Tuesday, August 8, 2017

Medicare Secondary Payer Compliance: Are You Sure You Know Everything about the Complex Secondary Payer Laws?

(Day 1)

Sponsored by Medicare Advocacy Recovery Coalition (MARC)
 

1:00 – 4:15 pm    
Crystal Ballroom G1
Convention Level

(Day 2 of this program is on Wednesday, August 9, 2017 beginning at 9:00 am in Crystal Ballroom G1.)
    
Program Moderator:
Greg McKenna
Chair of MARC and Senior Vice President of External Affairs
Gallagher Bassett Services, Inc.
Rolling Meadows, IL
    
1:00 – 2:00 pm    
A Brand New Day in Congress and the Trump Administration: Repeal, Replace and MSP Reform

    
Moderator:
Greg McKenna
Senior Vice President, External Affairs 
Gallagher Bassett Services, Inc.
Rolling Meadows, IL 
    
Speaker:
David Farber, Attorney
King & Spalding
Washington, DC 

The new Trump administration has unleashed a previously unheard debate about health care. The new focus on drug prices, the Affordable Care Act (ACA), and health care costs in general will fundamentally reshape the healthcare landscape and the Medicare Secondary Payer (MSP) program as well. Independent of all of that, physician reimbursement is also shifting from a fee-for-service to a value-based model, which raises the prospect of increasing the complexity of any MSP claim involving physician care. A leading lobbyist on MSP issues in Washington will unpack these issues and explain how the changes will reshape the MSP program. This presentation will include a detailed overview on the status of repeal and replace, Medicare access, CHIP Reauthorization Act of 2015 (MACRA) implementation, and current MSP topics in front of Congress today. 
    
2:00 – 3:00 pm    
Medicare Secondary Payer Update: The False Claims Act (FCA), Medicare Advantage and Part D

    
Moderator:
David Farber, Attorney
King & Spalding
Washington, DC 
    
Panel:
Roy Franco
Chief Client Officer
Franco Signor
Bradenton, FL 

Mary Re Knack, Attorney
Ogden Murphy Wallace PLLC
Seattle, WA
    
Michelle Allan, Attorney
Burns White
Pittsburgh, PA 

The member experts on this MARC panel will specifically discuss the following:
•The recent Takemoto and Hayes cases, other False Claims Act (FCA) decisions, and how potential FCA exposure will change the way all participants in the MSP process navigate claims; 
•The Medicare Advantage (Medicare Part C) MSP program, including new MSP cases and emerging MA-MSP trends; 
•The Medicare Prescription Drug Benefit (Medicare Part D) MSP program, including similar trends and renewed focus of MSP in the program;
•Updates to pending Part D MSP legislation

This session is intended to educate the audience on the evolving landscape of MSP related to the False Claims Act, Part C Medicare Advantage, and Part D Prescription Drug benefit. As court cases are decided, the Centers for Medicare and Medicaid Services (CMS) clarifies (and publishes formal or informal guidance) and Congress considers changing the law. This session will explore some of the tensions stakeholders navigate in claims resolution, secondary payer collection and achieving finality in case closure.
    
3:00 – 3:15 pm    
Break
    
3:15 – 4:15 pm    
Rethinking MSP – How Could It Work Better?

    
Moderator:
David Farber, Attorney
King & Spalding
Washington DC
    
Panel:
Mary Re Knack, Attorney
Ogden Murphy Wallace PLLC
Seattle, WA

Cari I. Miller
Director and Associate Counsel
Gallagher Bassett Services, Inc.
Itasca, IL 
    
Michelle Allan, Attorney
Burns White
Pittsburgh, PA 
    
Heather Sanderson 
Chief Legal Officer 
Franco Signor 
Bradenton, FL 

As Washington undergoes regulatory simplification and transformation, it is time to consider how the Medicare Secondary Payer (MSP) laws could be simplified and clarified. The goal of this session is to teach professionals the legal principles and concepts underlying the MSP laws, and to discuss, in a panel format, ways in which the MSP laws, regulations and subregulatory guidance could be streamlined, simplified, and clarified. 

Building on last year’s session, this panel will explore the fundamentals of the MSP laws, and how CMS has implemented the laws through regulation and sub-regulatory guidance. The complexity of the laws, and the agency’s implementation of them, is ripe for review. Given the environment in Washington and the anti-regulatory sentiment sweeping through the Department of Health and Human Services and the Centers for Medicare and Medicaid Services, it is appropriate to rethink how the goals of the MSP program could be achieved more simply and efficiently. Through this panel discussion, participants will learn how to navigate MSP issues in the context of claims resolution, and consider alternative methods of compliance.