6:00 AM

Exhibitor
Registration

Exhibitor Set-Up
Registration Opens

7:30 - 8:30 AM

Networking

Continental Breakfast

8:30 - 9:45 AM

Continuing Education  

Conference Kick-off and What’s Up Their Sleeve? The Future of LMSAs

Steven Miller, MSPharm, DPh, RPh, CMSP-F, The National MSP Network President; Bill Delaney, Esq., CMSP-F, Partner, Nyhan Bambrick Kinzie Lowry; Robert Finley, Esq., Partner, Hinshaw Law

CMS sent proposed Rules to the White House’s Office of Information and Regulatory Affairs.  How could new Rules change the world of civil litigation?Learning Objectives:

• Identify the current regulatory scheme for liability and no-fault cases

• Discover the difference between liability and workers’ compensation cases from an MSP perspective and learn about previous efforts to establish LMSA Rules 

• Learn how proposed changes could impact civil litigation

9:45 - 10:00 AM

Networking

Break with Exhibitors

10:00 - 11:00 AM

Continuing Education

Breaking Down Risk for Civil Monetary Penalties

Susan Montoya, Managing Director Medicare & Debt Resolution, Travelers; Christina White, Esq., Senior Counsel, New York City Law Department

Section 111 reporting noncompliance and/or error is one of the costliest risks for primary payers within the Medicare Secondary Payer universe. How and when civil monetary penalties may occur is the question keeping RREs up at night. Listen in on this descriptive session which will explore the following:

• Section 111 rules and requirements and common risks therein
• Details regarding the Civil Monetary Penalties rule-making
• How primary payers can protect their businesses from penalties
  

11:00 AM - 12:00 PM

Continuing Education

Conditional Payment Processes and Procedures with the CRC

Ted Doyle, MA, AHFI, DFE, CIFI, Project Director, CRC; Nicole Griffin, CRC Director, MSP Recoveries, Performant Group; Nancy Harple, CMSP, MSCC, Claims Supervisor, Chesapeake Employers' Insurance Company; Peggy Hoard, Performant Corp; Mileyka Ojeda, NGHP Healthcare Billing & Recovery Manager, MSP Commercial Repayment Center, Performant Corp

The Commercial Repayment Center is the contractor for workers' compensation conditional payments. Hear directly from the CRC about recent enhancements and improvements that can impact your claims.
Learning Objective:

• Catch up on recent enhancements and improvements that can impact your claims

12:00 - 1:00 PM

Networking

Lunch Break; Exhibit Hall Open

1:00 - 2:00 PM

Continuing Education

BCRC Bankroll

Jim Brady, Program Director, BCRC; Constance Callender, BCRC; Shawn Deane, MSCC, CMSP, General Counsel, Ametros; Bridget Gallardo, Group Health, Inc.; Renee Jones, BCRC CFW Manager, Group Health, Inc.; Angel Pagan, BCRC EDI Director, Technical Lead, GDIT; Will Sykes, BCRC Director, Call Center, Group Health, Inc.

The Benefits Coordination and Repayment Center manages Medicare conditional payments in general liability, no-fault and automobile claims. Don't miss this opportunity to learn directly from the BCRC how your claims are handled and how efficiencies can be discovered.
Learning Objectives:

• Better understand how the BCRC handles your claims
• Identify how efficiencies are discovered

2:00 - 2:15 PM

Networking

Break with Exhibitors

Continuing Education Breakout Sessions:
A. Squaring Up: Global Settlements, Mass Torts, and Medicare Liens

Debra Forsythe, Sr. Clinical Guideline Manager, Garretson Resolution Group; Barrye Miyagi, Esq., CMSP-F, Attorney, Taylor, Porter, Brooks & Phillips

Medicare has a well-defined process for handling conditional payment recovery in individual cases, but what about mass torts and global settlements? Is there a process for resolving Medicare conditional payments en masse? This panel discussion will provide information on the “AMP” process and other ways of approaching Medicare to resolve conditional payments and you may find participation in such processes can eliminate the need for Section 111 mandatory insurer reporting on the involved claims.
Learning Objectives:

• Identify methods of resolving conditional payments
• Describe the AMP process
• Analyze the need for Section 111 mandatory insurer reporting

B. A Deep Dive into Surgical Pricing

Dena Ramsey, JD, MBA, BSN, MSCC, CLCP, LNCCP, CWCP, Director, Life Plan MD

Inquiring minds want to know how Medicare approaches surgical pricing! Get your scrubs on and listen in! Building upon the valuable insight disseminated at last year’s conference, this session will perpetuate information concerning the following:

• How surgery is priced by state
• Additional factors, such as anesthesia and other facility costs
• Generalized pricing of some procedures that does not vary jurisdictionally

C. Rules of the Game: The MSP Statute and Regulations

Rasa Fumagalli, JD, MSCC, CMSP-F, Director of MSP Compliance Services, Synergy Settlement Services; Kate Riordan, JD, MSCC, Director, MSP Initiatives, ISO Claims Partners

Take a walk through the history of the WCMSA program to learn the statutory and regulatory basis for CMS’ WCMSA program and the extent of CMS’ legal authority for the program. Learning Objectives include:

• Learn the history of the WCMSA program, from before the Patel memo, and track its evolution through today
  
• Identify the statutory and regulatory authority which supports, or does not support, current WCMSA processes

Continuing Education Breakout Sessions:

A. Best Practices for LMSA in the Interim

Jennifer Mislanovich, JD, Vice President, Settlement Consulting, IMPAXX; Melisa Zwilling, JD, Shareholder, Carr Allison

Despite procedural limitations associated with review of Liability and No-Fault Medicare Set-Asides, obligations under the Medicare Secondary Payer Act still exist in the settlement of these cases. Anyone engaging in the settlement of liability or no-fault matters will benefit from this session, which will illustrate the following:

• History of rule-making and current status of proposed rules
• Methods of protecting interests and finalizing documentation
• Looking ahead to what may be on the horizon

B.  No Dice? Zero MSAs

Amy Bilton, Esq., MSCC, CMSP-F, Shareholder, Nyhan Bambrick Kinzie & Lowry; Michael Flower, Esq., MSCC, MSP Compliance Counsel, Optum Settlement Solutions; Jennifer Katz, JD, Senior Counsel, Claim Legal Workers Comp, Travelers

Both medical and legal questions in a claim can support a zero allocation for post-settlement medical benefits. So, what are zero MSAs and how do you get one?
Learning Objectives:

• Understand the differences between compromise and commutation settlements, and what the Code of Federal Regulations says about each
  
• Discover the difference between a legal and medical zero MSA and when each might be appropriate
  
• Learn to prepare a submission in support of each type of zero MSA

C. Playing Your Cards Right: How to put together a WCMSA submission

Kimberly Wiswell, CMSP-F, Senior Product Manager, Workers' Compensation, Gradient AI

Not everyone in the Medicare Secondary Payer world is a WCMSA submitter. Learn the basics of what goes into a submission and how to prepare your own.
Learning Objectives:

• Learn the basic sections of a submission and what goes into them
  
• Discover common submitter errors and how to avoid them
  
• Avoid development letters by including all necessary items in your submission
  

4:45 - 5:45 PM

Continuing Education

Continuing Education Breakout Sessions:
A. Settlement Strategies and Professional Administration

Brian Cowan, Esq., Vice President of Administration Services, ISO Claims Partners; Steve Shaw, Esq., CMSP-F, President, Shaw Legal Solutions; Jodi Taylor, Esq., Senior Attorney, Chesapeake Employers Insurance; Jennifer Wieroniey, JD, Executive Director, American Association of Settlement Consultants

One of the biggest MSP issues of 2022 is benefit denial for Medicare Beneficiaries settling cases where a primary payer may exist. Settlement tools are more critical now than ever to ensure successful resolution of claims. This session will provide helpful assistance with the following:

• Details and metrics surrounding benefit denial
  
• Professional administration utility and benefits
  
• Structured settlement funding opportunities

B. The Practical Application of Evidence Based Medicine

Nahla D. Rizkallah, PharmD, MSCC, Senior Clinical Pharmacist, ExamWorks Compliance Solutions; Jennifer Shymanski, Esq., CMSP-F, Vice President of Implementation and Strategy, IMPAXX

The industry frequently applies the buzz term “Evidence Based Medicine” as a descriptor for some allocating methodologies. But was does it mean exactly and when should it be applied? This session will illuminate the following:

• Medicare’s 2022 WCMSA Reference Guide updates
  
• Evidence Based Medicine allocating guidelines and benchmarks
  
• How EBM can apply in both submitted and non-submitted MSAs

C. Two of a Kind: Section 111 & Conditional Payment Appeals

Ciara Koba, Esq., Principal, Allan Koba Compliance Solutions; Amber Worman, Principal, A.K. Worman  & Associates

Proper Section 111 reporting is an important tool used to ensure CMS does not make payments for injury-related medical bills, and conditional payment appeals backstops the process to ensure CMS does not collect for unrelated payments. This session will focus on the basics of Section 111 reporting requirements and the five levels of appeals available to beneficiaries and primary payers when appealing conditional payment demands.
Learning Objectives:

• Understand what Section 111 reporting is and how it interplays with conditional payment recovery
  
• Learn the 5 levels of appeal from a conditional payment demand and how long each level takes
  
• Discover how to best present your appeal to achieve timely success
  

6:00 - 8:00 PM

Networking

Reception at 'Sport and Social'