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.