WorkersWorkers ' Compensation Claims and the Payer...

transcript

Presenting a live 90‐minute webinar with interactive Q&A

Workers' Compensation Claims and Workers Compensation Claims and the Medicare Secondary Payer ActMeeting Reporting Requirements, Satisfying Liens, and Structuring Set‐Asides in Settlements

Today’s faculty features:

1pm Eastern | 12pm Central | 11am Mountain | 10am Pacific

THURSDAY, JANUARY 19, 2012

Today s faculty features:

John Cattie, Head, Future Cost of Care Practice, Garretson Group, Charlotte, N.C.

The audio portion of the conference may be accessed via the telephone or by using your computer's speakers. Please refer to the instructions emailed to registrants for additional information. If you have any questions, please contact Customer Service at 1-800-926-7926 ext. 10.

Conference Materials

If you have not printed the conference materials for this program, please complete the following steps:

• Click on the + sign next to “Conference Materials” in the middle of the left-hand column on your screen hand column on your screen.

• Click on the tab labeled “Handouts” that appears, and there you will see a PDF of the slides for today's program.

• Double click on the PDF and a separate page will open. Double click on the PDF and a separate page will open.

• Print the slides by clicking on the printer icon.

Continuing Education Credits FOR LIVE EVENT ONLY

For CLE purposes, please let us know how many people are listening at your location by completing each of the following steps:

• Close the notification box

• In the chat box, type (1) your company name and (2) the number of attendees at your location

• Click the SEND button beside the box

Tips for Optimal Quality

S d Q litSound QualityIf you are listening via your computer speakers, please note that the quality of your sound will vary depending on the speed and quality of your internet connection.

If the sound quality is not satisfactory and you are listening via your computer speakers, you may listen via the phone: dial 1-866-258-2056 and enter your PIN -when prompted Otherwise please send us a chat or e mail when prompted. Otherwise, please send us a chat or e-mail sound@straffordpub.com immediately so we can address the problem.

If you dialed in and have any difficulties during the call, press *0 for assistance.

Viewing QualityTo maximize your screen, press the F11 key on your keyboard. To exit full screen, press the F11 key againpress the F11 key again.

Workers’ Compensation Claims and the Workers Compensation Claims and the Medicare Secondary Payer Act

Strafford January 19 2012January 19, 2012

Garretson Resolution Group

Boring but ImportantBoring but ImportantBoring, but Important.Boring, but Important.

MSP: The Medicare Secondary Payer Act

History…y• MSP – December 5, 1980• Medicare in 2003

• MMA 301 (expanded liability)• MMA 301 (expanded liability)• Medicare in 2006-07

• Changes in MSPRC• Medicare Part D

• Medicare in 2008-09• MMSEA (eff. 7-1-09:1/1/11)( )• MSP Reform Act (intro 5/09)• New CP procedures (eff. 10/1/09)

MSP: The Medicare Secondary Payer Act

History…y• MSP – December 5, 1980• Medicare in 2003

• MMA 301 (expanded liability)

What it means…• After 31 years of • MMA 301 (expanded liability)

• Medicare in 2006-07• Changes in MSPRC

evolution focused largely on plaintiff obligation….

• MMSEA “closes the loop” by involving the • Medicare Part D

• Medicare in 2008-09• MMSEA (eff. 7-1-09:1/1/11)

loop , by involving the defense / payer in the process( )

• MSP Reform Act (intro 5/09)• New CP procedures (eff. 10/1/09)

2012 MSP Compliance = 2 Obligations

“What do you mean by closing the loop?”REPORTING OBLIGATION [NEW]REPORTING OBLIGATION [NEW]Accountable Party is the Defendant

RESOLUTION OBLIGATION [OLD]RESOLUTION OBLIGATION [OLD]Accountable Party is the Plaintiff & Plaintiff Counsel

2012 MSP Compliance = 2 Obligations

“What do you mean by closing the loop?”REPORTING OBLIGATION [NEW]REPORTING OBLIGATION [NEW]Accountable Party is the Defendant

RESOLUTION OBLIGATION [OLD]RESOLUTION OBLIGATION [OLD]Accountable Party is the Plaintiff & Plaintiff Counsel

To sum it up…• Each settling party now has a role. • Our objective today is to illustrate

what each role is (and what it’s not).

New Concerns for Defendants: MMSEA

Common reactions to MMSEA: Overreaction or reasonable “belt & suspenders”?Overreaction or reasonable belt & suspenders ?

Not settling/paying without putting Medicare’s name on the check

• Not settling/paying unless plaintiff agrees to set up a Medicare Set Aside account Aside account

• Confusion over who is liable for any future Medicare issues• Defendant paying Medicare directly (and negotiating the Defendant paying Medicare directly (and negotiating the

reimbursement claim)• Adding overly-strict language to the settling release

New Concerns for Defendants: MMSEA

Common reactions to MMSEA: Overreaction or reasonable “belt & suspenders”?Overreaction or reasonable belt & suspenders ?

Not settling/paying without putting Medicare’s name on the check

• Not settling/paying unless plaintiff agrees to set up a Medicare Set Aside account

A quick note…Each of these topics will be covered in today’s Aside account

• Confusion over who is liable for any future Medicare issues• Defendant paying Medicare directly (and negotiating the

p ypresentation. For more in-depth analysis as well as practice tips, be sure to review your handout. Defendant paying Medicare directly (and negotiating the

reimbursement claim)• Adding overly-strict language to the settling release

The Big Shift

All this change is causing…• …shift away from reliance on “indemnification” clauses alone…• …to affirmative obligation to address liens before disbursing as

condition of settlementcondition of settlement

The Big Shift

All this change is causing…• …shift away from reliance on “indemnification” clauses alone…• …to affirmative obligation to address liens before disbursing as

condition of settlementcondition of settlement

What it means…R i t ti h li• Requires starting much earlier

• Requires formal verification of entitlement

MSP Obligations

KEY CONSIDERATIONSHow a How a formalized formalized

1. Medicare’s past and future interests are considered/protected appropriately.

2 The parties are MSP compliant (based on statute

formalized formalized approach to approach to MSP issues MSP issues yields MSP yields MSP 2. The parties are MSP compliant (based on statute,

regulations, guidance and case law).3. The claimant’s Medicare benefits are protected

going forward

yycompliant compliant

resultsresults

going forward.

MSP Reporting Obligations - What Has Changed?

The Medicare, Medicaid and SCHIP Extension Act of 2007 (“MMSEA”)

CMSCMS

HICNHICNCOBCCOBC

HICNHICNMSAMSA

RRERRE

ORMORM

TPOCTPOC ORMORM

Medicare Lingo

Before you can walk the walk,

you should be able to talk the talk

Medicare Lingo

Before you can walk the walk,

you should be able to talk the talk

Common Medicare acronyms include …• CMS Centers for Medicare & Medicaid Services• CMS – Centers for Medicare & Medicaid Services• RRE – Responsible Reporting Entity• MIR – Mandatory Insurer Reporting• HICN – Medicare Health Insurance Claim Number• COBC – Coordination of Benefits Coordinator• CPL – Conditional Payment Letter• MSA – Medicare Set Aside

MMSEA - 42 U.S.C. §1395y(b)(8)

To satisfy MSP REPORTING obligations Insurers (“RRE’s”) must To satisfy MSP REPORTING obligations, Insurers ( RRE s ) must engage in a two-step process:

St 1 D t i h th l i t (i l di i di id l h l i i Step 1: Determine whether a claimant (including an individual whose claim is unresolved) is entitled to Medicare benefits.

Step 2: If the claimant is determined to be entitled, submit certain informationabout the claimant to the Secretary of Health and Human Servicesabout the claimant to the Secretary of Health and Human Services

What must be reported?p

“Information is to be reported for claims related to liability insurance (i l di lf i ) f lt i d k ’ (including self-insurance), no-fault insurance, and workers’ compensation where the injured party is (or was) a Medicare beneficiary and medicals are claimed and/or released or the settlement, judgment, award, or other payment has the effect of releasing medicals” *

*Per Section 11.10.2 of Version 3.3 of the User Guide (p. 108)

MMSEA: A Verification Tool

Q: What’s the first step i h ld t k ?every insurer should take?

A: Verify claimant’s Medicare status with CMS’ QUERY ACCESS System

• RRE tool to determine claimants’ Medicare Entitlement StatusRRE tool to determine claimants Medicare Entitlement Status• RRE provides limited data (SSN/HICN, 1st initial of first name, 1st 6 characters

of last name, gender and DOB)• Confirms entitlement status (Match versus No Match)• Confirms entitlement status (Match versus No Match)• Tip – Query only requires 5 data points and not all 50+

Q: If Query Access only take 5 data points, h h ld th th d t when should the other data

points be provided?p p•Parties may consider sharing only limited data set prior to settlement for purpose of Query Access with understanding all other points will for purpose of Query Access, with understanding all other points will shared if settlement occurs and claimant is beneficiary•Many people debate the sharing of SSNRecognized exception to privacy lawsIt is the central data point O f S C

Other approach might be to share response from MSPRC to plaintiff’s initiation of tort recovery record

Q: If Query Access only take 5 data points, h h ld th th d t when should the other data

points be provided?p p•Parties may consider sharing only limited data set prior to settlement for purpose of Query Access with understanding all other points will A: Technically not required until after a settlement

for purpose of Query Access, with understanding all other points will shared if settlement occurs and claimant is beneficiary•Many people debate the sharing of SSN

occurs with a Medicare beneficiary

Recognized exception to privacy lawsIt is the central data point O f S C

Other approach might be to share response from MSPRC to plaintiff’s initiation of tort recovery record

Claimant Entitlement Verification: Case Law

Seger v. Tank Connection , LLC, 2010 WL 1665253 (D.Neb)Hackley v. Garafano, 2010 WL 3025597 (Conn.Super.)y , ( p )

Smith v. Sound Breeze of Groton Condominium Association, Inc., 2011 LEXIS 194 (Conn.Super.)

• Plaintiff refused to provide relevant info regarding Medicare enrollment• Court found that defense met its burden of proving relevance of information Court found that defense met its burden of proving relevance of information

requested (i.e., MMSEA)• Court determined plaintiff suffers no harm from providing information and orders

plaintiff to provide HICN or SSN and other identifying information to defenseplaintiff to provide HICN or SSN and other identifying information to defense• In Smith, Court also issued protective order, limiting the use of such information to

compliance under MMSEA Section 111.

How has the MMSEA changed what defendants / insurers (a/k/a RRE’s) now need to settle cases?(a/k/a RRE s) now need to settle cases?

CMS will request 50+ data points from RREs:q p Injured Party data (name, contact info, DOB, SSN, HICN) Primary Plan data (type, name, contact info, policy #, claim #, limits) Policy Holder data (name, self-insured) Injured Party/Claimant Attorney data Injury data Resolution data (settlement, amount, claim resolution, funding)

Tip #1: pCollaborate & Stipulate

to these data points

• Make sure the Final Demand from Medicare is truly final

to these data points.

Make sure the Final Demand from Medicare is truly final• Data reported by RRE should be consistent with how plaintiff

described injury when opening tort recovery record with MedicareThi d t lti t l i t l i t’ ki fil t • This data ultimately goes into claimant’s common working file at Medicare – You want that to be correct

Tip #1: pCollaborate & Stipulate

to these data points

• Make sure the Final Demand from Medicare is truly final

to these data points.

What will happen if you don’t?Make sure the Final Demand from Medicare is truly final• Data reported by RRE should be consistent with how plaintiff

described injury when opening tort recovery record with MedicareThi d t lti t l i t l i t’ ki fil t

What will happen if you don t?• Medicare repaid but not 100% satisfied.• Common working file includes “extra” medicals reported by RRE.• But those expenses remain unpaid leading to more work to fix later • This data ultimately goes into claimant’s common working file at

Medicare – You want that to be correctBut those expenses remain unpaid, leading to more work to fix later.

• CMS will consider file open, and may seek reimbursement.

2012 MSP Reimbursement/Resolution = 2 Obligations

“Consider and Protect” Medicare’s interests Past Interest (Date of Injury to Date of Settlement) Past Interest (Date of Injury to Date of Settlement)

Verify and resolve conditional payments Future Interest (Date of Settlement Onward)Future Interest (Date of Settlement Onward)

Determine IF an MSA is appropriate under the case/claim specific facts AND document the filep

2012 MSP Reimbursement/Resolution = 2 Obligations

“Consider and Protect” Medicare’s interests Past Interest (Date of Injury to Date of Settlement) Past Interest (Date of Injury to Date of Settlement)

Verify and resolve conditional payments Future Interest (Date of Settlement Onward)Future Interest (Date of Settlement Onward)

Determine IF an MSA is appropriate under the case/claim specific facts AND document the filep

Today’s Objective:To demonstrate how to address To demonstrate how to address these obligations in a compliant manner.

MSP Reimbursement for Past Medicals

What About Past Payments?What About Past Payments?

MEDICARE REIMBURSEMENT CLAIM

2000 ---------------------------------------- 2010

MEDICARE SET ASIDE?

2011 2012 2017 2022 2027 2032 2037 2042 2047 2052

Q: What’s my MSP obligation re: past payments? A: Verify, resolve and satisfy any conditional payments made by

2011 2012 2017 2022 2027 2032 2037 2042 2047 2052

y y y p y yMedicare from date of injury to date of settlement.

MSP Reimbursement for Past Medicals

What About Past Payments?What About Past Payments?

2000 ---------------------------------------- 2010 Early Verification = MEDICARE SET ASIDE?

2011 2012 2017 2022 2027 2032 2037 2042 2047 2052

Early Verification Key to Shortening Resolution Timeline.

Q: What’s my MSP obligation re: past payments? A: Verify, resolve and satisfy any conditional payments made by

2011 2012 2017 2022 2027 2032 2037 2042 2047 2052

y y y p y yMedicare from date of injury to date of settlement.

Medicare’s Conditional Payment System…

A Big Statement

If you are going to have to deal with Medicare in the end, why not start addressing it in the beginning?

Completion in 45 to 60 days from settlement?

start addressing it in the beginning?

• Is it possible? •“But, I have had cases going on with Medicare for over a year!”

• 120 - 150 days start to finish if done right• You can complete all Medicare reimbursement obligations in 45 to 60 days from date of settlement if you start early60 days from date of settlement if you start early.

A Big Statement

If you are going to have to deal with Medicare in the end, why not start addressing it in the beginning?

Completion in 45 to 60 days from settlement?

start addressing it in the beginning?

• Is it possible? •“But, I have had cases going on with Medicare for over a year!”

Ti #2 • 120 - 150 days start to finish if done right• You can complete all Medicare reimbursement obligations in 45 to 60 days from date of settlement if you start early

Tip #2: Start Early60 days from date of settlement if you start early.

Conditional Payment Reimbursement: Stricker

Effects of U.S. v. Stricker, 2010 WL 6599489 (N.D.Ala.)( )

First (and only) time CMS has pursued defense on MSP reimbursement issuesRaises timing concerns re: MSP compliance in light of this recent g p gcomplaint/dismissal, especially when coupled with new MMSEA “settlement reporting” requirements for insurersSo, does putting Medicare’s name on the check fix this problem?gIf not, who should resolve the claims?

Medicare’s Name on Check

Should Medicare’s name be put on the settlement check?p

• Does this offer protection?Thi i h i f MMSEA• This is not the intent of MMSEA

• Medicare doesn’t like it• It takes about 24 weeks to process a check with Medicare’s

name on it (after the reimbursement process is complete)

Medicare’s Name on Check

Should Medicare’s name be put on the settlement check?p

• Does this offer protection?Thi i h i f MMSEA• This is not the intent of MMSEA

• Medicare doesn’t like it• It takes about 24 weeks to process a check with Medicare’s

name on it (after the reimbursement process is complete)

Medicare’s Name on Check: Case Law

Tomlinson v. Landers, 2009 WL 1117399 (M.D.Fla.)Zaleppa v Seiwell 2010 WL 4633467 (Pa Super )Zaleppa v. Seiwell, 2010 WL 4633467 (Pa.Super.)

Schipper v. Dahl Trucking, File No. 46-CV-05-821 (MN)Wright v Liberty Med Supply 2011 U S Dist LEXIS Wright v. Liberty Med. Supply, 2011 U.S. Dist. LEXIS

81621 (July 25, 2011) Courts held fed law doesn’t mandate this as a matter of course Courts held fed law doesn t mandate this as a matter of course Parties are to be held to the terms of the settlement Defense cannot add Medicare’s name to check after the fact So, unless parties specifically bargained for Medicare’s name to

be on the check, it can’t be done.

MSP Reimbursement

Should Insurer negotiate the claim and pay it directly?

• Conditional payment obligation can be minimized via 42 C.F.R. §411.37.T i i i bli ti M di d l i tiff tt ’ t f t• To minimize obligation, Medicare needs plaintiff attorney’s costs of procurement

• What about waivers or post-settlement compromise?• What incentives to go through levels of appeals or other remedies?

MSP Reimbursement

Should Insurer negotiate the claim and pay it directly?

• Conditional payment obligation can be minimized via 42 C.F.R. §411.37.T i i i bli ti M di d l i tiff tt ’ t f t• To minimize obligation, Medicare needs plaintiff attorney’s costs of procurement

• What about waivers or post-settlement compromise?• What incentives to go through levels of appeals or other remedies?

While allowing plaintiff’s counsel to address MSP reimbursement obligations may minimize those reimbursement obligations may minimize those obligations, defense should consider steps to ensure Medicare closes its common working file.

Collaboration in Practice: MSP Release Language

6 step process to ensure MSP Compliance:6 step process to ensure MSP Compliance:1. Settlement agreement contains representations and warranties;2. Plaintiff shares evidence that tort recovery record has been opened with

Medicare (i e results of entitlement search);Medicare (i.e., results of entitlement search);3. Defendant pays settlement proceeds to counsel;4. Counsel agrees to hold back all net proceeds until conditional payment

amount received from Medicare (not necessary to hold back attorney ( y yfees/expenses because Medicare allows offsets for those [see Haro]);

5. Counsel then holds back conditional payment amount plus reasonable buffer (as agreed by parties) and distributes balance; and

6. After final resolution with CMS, plaintiff provides proof of satisfaction back to defendant to document defendant’s file.

MSP Reimbursement for Future Medicals

What About Future Payments?(D I d f th t id ?)(Do I need one of those set asides?)

2000 ---------------------------------------- 2010

MEDICARE SET ASIDE?

2011 2012 2017 2022 2027 2032 2037 2042 2047 2052

Q: What’s my MSP obligation re: future medicals? A: Determine IF a Medicare Set Aside (MSA) is appropriate under your

2011 2012 2017 2022 2027 2032 2037 2042 2047 2052

A: Determine IF a Medicare Set Aside (MSA) is appropriate under your case/claim specific facts and DOCUMENT THE FILE accordingly.

42 C.F.R. §411.46(d)

Lump-sum compromise settlement: Effect on payment for services furnished after the date of settlement—

ALL settlements must “adequately consider” Medicare’s interest, no shifting of Medicare to be primary payer for past & future medical care.care.Medicare will not pay for any medical expenses related to an injury after settlement until the time the portion of the settlement allocated to future medical expenses covered by Medicare is allocated to future medical expenses covered by Medicare is fully exhausted.

42 C.F.R. §411.46(d)

Lump-sum compromise settlement: Effect on payment for services furnished after the date of settlement—

ALL settlements must “adequately consider” Medicare’s interest, no shifting of Medicare to be primary payer for past & future medical care.care.Medicare will not pay for any medical expenses related to an injury after settlement until the time the portion of the settlement allocated to future medical expenses covered by Medicare is

REMEMBER – the basic rule is that Medicare will pay f f t i j l t d EXCEPT WHEN d

allocated to future medical expenses covered by Medicare is fully exhausted.

for future injury-related care EXCEPT WHEN proceeds allocated to future medical expenses.

42 C.F.R. §411.47(a)(1)

Determining amount of compromise settlement considered as a payment for medical expenses. p y p

“If a compromise settlement allocates a portion of the payment for medical expenses and also gives reasonable recognition to the income medical expenses and also gives reasonable recognition to the income

replacement element, that apportionment may be accepted as a basis for determining Medicare payments.”

Since WC matters have 3 “buckets” of recovery (indemnity/wage loss, past medicals & future medicals), if you know the wage loss component and the WC lien/CP amount, then the balance is the p ,allocated amount to future medicals.

MSA amounts should be capped at the amount allocated to future medicals, IF your case passes this test.

How to Consider/Protect Medicare’s Future Interest

ScreenScreen AssessAssess ValueValue EducateEducate

MSP Reimbursement – Future Interest

Relative to future medicals, settling parties should take four steps to ensure MSP compliance & “SAVE” a claimant’s Medicare card:

The Need to The Need to SAVESAVE

Medicare card:1. Screen to validate candidacy for MSA.2. Assess damages to determine future medical g

allocation.3. Value future medicals for candidate case.4 Ed t & Ad i i t MSA ( h i t )4. Educate & Administer MSA (when appropriate)

Are There Safe Harbors for MSAs?

• In CMS Memo dated May 11, 2011, the following thresholds are provided:thresholds are provided:

• Medicare entitled: over $25,000• “Reasonable Expectation”: over $250,000

No Safe No Safe HarborsHarbors

• Those same memos stress these are WORKLOAD REVIEW thresholds not safe WORKLOAD REVIEW thresholds, not safe harbor amounts

• Therefore, no safe harborsWhil CMS l i MSA i t i • While CMS only reviews MSAs in certain cases, MSAs should be established whenever appropriate

MSA Case Law – CMS Review/Approval

Smith(2011 LEXIS 90428)( )

Court found WCMSA for $14,647 was reasonable. Why?

P ti d t t f d id f MSA • Parties agreed to set funds aside for MSA;

• MSA vendor created allocation totaling $313,095.54; Garretson provides 2nd opinion; MSA = $14 647; submitted to CMS for provides 2nd opinion; MSA = $14,647; submitted to CMS for review/approval as condition of settlement.

• CMS declines opportunity to review Why?• CMS declines opportunity to review – Why?

• Joint motion for declaratory judgment to approve settlement.

• Court ratified what parties had already determined. Therefore, CMS future interests protected without requiring CMS approval.

Does Defense Have Any Liability for Future Medicals?

Current law only provides double damages to an insurer where conditional payment reimbursement obligations exist but were not satisfied. See 42 U.S.C. 1395y(b)(2)(B).

1395y(b)(2)(B) means that insurers have no liability for failing to make future payment arrangements. That responsibility is, and always has been on the Medicare beneficiary’s shoulders. The MSP statute, even its reporting obligations to insurer ( 111(8) of MMSEA), is statutorily looking to past payments made, not future payments to be made. Even an insurer’s reporting obligations stops where the person is not a

f fMedicare beneficiary at the time of settlement.

Does Defense Have Any Liability for Future Medicals?

Important Points…CMS b it M di ’ i b t f Current law only provides double damages to an insurer where conditional

payment reimbursement obligations exist but were not satisfied. See 42 U.S.C. 1395y(b)(2)(B).

• CMS website says Medicare’s reimbursement focus is on “entities that received” payment, not entities that made payment (http://www.cms.gov/WorkersCompAgencyServices/

1395y(b)(2)(B) means that insurers have no liability for failing to make future payment arrangements. That responsibility is, and always has been on the Medicare beneficiary’s shoulders.

02_workerscompensationoverview.asp#TopOfPage).• But, statutory language arguably includes payments

made or “to be made”, which has some commentators concerned about future payment

The MSP statute, even its reporting obligations to insurer ( 111(8) of MMSEA), is statutorily looking to past payments made, not future payments to be made. Even an insurer’s reporting obligations stops where the person is not a

p yliability.

Medicare beneficiary at the time of settlement.

Can/Should Attorneys Indemnify?

Depends on jurisdictionR i t t b thi i iReview state bar ethics opinions17 states that do not or arguably do not permit attorneys to indemnify: indemnify:

•Alabama •Arizona

•New York•North Carolina

•California•Florida•Illinois

•Oklahoma•Ohio •South Carolina

•Indiana•Kansas•Maine

•Tennessee•Vermont•Wisconsin

Maine•Missouri

Wisconsin

If the MSA Question Won’t Go Away…

• First, try to agree on parties’ roles (who does what)

• Second, try getting the experts together

• Third, discuss Medicare compliant language to insert into settlement agreement, and , p g g g ,if needed, a Lien Resolution Administrator (in mass tort cases)

• Fourth, if stuck with Hobson’s choice, get a MSA evaluationg i.e. Parties at a stalemate - “no MSA .. no settlement”, but there is a desire to nevertheless

settle In which case, submitting to Regional Office may help

• Finally, have clients acknowledge all of this in writing

If the MSA Question Won’t Go Away…

• First, try to agree on parties’ roles (who does what)

• Second, try getting the experts together

• Third, discuss Medicare compliant language to insert into settlement agreement, and Tip #3: , p g g g ,if needed, a Lien Resolution Administrator (in mass tort cases)

• Fourth, if stuck with Hobson’s choice, get a MSA evaluation

Tip #3: Take an educational

approach if MSA question g i.e. Parties at a stalemate - “no MSA .. no settlement”, but there is a desire to nevertheless

settle In which case, submitting to Regional Office may help

approach if MSA question persists.

• Finally, have clients acknowledge all of this in writing

MSP Obligations

KEY CONSIDERATIONSHow a How a formalized formalized

1. Medicare’s past and future interests are considered/protected appropriately.

2 The parties are MSP compliant (based on statute

formalized formalized approach to approach to MSP issues MSP issues yields MSP yields MSP 2. The parties are MSP compliant (based on statute,

regulations, guidance and case law).3. The claimant’s Medicare benefits are protected

going forward

yycompliant compliant

resultsresults

going forward.

Thank You

John V. Cattie, Jr.(866) 694-4446(866) 694-4446(704) 559-4300

j tti @ tjcattie@garretsongroup.com

WorkersWorkers ' Compensation Claims and the Payer...

Documents