Liability Medicare Set-Asides (LMSAs) and Section 111 Civil Monetary Penalty (CMP) Rulemakings: Coming in 2019?

3:15 – 4:15 pm

Crystal Ballroom G1
Convention Level

Sponsored by Medicare Advocacy Recovery Coalition (MARC)

The past decade has witnessed an explosion of interest in the Medicare Secondary Payer program. Yet, unknown to most in the claims community, there is an even larger program that may impact claims in the coming years – Liability Medicare Set-Asides (LMSAs). Further, the threat of Civil Monetary Penalties (CMPs) for noncompliance in Section 111 Reporting is looming over Responsible Reporting Entities (RREs) for a potential penalty of up to $1000 per day/per claim.

In fact, LMSAs can have considerable impact on the claims resolution process. This is because at least 10-20% of liability claims involve Medicare beneficiaries. Further, without specific safe harbors that would shelter RREs from CMPs, strict liability in Section 111 Reporting would be unfair to the primary plan.

Come join us to take a deep dive into exactly what these legislative rulemakings impacts may be against the settling parties. The session will also explore how the claims community has navigated the issues to date, and how the community will need to adjust its claims practice to get in front of these MSP changes.

Roy Franco
Chief Client Officer
Franco Signor LLC
Bradenton, FL

Mary Re Knack
Ogden Murphy Wallace PLLC
Seattle, WA

Jennifer Pickard
Director of Liability Claims
Bentonville, AR

Mark Popolizio
Vice President of MSP Compliance & Policy
ISO Claims Partners
North Reading, MA


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