Medicare
Set Asides in Workers' Compensation:
Understanding the Risks and Procedures
Bob Gisclair -
Gisclair Medical Services, LLC
Tom Files - myMatrixx
Tommy Ruli - Juge,
Napolitano, Guilbeau, Ruli, Frieman & Whiteley
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History |
- A comprehensive history
from the initiation of the Medicare Secondary Pay Statute (MSP) in 1980
up to the Medicare, Medicaid, and SCHIP Extension Act of 2007 (MMSEA)
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Statutory Provisions |
- Protecting
Medicare's interest
- Conditional Payments,
Reimbursements -
Self Reporting
Requirements Effective July 1, 2009 - You will receive a complete copy
of the MMSEA
Section 111 Medicare Secondary Payer Mandatory Reporting Liability
Insurance, No-Fault Insurance and Workers’ Compensation User Guide
version 1.0
- Enforcement and
Penalty Provisions
- Self Reporting
Requirements Effective July 1, 2019
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What is MSA |
- When the MSP applies -
what types of claims? The basics of what makes up a Medicare Set-Aside
Allocation
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Deciding on when to complete an MSA |
- What cases need an MSA
and what cases do not
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Setting the Claim |
- The in's and out's of
closing the file
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Funding the MSA |
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Components of an MSA |
- How do we determine just
how much to set aside
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Establishing the Allocation Amounts |
- Just how is this amount establish
- The specifics of how an allocator
reaches conclusions
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Drug Pricing |
- The latest on Average
Wholesale Price
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Administration Options and Requirements |
- Can the claimant
take care of these fund?
- What happens if he/she
can not?
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Exhausting the Account |
- What happens if
the claimant runs out of money in any particular calendar year?
- Will Medicare help?
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APPLIED FOR
-
6 Hours of
Mississippi Adjuster Licensing CE Credit
-
6 Hours of Louisiana
Department of Insurance P/C or LHA
-
6
Hours Mandatory Continuing Legal Education
Applied For
Continuing Education
Seminar (6 hrs)
The Bankers Center -
Baton Rouge, LA
Wednesday, March, 31
2010