4th Annual Medicare Secondary Payer Conditional Payment Forum

Jul 27, 2020 ‐ Jul 29, 2020

Uncover the Impact of the New Notice of Proposed Rule-making from CMS on Conditional Payment Recovery Learn directly from Medicare Secondary Payer experts from across the nation, network with industry leaders and identify critical new strategies for negotiating resolutions at the first conference to cover the NPRM. Offering a complete overview of the conditional payment process from conception to completion, this is a must attend event for claims, compliance, insurance, and risk specialists. 4

Standard: $500.00


Chairperson Welcome Remarks iconChairperson Welcome Remarks

Preview Available

Chairperson Welcome Remarks

Jul 27, 2020 8:50am ‐ Jul 27, 2020 9:00am


A Historical Review of Mandatory Reporting Civil Money Penalties

Jul 27, 2020 9:00am ‐ Jul 27, 2020 9:45am

Learning Objectives:
  • Review the legislative history of imposition of civil money penalties
  • Examine legislative provisions regarding mandatory reporting requirements
  • Summarize the public comments received on the 2013 advanced notice proposed rulemaking and how they serve as the foundation for the 2020 proposed rules

An Analysis of the Mandatory Reporting Proposed Civil Money Penalty Regulations

Jul 27, 2020 10:00am ‐ Jul 27, 2020 10:45am

Learning Objectives:
  • Evaluate civil money penalty bases and scope; assess its potential impact, especially as they relate to the conditional payment resolution process
  • Analyze civil money penalties imposition and amounts that could be handed by CMS, especially in connection with the resolution of conditional payments
  • Proven good faith effort to reduce or extinguish the possibility of receiving civil money penalties

Medicare Secondary Payer Conditional Payments Case Law Update

Jul 27, 2020 11:00am ‐ Jul 27, 2020 11:40am

Learning Objectives:
  • Analyze which organizations and individuals the U.S Federal Government is suing for reimbursement of conditional payments
  • Identify which entities Medicare Advantage Plans and their assignees are suing for reimbursement of conditional payments
  • Review of the hottest cases relative to resolution of conditional payment and how the case law is evolving, providing attendees with trends and patterns that allow for best practices

Medicare Advantage and Part D Conditional Payment Best Practices

Jul 27, 2020 11:55am ‐ Jul 27, 2020 12:40pm

Learning Objectives:
  • Outline current available methodologies to determine a beneficiary’s Medicare Advantage and Part D enrollment status
  • Identify key jurisdictions in which Medicare Advantage and Part D have the same double damages recovery rights as traditional Medicare
  • Provide Best Practices for payors to implement to avoid lawsuits and claims from Medicare Advantage and Part D for double damages

When Conditional Payments Go Wrong: Dealing with the U.S. Department of Treasury

Jul 27, 2020 1:10pm ‐ Jul 27, 2020 1:50pm

Learning Objectives:
  • Case Study: Dissect a recent account where the U.S. Department of Treasury offset an organization and another one in which a beneficiary’s monthly benefits were reduced
  • An overview from lawyers representing applicable plans/payers and beneficiaries dealing with the U.S. Treasury that were offset unreimbursed past due amounts
  • Strategies to avoid conflict with and offsets from the U.S Department of Treasury
  • Vanessa Lipsky, Partner/Section Lead Medicare Compliance Department, Eraclides Gelman Attorneys at Law

When Conditional Payments Go Wrong: Dealing with the U.S. Department of Justice

Jul 27, 2020 2:05pm ‐ Jul 27, 2020 2:45pm

Learning Objectives:
  • Hear what happens to lawyers and law firms representing Medicare beneficiaries who fail to reimburse conditional payments after the case settles
  • Examine if the same thing could happen to employers, carriers, and third party administrators
  • Identify when payers are responsible for reimbursement of conditional payment and how to avoid conflict with U.S. Department of Justice
  • Jason D. Lazarus, J.D., LL.M., MSCC, CSSC, Founder, Chief Executivve Officer, Synergy Settlements

Verification of Claimant's Medicare Beneficiary Status

Jul 27, 2020 3:00pm ‐ Jul 27, 2020 3:40pm

Learning Objectives:
  • Obtain the correct documentation from the beneficiary to verify current Medicare status
  • Validate with Medicare Advantage Plans and prescription drug plans to confirm status
  • Utilize the mandatory reporting process to verify current Medicare beneficiary status

Verification of Data Submitted Through Mandatory Insurer Reporting

Jul 27, 2020 3:55pm ‐ Jul 27, 2020 4:35pm

Learning Objectives:
  • Confirm date of accident/incident, ORM acceptance and termination dates, and TPOC date and amount are correctly reported
  • Verify the injuries related to the claim or that have been released/settled have been reported accurately
  • Certify ICD-10 codes that have been reported are accurate; and if they are not, what to do about it before you dispute or appeal CRC and BCRC’s request for reimbursement

Chairperson Closing Remarks iconChairperson Closing Remarks

Preview Available

Chairperson Closing Remarks

Jul 27, 2020 4:35pm ‐ Jul 27, 2020 4:45pm