RISE Medicare Secondary Payer World 2023 Conference

5 Major Features of RISE’s 2023 Mega Medicare Secondary Payer Conference

Rafael Gonzalez, Esq. Cattie & Gonzalez, PLLC

The industry’s most comprehensive Medicare Secondary Payer (MSP) event will take place March 1-3, 2023 at an exciting new venue in Tampa, Fla., the Westshore Grand, a Tribute Portfolio Hotel. Written by Tricia Rosetti, content marketer at RISE, here’s an inside look at the top five features we’ve planned for a premier conference experience.

Established and emerging leaders in insurance, health care, financial services, and litigation of auto, liability, no-fault, and workers compensation claims will convene at?MSP World 2023?to discuss critical topics including mandatory insurer reporting, conditional payment resolution, set aside allocations, legislative updates, current case law impacting MSP, and strategies to avoid civil money penalties. Featuring more than 20 sessions with industry-leading speakers, this year’s agenda offers high-quality content related to four key themes: resolving conditional payments with Medicare Advantage, agents, and assignees; mandatory insurer reporting updates; review of Medicare set asides pre- and post-settlement; and strategies for Medicaid and Medicare lien resolution.

Here are five features RISE has planned for the leading conference experience in the market:

1. A comprehensive preconference workshop

The conference will include a four-part preconference workshop on Wednesday March 1:

Part one will?explore successful conditional payment resolution with a Medicare Advantage Plan (MAP). Participants will assess all communication approaches between MAP and payer in liability, no fault, and workers compensation claims to resolve conditional payments, best practices between MAP, claimant, and the claimant attorney to identify what information and evidence is needed to resolve conditional payments, and the available appeals process to payers and claimant/counsel when conflict arises in resolution of conditional payments.

The second part will examine?best?practices to resolve conditional payments with MAP third party contracted agents. During this session, participants will analyze communication strategies between agent and payer to acquire critical information related to the claim, proven approaches used by agent, claimant, and claimant attorney to improve chances of a successful resolution of conditional payments, and successful appeals mechanisms for payers and claimant/counsel to secure a positive outcome when disputing conditional payments.

Part three will focus on?best practices for successful resolution with the MAP assignee, including how a MAP can assign a claim and how assignees are involved in the case, the legal procedures of the assignee during the collection process and how it differs from traditional recovery process, and different communication approaches when dealing with the assignee to resolve conditional payments.

The workshop will wrap with?a?review of MAP assignees private cause of action litigation trends,?where participants will examine individual cases against payers for double damages that have been filed, litigated, tried, and appealed. The discussion will focus on the process, information required, and potential outcomes, class action lawsuits and how they differ from individual cases, including evidence required, and information exchange during the lawsuit, and recently decided cases to identify common themes which define approaches for appropriate handling of MSP issues with assignees in future cases.

2. Headlining keynote address

To kick off the main conference,?Jay Wolfson, Dr.P.H., J.D,?distinguished service professor of public health, associate vice president for health law, policy and safety, senior associate dean for health policy and practice at the Morsani College of Medicine, University of South Florida, will deliver a keynote address, providing a federal and state level overview of the current Medicare and Medicaid landscape.

Dr. Wolfson researches and writes about health care law, ethics, policy, technology, safety, and finance; provides research-based analyses to state and federal branches of governments; and is a health policy consultant to national and international news organizations. Among his many accomplishments, he won the largest Medicare fraud and abuse settlement involving a single clinician in U.S. Centers for Medicare & Medicaid Services (CMS) history and has been a faculty scholar to the U.S. Centers for Disease Control and Prevention.

Throughout his keynote, Dr. Wolfson will delve into the statistics related to Medicare beneficiary growth and its impact on expenditure nationwide, the massive growth in Medicaid membership post pandemic, and its impact on state budget and spending, and the future of health care in America based on current trends, potential political changes, and updates to legislation from CMS.

3. Tailored concurrent track sessions

Both days of the main conference will feature two curated track sessions, each including three targeted sessions, to provide attendees with the opportunity to choose the sessions that would be most beneficial.

Day one tracks will include:

Track A, a?spotlight on strategies for Medicaid lien success. Sessions will include:

• An overview of Medicaid third-party liability liens federal law
• Assess variations between different state Medicaid lien laws
• US Supreme Court Gallardo effect on Medicaid liens

Track B, a?focus on techniques for positive Medicare lien outcomes,?with sessions including:

• A review of Medicare conditional payment federal law
• ORM accepted: Conditional payment resolution process
• ORM not accepted: Conditional payment resolution process

Concurrent track session topics on day two will be:

Track A, an?evaluation of MSA pre-settlement processes,?including:

• An overview of medically based traditional Medicare Set Asides (MSA)
• A summary on non-submit MSAs
• The status of MSA appeals

Track B, a?review of MSA post-settlement administration processes,?with the following sessions:

• Pros and cons of self-administration of MSA funds
• Pros and cons of professional administration of MSAs
• MSA exhaustion and turning Medicare into the primary payer

4. Thought-provoking panel discussions

This year’s agenda includes several general session panel discussions between industry leaders as they discuss critical topics related to the pillars of MSP.

During the session,?successful processes for payers to query and report to CMS, panelists will discuss the process of querying with Medicare for beneficiaries’ status, which information needs to be reported to Medicare depending on acceptance of Ongoing Responsibility for Medical (ORM), and reporting data to avoid errors and implement a process to capture and correct mistakes when needed to comply with mandatory insurer reporting (MIR).

Conference chair Rafael Gonzalez, Esq., partner, Cattie & Gonzalez, PLLC, will moderate the panel discussion,?new on the horizon: MSP 2023 and beyond, to gain leaders’ thoughts on the future of MSP. The panel will discuss valuable content covered in previous topics including resolving conditional payments with MAP or agent or assignees, CMS changes on the horizon that positively or negatively could impact MSP, changes in MSP processes based on recent trends of cases referred to the US Department of Treasury and Justice and successful resolution of Medicare and Medicaid liens, and future changes to MIR related to PAID Act information including MAP and prescription drug plans, and inevitable regulations on civil money penalties.

The conference will conclude with an?industry leaders wrap up discussion, moderated by Gonzalez, where panelists will explore MA , agents, and assignees right of reimbursement and current activity; the current state of mandatory insurer reporting and anticipated rules related to civil money penalties; and the pros and cons of self-administered or professionally administered post settlement process related to MSA funds.

5. A new, luxurious venue

Taking place at the unique and stylish Westshore Grand, a Tribute Portfolio Hotel in Tampa, Fla.,?MSP World 2023?will bring a new level of luxury to attendees’ conference experience. With an authentically modern feel combined with top-notch food and beverage, attendees will enjoy their networking time in style. Plus, located just five miles from downtown Tampa, shopping, dining, and nightlife is right nearby.

MSP World 2023?will take place March 1-3 at the Westshore Grand, a Tribute Portfolio Hotel in Tampa, Fla. Click?here?for the full agenda, speaker lineup, and registration information.