Archive for category: Events

<center>Upcoming CMS Webinar:<br>September 24, 2020</center>

Upcoming CMS Webinar:
September 24, 2020

According to the CMS website,, CMS will be hosting a Commercial Repayment Center (CRC) Non-Group Health Plan (NGHP) Applicable Plan webinar to go over procedures and best practices for post demand dispute appeals called redeterminations.

As listed on the website’s announcement, the “format will be opening remarks by CMS followed by a presentation from the CRC. This webinar will primarily focus upon how to effectively submit a redetermination request (sometimes called a first level appeal). During the presentation, we will also be reviewing appeal requirements, what is and is not subject to appeal, and details about what documentation is needed to support the appeal request in various situations. Questions for this webinar may be submitted in advance to Questions should be submitted no later than Friday, September 11, 2020.”

Call in details are below and it is suggested that participants call in 15 minutes prior to the call to ensure access:


Date: Thursday, September 24, 2020

Time: 1:00 PM ET

Webinar URL: NGHP Appeals Webinar

Conference Dial In: 888-829-8669

Conference Passcode: 6799170



CMS To Speak at NAMSAP Annual Meeting

The National Alliance of Medicare Set-Aside Professionals has just announced that representatives from the Centers for Medicare and Medicaid Services (CMS) will be speaking at their Annual Meeting of the on April 25-26 in Baltimore, Maryland.

The following CMS representatives will discuss current topics and take questions from NAMSAP members:

  • John P Albert, Acting Director, Division of Medicare Secondary Payer Policy and Operations
  • Barbara Jean Wright, Senior Technical Advisor, MSP
  • Cynthia Gross, Health Insurance Specialist, Division of Medicare Secondary Payer Policy and Operations
  • Elizabeth V. Poole, Health Insurance Specialist, Division of Medicare Secondary Payer Policy and Operations

NAMSAP Holds Inaugural Mid-Year Workshop in Chicago

The National Alliance of Medicare Set-Aside Professionals (NAMSAP) hosted a mid-year educational workshop on September 20, 2012 at the Chicago Marriott Schaumburg Hotel.   NAMSAP is a non-profit trade association that exclusively addresses the issues and challenges of the Medicare Secondary Payer Statute, and its impact on workers’ compensation and liability settlements.

This mid-year workshop, a first for NAMSAP, had about 65 attendees representing virtually all of the stakeholders in the Medicare Secondary Payer (MSP) compliance industry including allocators, insurance carriers, insurance defense attorneys, insurance plaintiff attorneys, life care planners, structured settlement brokers, MSP vendors, etc.   This diversity, the interactive format of the meeting, and the quality of the speakers and program made this one of the best MSP conferences I have ever attended.

Something that became clear to me this week is that news and events in the MSP world have moved into high gear.   News of some kind, whether it is a new court case, news of activity on a congressional bill, a CMS policy, U.S. Supreme Court activity, CMS request for comment, etc seems to break every day or two.   This makes a conference like this, put on by the MSP industry’s trade organization and the leading educator in the industry, even more relevant for those who work in this industry.


The NAMSAP Conference Committee

The talent and dedication of the NAMSAP conference committee and others is what made this important conference such a success.  So, my congratulations to the conference chairman Tom Matson (Medivest), the co-chairman and the other members of the committee, Gary Patureau (LASIE), Greg Gitter (Gitter & Associates), Tom Files (MyMatrixx) and Fran Provenzano (MSA Specialists).  Others that assisted were Leslie Schumacher (PlanPoint MSA) as the board liaison, Education Committee co-chairs Tom Spratt (Protocols) and Christine Melancon (ez-MSA), and president Mike Westcott (Ringler Associates).


The Educational Program

National Legislative Update: Ben Basista (Burns White) and Mike Westcott (Ringler Associates) discussed the latest developments involving the Strengthening Medicare And Repaying Taxpayers (SMART) Act of 2011, which interestingly, passed the full U.S. House Energy and Commerce Committee by unanimous vote that very afternoon.   The panel then discussed NAMSAP’s response to the recent Centers’ for Medicare and Medicaid Services (CMS) request for public comment on liability MSAs (known as CMS-6047-ANPRM).  Finally, the case of Hadden v. U.S. was discussed.  The U.S. Supreme Court had a conference on Monday, September 24, 2012 to decide if they will hear arguments on the case.

Tips for Weaning Claimants off of Narcotics:  Phil Walls RPh (MyMatrixx) and Dr. Mitchell Nudelman (Medical Director Solutions, LLC) presented a session on their strategies for successfully weaning claimants of heavy narcotics.

Trends for Allocators:  Speakers Fran Provenzano (MSA Specialists), Eileen Atkinson (Genex) and Leslie Schumacher (Planpoint MSA) provided a fascinating, in-depth look at the latest trends for allocators to consider in terms of file preparation, medical treatments, pharmaceutical trends, etc.

Payer Perspective:  Three experts, representing insurance carriers: Todd Reimer (Liberty Mutual), Sue Caito (Midwest Employers Casualty Corporation) and Neal Hayenga (QBE) talked about MSP issues from their perspective.   They discussed factors that can hold up a settlement, what they do with “below CMS threshold” cases, implantable devices, specific Rx pricing and treatment issues, CMS delays, lack of appeals process, Section 111, conditional payments, etc.  This was insightful, relevant and as good a presentation as I’ve ever heard anywhere.

Structured Settlement Broker Perspectives:  Brad Cantwell (EPS), Don Engels (Selective Settlements) and John Muir (Ringler Associates) presented on how CMS guidelines and procedures effect settlements.

Ethics in the MSP Industry:  This panel, lead by Earlene Doyle (Medical Management Concepts), James Early (Ringler Associates) and Perry Staub (Taggert Morton), talked about ethical issues facing the MSP professional.  The NAMSAP Statement of Ethics and Professional Responsibility was analyzed.  Then relevant federal and state laws were discussed followed by specific ethical situations that allocators and structured settlement brokers face.

Benchmark Rx Pricing & Industry Resources:  Matt Larkin (Experea Healthcare) finished the day by discussing prescription drug pricing related to the Longshoreman and Defense Base Act, Workers Compensation rates, Usual and Customary rates, Average Wholesale Price, etc.    Matt concluding his presentation by demonstrating a new software program that he is working on that will provide valuable Rx rate schedule information to the MSP Industry.


The NAMSAP Board Meeting

In addition to the Mid-Year Workshop, NAMSAP held a board meeting in Chicago where they conducted a long-term and short-term strategic planning session.   The current board members of NAMSAP are:  Michael Westcott (Ringler Associates) President, Doug Shaw (Medivest) President Elect, Deborah Pfeifle (Gould & Lamb) Secretary, David Korch (EPS Settlements Group) Treasurer, Aaron Fredrickson (MSP Compliance Solutions), Barbara Bate (Northeast Life Care Planning), Ben Basista (Burns White), Fran Provenzano (Medicare Set-Aside Specialists), Leslie Schumacher (PlanPoint MSA), Mark Popolizio (Crow Paradis), Matt Larkin (Experea Healthcare), Nicole Singleton – (Third Eye Group) Executive Director non-voting.


NAMSAP Hosts Eighth Annual Meeting and Educational Conference

The National Association of Medicare Set-Aside Professionals (NAMSAP) hosted its 8th Annual Meeting and Educational Conference at the Loews Royal Pacific Hotel, at the Universal Studios Resort in Orlando, FL on March 28-30, 2012. NAMSAP is a non-profit trade association that exclusively addresses the issues and challenges of the Medicare Secondary Payer Statute, and its impact on workers’ compensation and liability settlements.

Over 150 members representing attorneys, MSA vendors, insurers, structured settlement brokers and other stakeholders attended the conference. The feedback from the attendees was exceptionally positive. Many described it as the best conference NAMSAP has ever had. My congratulations to NAMSAP, and especially to the NAMSAP Conference Committee, for putting on a very successful program. The conference chairman was Tom Matson (Medivest) and the members of his committee were Gary Patureau (LASIE), Greg Gitter (Gitter & Associates), Tom Files (MyMatrixx), and Christine Melancon (EZ-MSA) with Leslie Schumacher (PlanPoint MSA) as the board liaison.

The Educational Program

Congressman Dennis Ross (R-FL): The highlight of the excellent educational program was the keynote presentation by U.S. Congressman Dennis Ross (R-FL), a co-sponsor of H.R. 1063: Strengthening Medicare and Repaying Taxpayers (SMART) Act of 2011. Congressman Ross spoke very knowledgeably about the SMART Act, past limitations and future improvements needed for the Medicare Secondary Payer (MSP) Program. He informed the audience of a new bill he is currently drafting and invited NAMSAP members to meet with him to offer their opinions as to what would help make this latest bill more successful.

Evidence Based Medicine and CMS Policy: Dr. Trang Nguyen, MD, Dr. Dave Randolph, MD, Dr. Suzanne Novak, MD and Attorney Perry Staub discussed the scientific approach of Evidence Based Medicine and why it should be used by Medicare as the standard in preparing and evaluating Medicare Set-Aside proposals.

Tips, Trends, and Tendencies: The Data and Development Committee: Speakers Deborah Pfeifle (Gould & Lamb), Marty Cassavoy (Crowe Paradis), Rita Ayers (Tower MSA) and Fran Provenzano (Medicare Set-Aside Specialists, Inc.) spoke about a very exciting project, primarily the brainchild of Matt Larkin (Experea Healthcare) to collect, aggregate and distribute data analytics for the Medicare Secondary Payer (MSP) industry. The goal of this effort is for NAMSAP to be an information resource and to lay the foundation for best practices through data analytics. In addition, these presenters discussed current trends and practice tips that the industry is experiencing.

Liability MSA Issues. Two panels dealt with the issues regarding Liability MSAs. The first, presented by Diana Dunn-Roberts (Medivest), Dan Smith (Coye Law Firm) and Steve White (Liberty Mutual) discussed the major differences between workers’compensation and liability MSAs. The second panel; Beth Meyer (Subrogation Claims Specialist), Daniel Simone (Weidner & McAuliffe) and Tom Ash (Ametros Financial) talked more about the specifics on how to prepare and utilize a liability MSA within a settlement.

Superbad Claims: Greg Gitter’s (Gitter and Associates) presentation focused on complex and catastrophic claims. Greg provided tremendous insight from his years of experience in dealing with these claims, and more importantly provided tips on mitigating the high exposures that are associated with these cases.

The Greater Good: Tom Files (MyMatrixx) helped usher in an era of cooperation and teamwork within NAMSAP. Tom spoke about common issues we all face working within the MSP compliance industry, and commented on that we are now coming together to make positive changes to the industry that will benefit us all.

Legal Update: Janice Rickert (Rickert & Rickert, P.A.), Gail Diamond Baker (Kelly Kronenberg), and John Cattie (Garretson Resolution Group) gave an insightful legal update reviewing current court decisions that will affect the MSA industry.

Pre, Current, and Post MSA: Stacy Guillory (LWCC), Jeff Knipper (CCS Holdings) and Steve Peacock (Safety National) discussed strategies that can be implemented throughout the claims process to help mitigate MSA costs.

MSA Jeopardy: The final event on Friday afternoon was the annual MSA game show, hosted by the incomparable Christine Melancon (EZ-MSA), where contestants from the crowd came up to play MSA Jeopardy.

Board of Directors: NAMSAP also announced their officers and board of directors for the upcoming year. My congratulations to the two newest Board members, Aaron Fredrickson and Matt Larkin! The 2012-13 Board of Directors are:
Michael Westcott (Ringler) – President
Doug Shaw (Medivest) – President Elect
Deborah Pfeifle (Gould & Lamb) – Secretary
David Korch (EPS Settlements Group) – Treasurer
Nicole Singleton – (Third Eye Group) – Executive Director non-voting
Aaron Fredrickson (MSP Compliance Solutions)
Barbara Bate (Northeast Life Care Planning)
Ben Basista (Burns White & Hickton)
Fran Provenzano (Medicare Set-Aside Specialists)
Leslie Schumacher (PlanPoint MSA)
Mark Popolizio (Crow Paradis)
Matt Larkin (Experea Healthcare)


NSSTA holds its 2010 Fall Educational Conference

The National Structured Settlement Trade Association (NSSTA) held its 2010 Fall Educational Conference at the Bellagio Hotel in Las Vegas on November 10th -12th.   Approximately 200 attendees were treated to an excellent educational program in impressive surroundings.

The program opened on Wednesday evening with Congressman Dean Heller, R-Nevada as the guest speaker at the welcome reception.   Congressman Richard Neal, D-Massachusetts was the luncheon keynote speaker on Thursday.  Both of these U.S. congressmen provided some very interesting perspectives on the recent elections and what to expect with the new Congress.

Thursday’s presentations covered a broad range of topics, including:  Political Report, In-Force Structured Settlements, Protecting Medicare’s Interest in ALL Settlements, The Do’s and Don’ts of Structured Settlements, A Perspective of Structured Settlements, NSSTA Legal Committee Update, How Life Care Planners Can Help You Tailor Your Settlement, and Ratings: Right and Wrong.

The conference continued Friday morning with: Wrongful Imprisonment & Structured Settlements, The Certified Structured Settlement Consultant (CSSC) Program, Structured Settlements: What I Tell My Clients About Them and Why, Marketing Structured Settlements Through the Internet, and 2010 Election Results – Impact on Structured Settlements.

As you can see, there was a strong focus on legislative affairs, which has been a top priority of NSSTA for many years now.  There was also some news that the marketing committee is working on some new plans to try to grow and expand the entire structured settlement industry.

David Korch, EPS Settlements and myself, Doug Shaw, Medivest Benefit Advisors, Inc. gave the panel presentation on Thursday which focused on MSA’s in Liability Settlements.   We emphasized that there is some clarity that is starting to form with  Medicare Secondary Payer compliance in liability settlements.  We also gave a current update which included comments about “TPOC” day, U.S v. Stricker, Bradley v. Sebelius, and U.S. v. Hadden, all of which we have explained in previous blogs.


NAMSAP holds its Sixth Annual Meeting and Educational Conference

The National Alliance of Medicare Set-Aside Professionals (NAMSAP) held its Sixth Annual Meeting and Educational Conference on September 30th and October 1st in Arlington Virginia.

The event was well attended by many different stakeholders in the industry including allocators, carriers, defense attorneys, plaintiff attorneys, structured settlement consultants and MSA professional administrators.  In my opinion, the highlight of the event was the exceptional quality of the educational presentations.   The panel approach, together with excellent audience interaction, was used for most presentations and it worked extremely well.  The topics were well chosen and maintained a broad appeal to a diverse audience.

Eric Vaughn, the current Executive Director of the National Structured Settlement Trade Association (NSSTA), did a terrific job as the keynote speaker.   He was dynamic, engaging and humorous throughout.  He challenged NAMSAP to work together with NSSTA on issues that we agree on in order to grow our industries together.  He said not only is his door always open, but there is also a chair at his table that is available to sit and work together.

The first legal update presentation by Mark Popolizio, Jill Schroeder and Martin Cassavoy updated the audience on current case law effecting our industry.  Interestingly, the US v. Stricker opinion was published the same afternoon that they were speaking about it (more about this in a later blog).  Later, Roy Franco updated the audience on the progress of the Medicare Secondary Payer Enhancement Act (HR 4796), which was introduced in the House of Representatives in April of 2010.

There were six additional presentations which discussed topics ranging from professional administration and structured settlements to an MSA case study and rated age discussion.  There was also a buffet dinner provided in the hotel’s top floor restaurant, which provided an excellent networking opportunity.  As part of his closing remarks, President Michael Westcott announced that the next annual meeting would be held in New Orleans in October 2011.

On a personal note, I am honored to be serving on the board of directors of NAMSAP for this upcoming term.   I also will be serving as Secretary of the Board.   These are exciting times to be in the Medicare Set-Aside Industry.

For a very good review of the event see the blog article written by Patrick Hindert, Managing Director of The Settlement Services Group, at .