Medicare Secondary Payer Act: New Changes to Enforcement & How They Impact Your Liability or No Fault Case


CLE Credits earned: 2 GEN

This program will focus on the application of the Medicare Secondary Payer Act (MSP) to Liability and No Fault cases. Of note, the program will include a detailed discussion of the October 2017 changes to the Medicare Common Working File, as well as anticipated MSP enforcement changes expected in 2018, and how these changes impact your Liability or No Fault case. The program will include an introduction to the MSP statute and then a detailed discussion of the three requirements of the statute: Section 111 reporting, Reimbursement of Conditional Payments, and ensuring Medicare remains as a secondary payer with settlement proceeds remaining the Primary payer for post-settlement accident related medical treatment. Time permitting; the CLE will also discuss recent case law developments (CIGA, Aranki, and the 2016 Humana decision).

This course is co-sponsored by the Federal Bar Association.

Key topics to be discussed:

•   New! 2017 changes to the Common Working File
•   Anticipated expansion of the MSA review process in 2018
•   The Final CP Process and how to decide if it is right for your case

Date / Time: November 2, 2018

•   2:00 pm – 4:00 pm Eastern
•   1:00 pm – 3:00 pm Central
•   12:00 pm – 2:00 pm Mountain
•   11:00 am – 1:00 pm Pacific

Choose a format:

•   Live Video Broadcast/Re-Broadcast: Watch Program “live” in real-time, must sign-in and watch program on date and time set above. May ask questions during presentation via chat box. Qualifies for “live” CLE credit.
•   On-Demand Video: Access CLE 24/7 via on-demand library and watch program anytime. Qualifies for self-study CLE credit. On-demand versions are made available 7 business days after the original recording date and are view-able for up to one year.

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Christine Hummel, Esq. is the President and founder of Hummel Consultation Services, a legal consultation practice specializing in the application of the Medicare Secondary Payer Act. An active attorney with licensure in the state of Colorado, she earned her Juris Doctor from the University of Denver in May 2000. Christine focused her internships on Medicare compliance for two years before earning her degree, and continues to practice in this field of law. In 2002 Christine opened her own firm. With seventeen years of experience, Christine is a published author and popular speaker on a wide array of topics related to Medicare compliance. She is a member of the American Bar Association, the Colorado Bar Association, and the ABA Health Law Section, and includes with her legal experience work in Medicaid, probate, and elder law. Christine donates a significant amount of volunteer time giving presentations on the roles of women throughout multiple time periods in history.

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Section I. Introduction to Medicare and the Medicare Secondary Payer Act
a) How does a person qualify for Medicare
        i. By age
        ii. By receives SSD
b) Can younger persons/minors qualify for Medicare
c) What is the MSP statute

Section II. Section 111 Reporting
a) Who is required to report
b) When must they report
c) What must they report
d) Why is the reporting requirement important to Plaintiff’s

Section III. Reimbursement of Medicare Conditional Payments
a) Medicare A/B conditional payment searches
        i. Disputes of A/B charges including a discussion of the CIGA case
        ii. Waiver vs compromise requests
b) The CRC vs BCRC
        i. How this may complicate your Automobile case
c) Medicare Part C and Part D conditional payment recoveries
        i. Case Law discussion, including the 2016 Humana Case and the In re Avandia case
d) The Final CP Process

Section IV. Future Medical Allocations/Medicare Set Asides
a) When is Medicare secondary to your settlement
b) How does CMS/Medicare determine a settlement is primary to Medicare
c) How do the October 2017 changes to the Common Working File impact settlements
d) What treatment should an MSA /future medical allocation pay for and how is this determined
e) Discussion of anticipated expansion of the formal MSA review process in 2018
f) Discussion of the Aranki case
g) What are we expecting in 2018?