Medicare Set Asides in Personal Injury: New Requirements


CLE Credits earned: 2 GENERAL (or 2 LAW & LEGAL for WA state)

This program will provide a detailed look at the Medicare Secondary Payer Act (MSP). The program will begin with a brief discussion of Medicare eligibility processes and a general overview of the MSP statute.

After the general introduction, the program will begin a detailed discussion of the MSP’s requirement to maintain Medicare as a secondary payer relative to settlement proceeds. Specifically, we will discuss:

•   How CMS determines a settlement includes “medical damages”?
•   What type of medical care should be paid from settlement proceeds?
•   What exactly is a “Medicare Set Aside”?
•   Strategies to minimize the “Medicare Set Aside” allocation amount.
•   Settlement language ideas to address the Medicare Secondary Payer act requirements.
•   October 2017 changes to the Medicare Common Working File
•   November 2017 educational outreach to the Medical community regarding MSP compliance
•   Anticipated changes in 2018

The program will also work in practice tips and settlement tips to assist the practitioner in efficiently identifying and addressing MSP issues in a given case or fact pattern.
Time permitting, we will also address reimbursement of the Medicare Conditional Payment Amount and Section 111 reporting.

Finally, the program will include ample time for questions from conference attendees.

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

Key topics to be discussed:

•   When is your settlement primary to Medicare?
•   2017 changes to the Common Working File and Educational Outreach to Medical Providers
•   Anticipated expansion of the MSA review process in 2018

Date / Time: February 4, 2019

•   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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Original Broadcast Date: July 17, 2018

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. In 2002 Christine opened her own firm, which recently celebrated its fifteenth continuous year of operation. With nearly twenty years of experience, Christine is a published author and popular speaker on a wide array of topics related to Medicare compliance. Christine has significant experience working with the Centers for Medicare and Medicaid Services in regarding applicability of the Medicare Secondary Payer Act to liability settlements. She is a member of the American Bar Association, the Colorado Bar Association, and includes with her legal experience work in Medicaid, probate, and elder law. Christine volunteers her free time by 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?: General Overview

Section II. Statutory Requirement to Maintain Medicare as a Secondary Payer
a) How does CMS/Medicare determine a settlement is primary to Medicare?
b) What is an “MSA”? And is it actually “mandated” by the Medicare Secondary Payer Act?
c) What treatment should an MSA /future medical allocation pay for and how is this determined?
d) Strategies for reducing the future-medical funding
e) How is an MSA funded?
f) What happens to the MSA funds at the death of the beneficiary?
g) Discussion of the Aranki case
h) How do the October 2017 changes to the Common Working File impact settlements?
i) From a practical point of view, how does the November 2017 educational outreach by CMS to the Medical community impact my case?
j) Discussion of anticipated expansion of the formal MSA review process in 2018

Section III. Brief discussion of the Medicare Conditional Payment and Section 111 reporting
a) Medicare A/B reimbursements
b) Medicare Part C and D reimbursements
c) The BCRC vs the CRC
d) Overview of the Section 111 reporting requirement