + Documentation and Evidence, Wednesday, October 7, 2020, 8:00 a.m.
Adriana Begley is a Medicare Attorney serving as the Quality Manager and WCRC Litigation Contact for Capitol Bridge. She previously had experience as an MSA Analyst and Medicare Appeal Officer.
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McKenzie Bennett
Principal, Mehlman Castagnetti Rosen & Thomas
PAID Act, Tuesday, October 6, 2020, 3:00 p.m.
McKenzie Bennett is an expert health policy lobbyist with experience serving in a number of influential health policy positions on Capitol Hill. She currently serves as a principal at Mehlman Castagnetti Rosen & Thomas, a top bipartisan lobbying firm in Washington, D.C. In her current role developing and advancing health policy initiatives on Capitol Hill, McKenzie represents and advises a range of health care stakeholders. Her expertise in the specifics of health policy and her near decade-long experience working for high profile members of the United States Senate have enabled McKenzie to notch several wins on behalf of her clients. Prior joined Mehlman Castagnetti in May of 2019, McKenzie was the Senior Health Policy Advisor for Senator Maggie Hassan (D-NH), a member of both of the key Senate committees overseeing health care policy. While working with Senator Hassan, McKenzie led the planning, development, coordination and implementation of Hassan’s health policy agenda. Among her accomplishments was securing increased funding for New Hampshire to help combat the crisis. McKenzie also led Hassan’s work to address surprise medical bills, drafting legislation to protect patients from such bills and to resolve payment disputes between plans and providers. Prior to working with Hassan, McKenzie was a Health Policy Advisor to former Democratic Leader Harry Reid (D-NV), spearheading much of his health care work and coordinating the caucus strategy on health. During her time with Leader Reid, McKenzie played a critical role on high-profile health care priorities, including helping to negotiate the passage of the $1.1 billion supplemental appropriations legislation to address the Zika virus in 2016. She also represented the Democratic Leader during several high-stakes negotiations on health care legislation. McKenzie has extensive experience with the Senate budget process, including as part of a key group of Leadership and Committee staffers arguing before the Senate Parliamentarian during the budget reconciliation process related to the Affordable Care Act in 2015. She was also involved in the passage of several major pieces of health care legislation. McKenzie began her career on the Hill with Senator Sherrod Brown (D-OH), where she conducted research on health care issues, and then moved to the office of Senator Jim Webb (D-VA).
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Amy Bilton, Esq., MSCC, CMSP-F
Shareholder, Nyhan Bambrick Kinzie & Lowry
WCRC + Documentation and Evidence, Wednesday, October 7, 2020, 8:00 a.m.
Amy
E. Bilton, Esq. is a shareholder and workers’ compensation defense
trial attorney at the Chicago law firm of Nyhan, Bambrick, Kinzie &
Lowry. She received her BA from the University of Michigan, JD from
DePaul University College of Law and has her MSCC certification. Ms.
Bilton is a frequent lecturer on workers’ compensation, Medicare
Secondary Payer issues and Medicare Set-Asides. In addition to being a
NAMSAP member and legal committee chair, she is a member of the Chicago
Bar Association, Illinois State Bar Association and Illinois Workers’
Compensation Lawyers Association. She has specific interest in bringing
evidence-based medicine to MSAs.
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Jim Brady Program Director, BCRC
CRC and BCRC - Interplay and Differences, Tuesday, October 6, 2020, 1:30 p.m.
Jim Brady has 30 years of Medicare experience. He is currently the Program Director for the Benefits Coordination and Recovery Center (BCRC) with overall responsibility for all functions under that contract. Brady
has led the BCRC since the inception of the program.
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John V. Cattie, Jr.
Founding Member, Cattie, PLLC
Spotlight on Asbestos Claims, Tuesday, October 6, 2020, 4:00 p.m.
John
V. Cattie, Jr. is one of the nation’s most well-respected MSP legal
scholars. Cattie received his BA from the University of North Carolina
and his JD/MBA from Villanova University.
Cattie
has personally reviewed or overseen the review of over 10,000 distinct
fact patterns. Federal and state court opinions such as Smith v. Marine Terminals of Arkansas, Tye v. Upper Valley Medical Center, and Doe v. Company X cite
his analysis favorably. In each case, his client’s future medical
exposure was minimized or extinguished based on how Cattie analyzed the
MSA issue. In the Doe case, that difference amounted to a 90% or almost $900,000 reduction in future medical exposure for his client. The Doe Court
stated the following in its opinion: “The Court finds that Mr. Cattie’s
analysis is more credible [than his opponent’s] in the liability
context.”
Cattie
is the Founding Member of Cattie, P.L.L.C. His law firm is dedicated to
extinguishing a client’s future medical exposure under the MSP Act. He
focuses his law practice on MSA issues, providing legal opinions
regarding MSA requirements, a client’s future medical exposure under the
MSP Act and proper MSA funding.
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Lavonya Chapman Medicare Secondary Payer Compliance Counsel, Optum Settlement Solutions
ETHICS: What MSP Professionals Need to Know, Wednesday, October 7, 2020, 1:15 p.m.
As
Medicare Secondary Payer Compliance Counsel at Optum Settlement
Solutions, Lavonya Chapman is a consultant on Medicare Secondary Payer
(MSP) claim compliance issues, including Mandatory Insurer Reporting,
ICD injury code reporting, Conditional Payment Resolution, Medicare
Set-Aside Allocations, CMS approval and professional administration.
Prior
to joining Optum in 2014, Chapman served as director of MSP compliance
for Arthur J. Gallagher & Company for 14 years. She was also the
claim director for a new liability captive in which nearly all the
claimants/plaintiffs were Medicare beneficiaries or dual eligible.
Additionally, Chapman has experience in private law practice, litigating
medical malpractice, premises and auto liability claims as well as
workers compensation cases. She taught pharmacology many years at the
University of Alabama at Birmingham, and was a utilization review and
HIPAA consultant for the Alabama Hospital Association.
Chapman
presents on all aspects of the Medicare Secondary Payer Act as it
pertains to claim compliance involving all type of claims. She is a
licensed registered nurse, an attorney licensed in both Alabama and
Florida, and a certified Medicare Secondary Payer Professional
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Jacqueline Cipa Medicare Secondary Payer Operations Team Lead, Division of Medicare Secondary Payer Operations, CMS
CMS Fireside Chat, Wednesday, October 7, 2020, 4:15 p.m.
Jacqueline "Jackie" Cipa started her career with CMS in 2010 after graduating with her Master of Public Health from the University of Pittsburgh. The majority of her time at CMS has been spent in the Office of Financial Management working
with Medicare Secondary Payer (MSP) in multiple capacities. Cipa has both breadth and depth of experience, having been or currently performing as a project lead and a subject matter expert across several diverse areas, among other
roles. She has led the development and execution of several new procurements, implemented quality improvement projects, and mentors newer staff. In 2015, Cipa became the MSP Operations Team Lead. The team she leads oversees the operations
of the Benefits Coordination and Recovery Center (BCRC) and the Commercial Repayment Center (CRC).
Cipa was originally a chemist from Pittsburgh, PA. She lives with her husband and daughter on several acres of land along with their cats and chickens and yes, she was once a Jeopardy! champion.
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| Claire Covington, MSCC, CMSP-F, Certified Adjuster, SIP Medicare Set Aside Consultant, Travelers
Allocating 101, Tuesday, October 6, 2020, 3:00 p.m.
Claire Covington has served as a Medicare Set Aside Consultant for Travelers since 2007 after over five years as a WC Claim Adjuster. In her current role in the Workers Compensation Major Case Unit, she creates Workers Compensation Medicare Set Aside (WCMSA) reports, CMS submissions, and assists with settlement document language related to Medicare and WCMSAs. She also works with conditional payment issues and Section 111 data integrity. She serves as a subject matter expert for internal Travelers employees in those areas and provides training to adjusters and staff counsel on WCMSAs, conditional payments, and section 111 data integrity as needed. Prior to joining Travelers, she also worked in group claims for medical, dental, life insurance, long term and short term disability as a claims person, auditor, and trainer. |  | Patrick Czuprynski, JD, MSCC Director of Lien Resolution, NuQuest
Case Law Update, Wednesday, October 7, 2020, 9:00 a.m.
Patrick Czuprynski is
NuQuest’s Director of Lien Resolution. In addition to leading the lien
resolution team, he represents debtors in conditional payment
administrative appeals and negotiations through the Medicare Appeal
Council and provides consulting services for settlements and Section 111
inquiries. MCzuprynski presents webinars on Medicare secondary payer
compliance on behalf of NuQuest. He has also been published in the
Illinois State Bar Association Workers’ Compensation Newsletter, the
ISIA Newsletter, The National Alliance of Medicare Set-Aside
Professionals publication, Workers’ Compensation Law, and the Maryland
State Bar Association publication. An attorney, licensed in Illinois, Czuprynski is a member of the National Alliance of Medicare
Set-Aside Professionals, serving on the Legal Round Table, Policy and
Legislation and Liability MSP Advisory committees. He holds a
J.D. from Valparaiso University Law School, and a B.B.A from University
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Annie M. Davidson, Esq.
Senior MSP Compliance Counsel and Policy Strategist, ExamWorks Compliance Solutions
Hot Topics: Civil Monetary Penalties & LMSA, Tuesday, October 6, 2020, 9:00 a.m.
Annie M. Davidson is the Senior MSP Compliance Counsel and Policy Strategist for ExamWorks Compliance Solutions.
Davidson has comprehensive experience in the areas of Medicare Secondary Payer (MSP) Act compliance and Medicaid recovery in liability, no-fault, and workers’ compensation matters. Davidson provides high-quality legal analysis to ensure the integrity and quality of ExamWorks Clinical Solutions’ Medicare Secondary Payer compliance services and related products. Additionally, she is a nationally recognized expert on MSP issues who presents regularly at local and national conferences.
Davidson is admitted to practice law in the State of Minnesota and the United States District Court for Minnesota. Prior to her work with ExamWorks Clinical Solutions, she practiced as an insurance defense litigator with a Minneapolis law firm. In that position, Davidson gained significant experience handling workers’ compensation, liability, and no-fault cases and coordinated the firm’s policies for handling Medicare requirements.
She is co-chair of the Policy and Legislative Committee of the National Alliance of Medicare Set-Aside Professionals. Davidson graduated cum laude from William Mitchell College of Law and received her Bachelor of Arts degree from the University of Minnesota, Twin Cities. In her free time, Davidson serves on the board of a comprehensive non-profit mental health and human services organization, and practices meditation and Pilates.
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Shawn Deane, JD, CMSP-F General Counsel, Ametros
Prescription Drugs in Professional Administration, Tuesday, October 6, 2020, 4:00 p.m.
Shawn Deane is General Counsel and leads our legal team at Ametros. He has over a decade of experience practicing law and in Medicare Secondary Payer (MSP) compliance as an industry thought leader. He was previously Vice President
of Medicare Compliance & Policy at ISO Claims Partners. Prior to that he practiced insurance defense litigation and healthcare law.
He has been heavily involved with the National Alliance of Medicare Set Aside Professionals (NAMSAP), having served as chair of the webinar and education committees, on the Board of Directors, and was past President in 2017. He
was also former executive committee member with the Medicare Advocacy Recovery Coalition (MARC). Deane is faculty for the Certified Medicare Secondary Payer Professional Program (CMSP).
Deane is a member of the Massachusetts Bar and is licensed in both state and federal courts in Massachusetts. His law degree is from the Massachusetts School of Law. He also holds a master’s in education from Cambridge College
and undergraduate degree from Berklee College of Music. He resides north of Boston with his family and strives to live by the following: “Be Kind. Do Right. Serve Others. Work Hard. Have Fun.”
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Ted Doyle, MA, AHFI, DFE, CIFI Vice President, Healthcare Markets, Performant Financial Corporation
CRC and BCRC - Interplay and Differences, Tuesday, October 6, 2020, 1:30 p.m.
Ted
Doyle is a senior leader in healthcare administration and payment
integrity for both the private and public healthcare sectors with over
30-years related experience. His background includes the Centers for
Medicare and Medicaid Services (CMS) with over 12 years in a variety of
senior leadership positions, predominately in policy administration,
financial systems and payment integrity. Doyle’s background also
includes the responsibility of managing both the Los Angeles and Miami
field investigative offices, as well as working directly with CMS
partners, law enforcement agencies, and stakeholders to prevent
healthcare fraud and ensure payment integrity. He has developed
innovative and leading-edge analytics that significantly reduce
healthcare administrative costs through the enhanced detection of
fraudulent, wasteful, and abusive claims.
Doyle has worked diligently
towards the expansion of domestic and international market strategies
for payment integrity services and solutions. Doyle is an Accredited
Health Care Fraud Investigator (AHFI), Certified Fraud Examiner (CFE),
Licensed Private Investigator, Certified Insurance Fraud Investigator
(CIFI), and experienced project manager.
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David Farber
Partner, FDA and Life Sciences, King & Spalding
SMART Act - Where are we now?, Tuesday, October 6, 2020, 10:30 a.m.
David Farber specializes in litigation, regulatory matters, and public policy, with a focus on healthcare, Mediare and Medicaid issues for pharmaceutical and medical device companies, hospitals and pharmacies. A member of King & Spalding's FDA, Life Sciences, and Healthcare, and Government Advocacy practices, Farber represents clients in healthcare litigation, False Claims Act cases and other commercial disputes, as well as in advocacy before Congress and federal agencies on coverage, coding, reimbursement and other issues. He is a recognized national expert on Medicare Secondary Payer issues.
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Steve Forry Director of Division of Medicare Secondary Payer Program Operations, CMS
CMS Fireside Chat, Wednesday, October 7, 2020, 4:15 p.m.
Steve Forry has served as the Division Director for MSP Operations at CMS since 2011. Prior to his tenure at CMS, FOrry was a Software Project Manager at ViPS and a Computer Specialist at the Social Security Administration.
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Rasa Fumagalli, JD, MSCC, CMSP-F Director of MSP Compliance Services, Synergy Settlement Services
Amended & Re-Review, Wednesday, October 7, 2020, 11:15 a.m.
Rasa Fumagalli, JD, MSCC, CMSP-F is an Illinois-licensed attorney and
the Director of MSP Compliance Services for Synergy Settlement
Services. Prior to joining Synergy Settlement Services, Fumagalli worked
as a workers’ compensation insurance defense attorney in the Chicago
area. She has spent the last ten years focusing her practice on Medicare
Secondary Payer compliance issues. As the former Director and VP of MSP
Compliance for a national vendor, she has extensive experience in
working with parties to effectuate settlements while addressing
Medicare’s interests in a reasonable manner. her knowledge, experience
and passion for navigating the intricacies of the Medicare Secondary
Payer Act, supporting regulations and CMS allow her to provide valuable
and pragmatic guidance in all stages of settlement discussions. Fumagalli
has been an active member of the National Alliance for Medicare
Set-Aside Professionals (NAMSAP) organization since 2009. She is the
current co-chair of the Communications Committee and a former co-chair
of the Liability Committee.
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Jeanie Goldstein Senior MSP Compliance Counsel, MEDVAL
Amended & Re-Review, Wednesday, October 7, 2020, 11:15 a.m.
Jean Goldstein is the Senior MSP Compliance Counsel for MEDVAL. She is a licensed attorney admitted to practice in the State of Maryland, with over fifteen years of diverse legal experience in Medicare Secondary Payer compliance, class
action litigation, estate planning, elder law, and administrative proceedings.
With a keen understanding of Medicare Secondary Payer compliance, Goldstein is often consulted to offer insight, direction, and training to insurance carriers, self-insured entities, third-party administrators, and law firms.
Her focus is on Medicare issues involving liability, no-fault, and workers’ compensation claims and finding settlement solutions in the best interest of all parties. Goldstein is also a nationally recognized blogger and author
on Medicare Secondary Payer compliance and claims management.
Prior to joining MEDVAL, Goldstein worked in the public sector, at the Maryland Office of the Attorney General. She received a Bachelor of Arts from Goucher College and her Juris Doctor Degree from the University of Baltimore School
of Law. Goldstein is an active member of NAMSAP’s Policy and Legislative Committee and the Liability MSP Advisory Committee.
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Rafael Gonzalez, Esq. Partner, Cattie and Gonzalez, PLLC
CRC and BCRC - Interplay and Differences, Tuesday, October 6, 2020, 1:30 p.m.
As President of Settlement Solutions, Rafael Gonzalez is responsible for all aspects of Medicare and Medicaid compliance issues, including Mandatory Insurer Reporting, Conditional Payment Resolution, Medicare Set Asides, MSA Post Settlement
Administration, Third Party Lien Reimbursement and Special Needs Trusts Administration.
Gonzalez has over 35 years of experience in the auto, liability, no-fault and workers’ compensation insurance industries. He has written extensively on liability, workers’ compensation, social security and Medicare/Medicaid
issues and has taught these subjects at several law schools and medical schools in Florida. He continues to lecture throughout the country on these topics.
Gonzalez has been actively engaged in legislative matters concerning workers’ compensation, social security and Medicare/Medicaid at both the state and federal levels. He has attended hearings, testified before legislative
committees and executive commissions, and served as a consultant to legislative and congressional staff. He received the Presidential National Service Award from President George W. Bush for his work on improving the Medicare Secondary
Payer system and again by President Barack Obama for his work and support of the Affordable Care Act.
Gonzalez earned his Bachelor of Science from The University of Florida and his Jurisprudence Doctorate from Florida State University. He contributes regularly to a series on workers’ compensation, social security and disability
and Medicare Set-Asides.
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 | Nicole Griffin CRC Director, MSP Recoveries, Performant Corp
CRC and BCRC - Interplay and Differences, Tuesday, October 6, 2020, 1:30 p.m.
Nicole Griffin is the CRC Director, MSP Recoveries at Performant Corp. She has previously served as Manager of Healthcare Billing & Recovery Operations. In 2018, she received her certificate in Project Management Essentials from the Management and Strategy Institute.
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Holly Havens WCRC Project Director, Capitol Bridge
WCRC + Documentation and Evidence, Wednesday, October 7, 2020, 8:00 a.m.
Holly Havens has served as WCRC Project Director at Capitol Bridge for nearly three years. He was previously an Attorney Manager at Maximus Federal Services, Capitol Bridge's business partner.
|  | Beth Hostetler, RN, BSN Director of Medicare Services, Corporate Risk Management, Albertsons Companies
MSP Wishlist, Wednesday, October 7, 2020, 3:45 p.m.
Beth Hostetler is a
nurse with over twenty five years experience in the field of disability
management and cost containment services in Workers Compensation. She
has a Bachelor of Science in Nursing from Case Western Reserve
University. She has been a certified Life Care Planner and is currently a
Certified Medicare Set- Aside Allocator, and Certified Medicare
Secondary Payer Professional. Her experience includes nearly fifteen
years as Branch Manager in the Healthcare Division of Crawford &
Company as well as several years as owner of her own company which
provided case management, life care planning and Medicare set-aside
services. Presently, she is the Director of Medicare Services in the
Corporate Risk Management Department of Albertson’s Companies which is
one of the largest food and drug retailers in North America. She has
developed Albertson’s internal MSP Compliance program for Workers
Compensation which includes policy and procedure for MMSEA Section 111
reporting, Conditional payment identification and resolution and the MSA
program. She routinely provides internal training on Medicare Secondary
Payer compliance and all aspects of the MSA process. |  | Kathleen Hunter BCRC Director of Correspondence Processing, Group Health, Inc.
CRC and BCRC - Interplay and Differences, Tuesday, October 6, 2020, 1:30 p.m. Kathleen (Keenie) Hunter has
over 17 years of Medicare Secondary Payer experience. She began her
Medicare career as an MSP examiner with Empire Medicare in Syracuse, NY
and later became the Supervisor of the NGHP Recovery staff
at Empire. When the MSPRC was launched in 2006, Hunter became the
Manager of the GHI Syracuse staff and went on to serve as the MSPRC
Policy Specialist. In 2013, she was made the Director of Correspondence Processing for the BCRC where she currently serves today. |
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John Jenkins, MSHS, MSHA Health Insurance Specialist, CMS
CMS Fireside Chat, Wednesday, October 7, 2020, 4:15 p.m. Over the last twenty years, John Jenkins has covered nearly every aspect of medical management, from direct patient care to combat hospitals. He has put the combined training and education from formal venues as well as performance into practice in the furtherance of his career. Now, he is using that knowledge to pass on to the next generation of medical personnel as an instructor. For many years, he provided emergency care for those in urgent need. Now, that experience coupled with formal education in the areas of healthcare administration and emergency management is available to help others. |
 | Renee Jones BCRC CFW Manager, Group Health, Inc.
CRC and BCRC - Interplay and Differences, Tuesday, October 6, 2020, 1:30 p.m.
Renee Jones has
17 years of MSP experience, beginning as a Call Center Advocate in 2002
for the Coordination of Benefits Contractor (COBC). She was hired as an
Analyst for the CWF Auditing department that is responsible for the
processing of ECRS Assistance Requests from various Medicare Contractors
to ensure the appropriate MSP status of files in the Common Working
File. Renee was promoted as the Senior Business Analyst for the CWF
Auditing department in 2013, when GHI was awarded the Benefits
Coordination and Recovery Center (BCRC) contract. She also serves as the
CWF department's Subject Matter Expert, Trainer and Project Lead for
all various CWF related work types and projects, including Phase 4 of
the System Consolidation project for the Benefits Coordination and
Recovery System (BCRS). Jones was promoted in 2017 to BCRC CWF Manager. |
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Jennifer Jordan, JD, CMSP-Fellow, Counsel, LASIE
Counsel, LASIE
Due Process in MSP, Wednesday, October 7, 2020, 2:15 p.m.
Jennifer
Jordan is a nationally recognized expert on the subject of Medicare
Secondary Payer (MSP) compliance. Formerly Chief Legal Counsel and
co-founder of MEDVAL, she currently serves at counsel for the Louisiana
Association of Self-Insured Employers (LASIE). For nearly 20 years, Ms. Jordan has regularly spoken at industry and educational events nationally, authored articles for both industry publications and legal resources, been designated as an
expert witness in MSP litigation and been cited in judicial opinions.
In
conjunction with extensive structured settlement experience, Ms. Jordan
is focused on finding settlement solutions and resolving claims with
the best interest of all parties, not just Medicare, in mind. Ms. Jordan
is Editor-in-Chief of The Complete Guide to Medicare Secondary Payer
Compliance, published annually by LexisNexis since 2010, and is the
recipient of a 2010 Workers’ Compensation Notable Person Award and Top
25 Workers’ Compensation Blog Awards from 2009 through 2014 from
LexisNexis.
She
currently serves on the board of a number of organizations such as the
Larson’s National Workers’ Comp Advisory Board, WorkCompCentral, Comp
Laude Advisory Board, Friends Research Institute, and the Medicare
Secondary Payer Charitable Foundation. She was named to the
WorkCompCentral President’s Honor Roll in 2015 for her contributions to
the industry and received a Best Blogs award in 2016 and 2017 from
WorkersCompensation.com.
Ms.
Jordan received her J.D. from the University of Baltimore, School of
Law where she was a member of the Law Review and Editor-in-Chief of the
University of Baltimore Intellectual Property Law Journal. She received
her MBA from the University of Baltimore, Robert G. Merrick School of
Business and B.A.s in Economics and Fine Arts from Virginia Tech.
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John Kane, AIC, MSCC, CMSP-F Medicare Program Director, Liberty Mutual Insurance
MSP Wishlist, Wednesday, October 7, 2020, 3:45 p.m.
John Kane serves as the Medicare Program Director for the Liberty Mutual Insurance. As a twenty-eight year employee with Liberty Mutual John has served in a variety of claim positions including Liability and Workers’
Compensation including Regional Claims Manager for Integrated Disability Management and Loss Portfolio Risk Manager. He has been actively engaged in MSP compliance over the last fifteen years.
He developed Liberty Mutual Centralized Medicare Department and is responsible for Vendor Management, Quality Assurance, MSP Compliance and a liaison to Public Affairs to advocate for Medicare reform.
Kane is an active member of the Medicare Advocacy Recovery Coalition (MARC) and former member of the Property Casualty Insurer Medicare Task Force Committee. He serves on the National Alliance of Medicare Set Aside Professionals
Board of Directors and participates in panel discussions at the annual conferences. John is an instructor for the Certified Medicare Set-aside Professional & Fellow program educating attorneys, nurses, risk managers and case
managers on Medicare Secondary Payer (MSP) compliance.
Prior to Liberty Mutual, Kane worked in the financial sector as a financial planner with a degree in Business Management. He has an Associate in Claims (AIC), Medicare Set-Aside Consultant Certified (MSCC) and Certified
MSP Professional (CMSP) & Fellow designations.
Kane volunteers as a Liberty Leader in the local community that focuses on affordable housing and transition to work. He is also involved with volunteer work with young adults with disabilities to create inclusive social and recreational
opportunities.
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Ciara F. Koba, Esq. Partner, Gordon & Rees
NAMSAP President / Conference Emcee; HOT Topics - Civil Monetary Penalties & LMSA - Monday, October 6, 2020, 9:00 a.m.; CMS Fireside Chat - Tuesday, October 7, 2020, 4:45 p.m.
Ciara F. Koba is a Partner in the Pittsburgh office of Gordon & Rees and is a member of the Medicare Compliance Group. Koba is an attorney and licensed registered nurse with significant general and surgical nursing experience and
she brings a unique understanding of the healthcare industry to the resolution of Medicare issues. She focuses her practice on Medicare Secondary Payer Compliance issues that arise in the resolution of workers’ compensation,
longshore, Jones Act, Federal Employers Liability Act and general liability claims and she has been instrumental in settling tens of thousands of cases nationwide involving Medicare issues. Her work includes MMSEA Section
111 Mandatory Insurer Reporting, Medicare Compliance Audits, Medicare Conditional Payment resolution, and the preparation of Medicare Set-Aside Allocations.
Koba is a recognized national presenter on Medicare Secondary Payer compliance topics and frequently lectures to insurance carriers, self-insured businesses, third-party administrators, law firms and professional industry organizations.
She graduated from Duquesne University School of Law, cum laude, in 2011. While there, she founded the university’s first Health Law Society and served as its president. Koba received a Bachelor of Science in Nursing
from Duquesne University in 2006.
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Nathan Krahn Associate General Counsel, Optum
MAO Panel, Tuesday, October 6, 2020, 11:30 a.m.
Nathan Krahn is the Associate General Counsel at Optum, providing general counsel support and enterprise risk management for multiple Optum business segments inlcuding Behavioral Health, Physical Health, OptumRX, Subrogation Services, and the Sanctions group (FW&A). He has coordinated and managed high visibility, nationwide litigation and risk management efforts for health plans and served as subject matter expert across UnitedHealthGroup. Krahn has a broad and deep understanding of the challenges facing dynamic, highly regulated industries across the legal, business and compliance landscape.
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Chris Lagnese Vice President of Pharmacy and Managed Care, Ametros
Prescription Drugs in Professional Administration, Tuesday, October 6, 2020, 4:00 p.m.
Chris Lagnese began his career as a pharmacist, and has had over 25 years of of experience working with drug store chains and various pharmacy benefit management organizations. He now works on improving pharmacy and medical care
programs for our members.
Lagnese graduated from Ohio State University, and resides in South Carolina. His two sons have become a medical doctor and engineer. He enjoys gardening, playing the guitar, and kayaking...just not all at the same time.
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Brian MacAllister, AIC, MSCC, CMSP-F Director, Conditional Payment, Liberty Mutual Insurance
Due Process in MSP, Wednesday, October 7, 2020, 2:15 p.m.
During his sixteen years with Liberty Mutual, MacAllister has held roles in both Liability and Workers' Compensation, with expertise in complex high exposure claims. He was previously a Complex Technical Claims Specialist and Manager
of a Critical Strategies Unit. Currently, MacAllister is responsible for Conditional Payment Compliance, providing settlement consultation, and developing training. He has a degree in Criminal Justice from Northeastern
University, Associate in Claims (AIC), Medicare-Set-Aside Consultant Certified (MSCC), Certified Medicare Secondary Payer Professional Fellow Designation (CMSP-F), and is an active member of NAMSAP.
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 | Luz Maldonado CRC Recovery Specialist, Performant Corp.
CRC and BCRC - Interplay and Differences, Tuesday, October 6, 2020, 1:30 p.m. Luz Maldonado serves as the CRC Recovery Sepcialist at Performant Corpt. She has held this position for over two years and previousl served as a Recovery Specialist and Medical Biller/Coder.
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Christine Melancon, RN, CMSP-F Director of Regulatory Compliance, CLARA Analytics
Amended & Re-Review, Wednesday, October 7, 2020, 11:15 a.m.
Christine Melancon currently serves as the Director of Regulatory Compliance at CLARA analytics, the leading provider of artificial intelligence (AI) technology in the commercial insurance industry. Previously, Melancon served as an
Operations Strategist for Cobalt Compliance Partners, LLC and was the Founder and Vice President of Operations at EZ-MSA.
In the past, Melancon has served as Co-Chair of NAMSAP’s Education Committee and as a Board Member and Officer of the assocation. She enjoys educating others who desire to learn more about Medicare Secondary Payer Compliance issues
and is a frequent speaker at various events, as well as an instruction for the Louisiana Association of Self-Insured Employers’ (LASIE) Certified Medicare Secondary Payer Professional Fellow (CMSP-F) Program.
Melancon is a graduate of Charity Hospital School of Nursing and the University of New Orleans. She has successfully transferred many years of clinical experience into a successful career in the Medicare Secondary Payer Compliance.
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Shannon Metcalf Partner, Hedrick Gardner Kincheloe & Garofalo, LLP
Demonstration of Responsibility, Tuesday, October 6, 2020, 5:00 p.m.
Shannon Metcalf is a partner in the firm’s Charlotte office and represents a
variety of carriers and employers, from small businesses to large
Fortune 500 companies, in the defense of workers’ compensation claims.
Her clients include reputable retail and insurance companies, as well as
professional sports teams throughout the country. As a Medicare
Set-Aside Certified Consultant (MSCC), her practice also focuses heavily
on Medicare Secondary Payer Act compliance. Metcalf is an active
member of the North Carolina State Bar, North Carolina Bar Association,
North Carolina Association of Defense Attorneys, Mecklenburg County Bar
Association, Defense Research Institute, and the National Alliance of
Medicare Set-Aside Professionals. Metcalf is AV peer-rated by Martindale-Hubbell and was selected to North Carolina’s 2010 Rising Stars list in Workers’ Compensation, published nationwide in Super Lawyers Magazines®.
She was also listed as one of Business Leader’s 2011 Movers &
Shakers. Additionally, she was recognized in the 2014 listing in The
Bar Register of Preeminent Women Lawyers. |
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Steven J. Miller, CMSP-F, MSPharm, DPh, RPh CEO, PharmacyMSA.com
Prescription Drugs in Professional Administration, Tuesday, October 6, 2020, 4:00 p.m.
Steven J. Miller, C.M.S.P.-F, MSPharm, D.Ph., R.Ph, is the CEO of PharmacyMSA.com, a provider of a pharmacy benefit services for MSA specialists throughout the United States, including drug utilization reviews, pharmacy benefit administration,
and medication therapy management for geriatric patients and injured worker., Dr. Miller is active in development of cost containment programs for MSA proposals, pharmacy formulary review and analysis, provider interventions,
and managed care pharmaceutical reimbursement programs. He is a clinical pharmacist with many years’ experience in managed care workers compensation, commercial, Medicare, and Medicaid pharmacy benefit consulting. He
is also a part-time dispensing pharmacist with Walgreens.
Miller has served in several capacities with many types of managed care organizations and has made numerous regional, national, and international presentations on pharmaceutical care and cost-effectiveness, including medication
issues for the elderly, cost-effective drug therapies, and pharmaceutical benefit management. He currently serves on the board of directors of the National Alliance of Medical Set Aside Professionals (NAMSAP), service a three
year term. He also serves on several pharmaceutical manufacturers’ advisory boards, and on the editorial advisory board of ODG/ODG Treatment publications for the Work Loss Data Institute. He graduated with his B.S. in pharmacy
from the University of Iowa and his M.S. in Pharmacy Practice from the University of Maryland.
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 | Jennifer Mislanovich, JD Division Manager, Attorney, Medval
Amended & Re-Review, Wednesday, October 7, 2020, 11:15 a.m.
As a Division Manager at MEDVAL, Jennifer Mislanovich oversees accounts in multiple jurisdictions throughout the U.S. Prior to joining MEDVAL in 2012, Mislanovich worked with a Pittsburgh-based law firm and focused her practice on Medicare Secondary Payer Act compliance. She began her career at MEDVAL as an MSA Analyst in 2012 and was promoted to Team Lead MSA Analyst in October 2014. In October 2016, She was promoted to Division Manager and currently oversees MEDVAL’s Eastern Region allocation team, but she also consults on various complex claims and matters throughout the country. Mislanovich is a graduate of Duquesne University with a Bachelor of Science in Economics. She is also a graduate of the University of Pittsburgh School of Law and is admitted to practice law in Pennsylvania. |  | Suzanne Novak, MD, PhD President, Austin Outcomes Research
MSP Wishlist, Wednesday, October 7, 2020, 3:45 p.m. Suzanne Novak, MD, PhD is a board certified anesthesiologist. Her PhD is in Pharmacy Administration, with a specialty in pharmacoeconomics and outcomes research from the University of Texas at Austin. She is president of Austin Outcomes Research, Inc., a healthcare consulting and utilization review firm with multiple national carriers and legal firms as clients. She is the lead author of the Pain Chapter of the ODG Treatment Guidelines. Dr. Novak is also a clinical assistant professor at the College of Pharmacy at the University of Texas at Austin where she is active in the Pharmacy Practice Division. |  | Angel Pagan BCRC EDI Director, Technical Lead, Group Health, Inc.
CRC and BCRC - Interplay and Differences, Tuesday, October 6, 2020, 1:30 p.m.
Angel Pagan has
18 years of Medicare experience. He began his career with the
Coordination of Benefits Contractor (COBC) in 2001 and then with the
Medicare Secondary Payer Recovery Contractor (MSPRC) in 2006. Angel
was the MSPRC supervisor for several years before taking the position of
MSPRC Quality Assurance Officer in 2011. In 2013, GHI was awarded the
BCRC contract and Angel served as its MSP Policy Specialist from 2013 to
2018 overseeing the BCRC’s Change Management and Training departments. Angel is currently the BCRC EDI Director and technical lead for the MMSEA Section 111 reporting process. |
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Jennifer Pickard
Senior Director Risk Management, Walmart Stores
PAID Act, Tuesday, October 6, 2020, 3:00 p.m.
Jennifer Pickard is the Senior Director Risk Management for Walmart Stores, Inc. She has served in this position since 2005, leading cross-functional teams to implement organizational strategies to drive performance. She analyzes accident trend and industry data to develop and implement business strategies to eliminate or mitigate risks. Pickard has worked with Walmart in Risk Management since 2006 and in workers comp claims since 1999.
Pickard received her BA in business administration from American Public University.
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Mark Popolizio
Vice President, MSP Compliance and Policy, ISO Claims Partners
SMART Act - Where are we now?, Tuesday, October 6, 2020, 10:30 a.m.
Due Process in MSP, Wednesday, October 7, 2020, 2:15 p.m.
Mark Popolizio is the Vice President of MSP Compliance and Policy for ISO Claims Partners. He is a nationally recognized authority in Medicare Secondary Payer (MSP) compliance and has practiced insurance defense litigation for ten
years concentrating in the areas of workers’ compensation and general liability.
Since 2006, Popolizio has dedicated his practice exclusively to MSP compliance working with carriers, self-insureds, TPAs and other claims professionals in addressing MSP compliance issues. He is a regularly featured presenter on MSP
issues at national seminars and other industry events – and has authored numerous national articles addressing several topics related to MSP matters, including a chapter in the California Bar CLE publication, Special Needs Trusts:
Planning, Drafting and Administration. He is also active with other industry groups, including MARC, DRI and NAMSAP.
Popolizio graduated Summa Cum Laude from Quinnipiac University in Hamden, Connecticut with Bachelor of Science degrees in Legal Studies and Sociology. He relocated to South Florida in 1992 to attend law school at Nova Southeastern
University School of Law in Ft. Lauderdale, Florida. While at law school, Popolizio served as a Judicial Clerk to the late Honorable John D. Wessel (15th Judicial Circuit, Palm Beach County, Florida) and was a research assistant
for Professor Leslie Larkin Cooney. He graduated from Nova in 1995 and is licensed to practice law in Florida and Connecticut.
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 | Fran Provenzano, RN, BSN, CDMS, CCM, CLCP, MSCC President, MSA Specialists, Inc.
MSP Wishlist, Wednesday, October 7, 2020, 3:45 p.m. Fran Provenzano, BSN, is the President and CEO of Medicare Set-Aside (MSA), Specialists, Inc. She formed the company in 2002 and it has flourished under her guidance. MSA Specialists has been accepted as a national provider of MSAs by several major insurance carriers as well as some of the top Third Party Administrators. Provenzano is a highly sought speaker on MSAs. She has addressed the National Conferences of Legal Nurse Consultants, several national education seminars on MSA instruction and many evaluation criteria/education sessions for Claims Adjusters. She earned her RN license and BSN Degree. Within the hospital setting, she has served in virtually all phases of the nursing field from the operating theater, through patient education, Lamaze Instruction and discharge planning. In the late 1980s, Provenzano directed her talents toward Disability Management, obtaining her Certified Disabilities Management Specialists (CDMS). She was among the first nurses to obtain Certified Case Manager (CCM) Certification followed shortly thereafter by her Life Care Planning Certification (CLCP). Most recently, she once again was among the first in the nation to earn the Medicare Set-Aside Consultant-Certified (MSCC) designation. |
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Kevin Puckett President/Owner, KP Underwriting, LLC
Rated Age, Tuesday, October 6, 2020, 5:00 p.m.
Kevin Puckett is President and Owner of
KP Underwriting, LLC, an independent underwriting company that provides
rated ages and decreased life expectancies for Life companies and
Medicare Set-Asides. He has over 20 years of medical underwriting
experience with multiple life companies. Puckett has his BBA in Business
Administration and Biology from Eastern Kentucky University, an
Associates designation from the Academy of Life Underwriting and his
FLMI (Fellow, Life Management Institute).
He began his career with AEGON as a life insurance
underwriter, but later moving into Structured Settlement and Rated Age
underwriting. After 10 years with AEGON, Puckett was recruited by John
Hancock to start their rated age program. After building the John
Hancock program, he ventured out and started KP Underwriting, LLC. With
KP Underwriting, Puckett has performed underwriting services for
multiple life companies, including, writing underwriting manuals,
auditing underwriting departments as well as performing expert witness
testimony on life expectancy in multiple states.
Currently, Puckett and KP Underwriting, perform rated age
services for a majority of the companies in the Medicare Set-Aside
market.
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Robert Sagrillo President, National Accounts and Settlements Consulting, NuQuest
Hot Topics: Civil Monetary Penalties & LMSA, Tuesday, October 6, 2020, 9:00 a.m.
Robert Sagrillo is a highly respected professional in the Medicare
Set-Aside arena and was one of the first Medicare Set-Aside advisors in
the country. He is a recognized authority on a wide-range of subjects
including estate planning and probate procedures, frequently lecturing
before local, regional and national professional and legal organizations
and authoring many publications on these issues.
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Heather S. Sanderson, Esq., MSCC, CHPE, CLMP, CMSP
Chief Legal Officer, Franco Signor, LLC
SMART Act - Where are we now?, Tuesday, October 6, 2020, 10:30 a.m.
PAID Act, Tuesday, October 6, 2020, 3:00 p.m.
Heather Schwartz Sanderson is Chief Legal Officer for Franco Signor LLC, the nation's
compliance authority for Medicare Secondary Payer (MSP) matters. She has
lectured on MSP compliance to the workers’ compensation and liability
insurance communities at conferences, associations, and individual
offices nationwide. She is a regularly published author on court
decisions and legislative reforms involving Medicare Set-Asides,
conditional payments, and Mandatory Insurer Reporting issues.
Understanding that compliance with the Medicare Secondary Payer Act can
be at times complex and frustrating for those that handle claims with
Medicare beneficiaries, Heather’s goal is to speak and write with the
primary goal being simple and understandable solutions to compliance.
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Jennifer Shymanksi, CMSP-F
Director of Implementation and Strategy, NuQuest
Spotlight on Asbestos Claims, Tuesday, October 6, 2020, 4:00 p.m.
Jennifer Shymanski, NuQuest’s Director of Implementation and Strategy, holds a law degree from Northern Illinois University College of Law and a Bachelor of Arts in
Political Science from the University of Wisconsin - Stevens Point. She is admitted to practice law in the State of Wisconsin.
Prior to joining NuQuest in March
of 2010, she spent over ten years at Nationwide Insurance working with
both workers compensation and personal liability claims teams.
Shymanski utilizes her extensive experience in claim handling and negotiation to lead the NuQuest Settlement Consultant Team in working with clients to choose the correct
products and services for their needs and to support and advise them throughout the settlement process. One of Shymanski’s primary focuses is on assisting clients in
designing, implementing and monitoring their Medicare Secondary Payer compliance programs.
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Bridget Smith VP of Compliance and Customer Relations, NuQuest
Demonstration of Responsibility, Tuesday, October 6, 2020, 5:00 p.m.
Prior to joining NuQuest, Bridget Smith received her undergraduate Political Science Degree from Gannon University and received her Master of Arts and Juris Doctorate degrees from Duquesne University. She thereafter served as a judicial clerk for the Hon. Dante Pellegrini, President Judge of the Commonwealth Court of Pennsylvania. Smith went on to practice as a shareholder at a top Pittsburgh law firm serving as Vice-Chair of the Medicare Compliance Group. She concentrated her practice in the area of Medicare compliance as well as workers’ compensation litigation, medical malpractice, and general insurance defense. Smith also served as a Medicare compliance attorney and shareholder for a national defense firm and worked as in-house counsel for a leading Pittsburgh health facility. Smith was selected for inclusion in the Pennsylvania Rising Stars list of outstanding young attorneys in 2008 and has been listed in Best Lawyers since 2011 in the area of workers’ compensation. She is involved in various charitable organizations and serves as a volunteer faculty advisor for a local high school trial advocacy team. Smith is licensed to practice law in Pennsylvania and West Virginia. In her role as VP of Compliance and Customer Relations, she utilizes her extensive compliance, litigation, and workers’ compensation experience to provide customers guidance on Medicare Secondary Payer (MSP) issues . She has lectured throughout the country on MSP compliance and has written numerous articles on various subjects.
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Thomas Stanley, MSCC, CMSP-F
President, Stanley Insurance Services
Hot Topics: Civil Monetary Penalties & LMSA, Tuesday, October 6, 2020, 9:00 a.m.
Thomas Stanley is the President of the
Stanley Insurance Agency, Inc. Since 2002, the Agency has provided full
service WC Medicare Set-Aside consultation to a varied clientele. WCMSA
services are a natural compliment to the settlement annuity services the
Agency began providing in 1987. Stanley holds the MSSC and CMSP
certifications. Recently, he was one of the first to complete the
Masters in Structured Settlement Consulting program at the University of
Notre Dame. Stanley has an MBA in finance and economics. He is a native
of Minnesota and now lives in Las Vegas, Nevada.
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Jeffrey C. Swann, Esq.
General Counsel, The Rawlings Group
MAO Panel, Tuesday, October 6, 2020, 11:30 a.m.
Jeffrey Swann, Esq., oversees more than 25 attorneys in providing legal services both internally and to The Rawlings Group's clients. He is also involved in the company’s mass tort litigation activities. Prior to joining the company in
2005, he was an attorney with a major subrogation vendor and a local law firm.
Swann received his undergraduate degree from Vanderbilt University and his J.D. from the University of Louisville School of Law.
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 | Will Sykes BCRC Director, Call Center, Group Health, Inc.
CRC and BCRC - Interplay and Differences, Tuesday, October 6, 2020, 1:30 p.m.
Will
Sykes, from New York, is the director of the BCRC Call Center. He has
over 15 years of contact center management experience specializing in
Vendor Relationship and Workforce Management. Additionally, he has been
involved with Medicare and specifically the Medicare Secondary Payer
space since 2006. |
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Marques Torbert Chief Executive Officer, Ametros
Administration, Wednesday, October 7, 2020, 10:15 a.m.
Prior to Ametros, Torbert worked as an investor and consultant within the insurance and business services sector. He was previously the principal adviser to Millbrook, an Associate with Clarion Capital Partners (a middle market private
equity firm), and an investment banker with Lazard Freres. He has been instrumental in working with multiple privately held organizations within the claims solutions management and managed care industries.
Torbert obtained his B.A. in Economics from Columbia University and his MBA from Harvard Business School. He is currently on the Board of Directors of Ametros Financial, and is also a member of the Board of Trustees for Merrimack College,
as well as, University School, a private K-12 school in Cleveland. He currently resides in Boston with his wife Alexandra and (un)fortunately is also a Cleveland Browns fan.
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S. Philip Unwin Partner, Goldberg Segalla
Case Law Update, Wednesday, October 7, 2020, 9:00 a.m.
Philip Unwin has been defending workers’ compensation claims and Section
120 discrimination claims since 2005. He has handled hundreds of trials
at the Workers’ Compensation Board (WCB), including lay witness
testimony and medical testimony on the issues of accident, notice and
causal relationship, period and extent of disability, entitlement to
medical benefits under the board’s Medical Treatment Guidelines, and
fraud. He has advised clients on claims handling procedures, the
defenses available at the outset of claims, and the timelines for
conducting investigation and filing with the WCB. In addition, Philip is
co-chair of the firm’s Medicare Compliance practice. He is a Medicare
Set-Aside Certified Consultant and assists clients with Medicare
Set-Asides and conditional payments, including advising them of their
rights and obligations under the Medicare Secondary Payer laws in both
workers’ compensation and general liability claims. |
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Monica A. Williams, RN, CCM, CRRN, LNC, MSCC, CMSP, CNLCP Manager, Medicare Compliance, Innovative Claims Strategies
ETHICS: What MSP Professionals Need to Know, Wednesday, October 7, 2020, 1:15 p.m.
Monica Williams has over 20 years of Managed Care and
Workers Compensation experience. She is the Medicare Compliance Manager
for Innovative Claims Strategies (ICS) where she has oversight of
Medicare Set Aside program which includes CMS legal submission and
Conditional Payment Resolution. As Manager she has developed and
implemented the Medicare Compliance Department internal workflow
processes. She was formerly the District Manager for Georgia and then
National Catastrophic Program Manager for Intracorp.
Williams is President of MWC, LLC consulting practice in State
of Georgia which provides Complex Case Reviews, Medical, Catastrophic
Field Case Management and Life Care Plans.
She is currently a member of NAMSAP Board, Annual
Conference Committee, Liability Committee and Co-Chair of Membership
Committee.
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Aaron Winnell, CMSP Vice President of Operations, Medivest
Administration, Wednesday, October 6, 2020, 10:15 a.m.
Aaron Winnell, CMSP is the Vice President of Operations for Medivest, a national MSP compliance company specializing in the professional administration of Medicare Set-Aside arrangements. He began with Medivest as a consultant hired
to develop case management software tailored to requirements of MSA custodial services in 2006, and became Director of Professional Administration Services in 2011. He’s overseen general operations for Medivest since 2014.
Winnell is an alumni of Marshall University with a degree in Communications Electronics. He resides in Montverde, Florida with his wife and twin daughters.
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Kimberly Wiswell, CMSP
Vice President, Managed Care Operations and Team Excellence, CLARA Analytics
Reference Guide Lesser Known Facts and Fallacies, Wednesday, October 7, 2020, 12:15 p.m.
Kimberly
Wiswell has been engaged in the workers’ compensation managed care and
occupational health services industries since the late 1970’s, with a
focus on Medicare Secondary Payer compliance since 2005. She currently
serves as the Vice President of Managed Care Operations at CLARA
analytics.
Prior to joining CLARA she was a Vice President at MEDVAL, responsible for product management, and also managed operations for four years, building a technological infrastructure to facilitate the company's growth. She previously
co-founded and served as Managing Director over CompProjections Medicare Set-Asides, under CompPartners. Prior to that, she served as Sr. Vice President, Operations over the Medicare Set-Aside and Specialty Network division of
Coventry HealthCare’s First Health Priority Services sub-division.
Wiswell has extensive knowledge and experience in the area of workers’ compensation managed care including Medicare set-asides, medical bill review, systems analysis/ development, medical coding and reimbursement, and occupational
health administration. She has provided consulting services to the CMS, the California Workers' Compensation Institute, and a number of state agencies and associations. Wiswell presents at industry conferences, seminars and
training sessions concerning Medicare Secondary Payer Compliance, medical cost management, and provider coding and reimbursement. She is a member and past president of the Board of Directors for the National Alliance of Medicare
Set-Aside Professionals (NAMSAP); she sits on the faculty for WorkCompCentral’s WorkCompSchool; and serves as the Fee Schedule Committee Chair for a California legislative advisory body composed of top risk managers and select
attorneys who advocate for industry insurance defense and related workers’ compensation legislation.
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