Medicare Secondary Payer Master Class

Feb 9, 2021 ‐ Feb 10, 2021

Standard: $500.00


Welcome Remarks and Tactics to Avoid Civil Money Penalties from CMS

Feb 9, 2021 8:45am ‐ Feb 9, 2021 9:40am

Identification: TUE001

Welcome Remarks iconWelcome Remarks

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Welcome Remarks

Feb 9, 2021 8:45am ‐ Feb 9, 2021 8:55am

Identification: TUE01


Tactics to Avoid Civil Money Penalties from CMS

Feb 9, 2021 8:55am ‐ Feb 9, 2021 9:40am

Identification: TUE02

•    Analyze all necessary requirements under mandatory reporting to avoid financially costly errors
•    Discuss ongoing responsibility for medical to reduce possibility of receiving CMPs
•    Improve reporting of correct ICD-10 codes to minimize chances of obtaining penalties
•    Ensure correct and complete information is reported to Medicare related to Total Payment Obligation to Claimant


Assure RREs Do Not Fail to Report Appropriate NGHP Beneficiary Information

Feb 9, 2021 9:50am ‐ Feb 9, 2021 10:35am

Identification: TUE03

•    Avoid violations by assuring RRE self-registration with CMS for purposes of completing mandatory reporting
•    Examine which critical information is needed to report to CMS for claimant and accident to minimize potential errors
•    Strategies on what and when to report to CMS if you accepted ORM (no-fault and work comp claims) or did not accept ORM (liability claims)


Analyze Possible Penalties for NGHP When Contradicting MIR Response Through CMS Recovery Efforts

Feb 9, 2021 10:45am ‐ Feb 9, 2021 11:30am

Identification: TUE04

•    Maintain consistent reporting thru conditional payment resolution process, even when challenging Medicare’s entitlement for reimbursement
•    Comprehend the impact of under reporting medical impairments related to the claim in relation to CMS recovery efforts
•    Discuss the effect of over reporting unrelated medical impairments throughout life of claim

  • Lavonya Chapman, Esq., RN, CMSP, Associate General Counsel, Optum Settlement Solutions

Avoid Costly Mistakes- Staying Away from NGHP Exceeding CMS Error Tolerance Thresholds

Feb 9, 2021 11:40am ‐ Feb 9, 2021 12:25pm

Identification: TUE05

•    Utilize innovative approaches to drastically reduce errors in all pertinent information reported to CMS to avoid costly penalties
•    Examine the financial significance of exceeding the threshold error rate of 20% and strategies to reduce error rate
•    Lesson Learned: Accept errors as an opportunity to improve reporting methods each quarter to avoid red flags and costly penalties


Virtual Networking Lobby iconVirtual Networking Lobby

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Virtual Networking Lobby

Feb 9, 2021 12:25pm ‐ Feb 9, 2021 1:05pm

Identification: VNL1

Don’t Miss Out! Turn on your camera and join us in the Virtual Lobby for that face-to-face networking experience we’ve all been missing. Connecting with your peers and vendors including MSP professionals from across the country never been easier - click on an open seat, say hello to familiar faces, and take part in conditional payments, Medicare Set-Asides, and mandatory reporting discussions. We’ll see you in the lobby!

And Still……. No Federal Regulations for MSA’s from CMS

Feb 9, 2021 1:05pm ‐ Feb 9, 2021 1:50pm

Identification: TUE06

• Analyze statutory provisions of Medicare Secondary Payer law to understand CMS requirements for all parties
•    Review of the current limited regulations in the workers compensation arena to comprehend CMS perspective on MSAs
•    Examine case law at Federal level nationwide on the requirements for MSAs to grasp CMS conditions for all stakeholders


An Overview of The Basics: Traditional Medically Based Medicare Set-Asides

Feb 9, 2021 2:00pm ‐ Feb 9, 2021 2:45pm

Identification: TUE07

•    Determine life expectancy of injured party to identify cost of care for future medical needs
•    Review medical records through life of claim to extract recommendation from physician for future medical care related to claim and Medicare allowable
•    Calculate pricing of recommendations of Medicare allowable treatment to establish overall cost of care
•    Strategies for watertight submission of MSA to CMS review and approval


A Second Option: Data Driven, Medical Guidelines Based Medicare Set-Asides

Feb 9, 2021 2:55pm ‐ Feb 9, 2021 3:40pm

Identification: TUE08

•    Establish life expectancy of claimant and calculate cost of care for future medical needs
•    Analyze payers’ medical claims data to determine projected cost of claimants related injuries
•    Utilize medical guidelines to generate recommended future cost of care per injury
•    Strategies to minimize future medical costs expense and reduce exposure of MSA