Agenda / Content Covered

All times are shown in Eastern time

1. Medicare Secondary Payer, Conditional Payments and Set-Asides: Recent Changes
   10:00 - 10:30, Casey Fundarek
2. Medicare Conditional Payment Recovery
   10:30 - 11:30, Casey Fundarek
   1. Conditional Payment Essentials and Process Overview
   2. Rights and Responsibilities Letter
   3. Conditional Payment Letter
   4. Disputing Unrelated Payments
   5. Criteria for Obtaining CMS Approval
   6. Recovery Demand Letter
   7. Forms and Checklist
3. CMS Notification Process and Communication Tips
   11:45 - 12:15, Casey Fundarek
   1. Reporting the Case
   2. Getting Quick Responses: Tips and Tactics That Really Work
   3. The Amended Review Process
4. Navigating the Medicare Secondary Payer Recovery Portal
   12:15 - 12:45, Susan V. Mason
5. Medicare Set-Asides
   1:15 - 2:15, Susan V. Mason
   1. Evaluating the Case for Future Medicals
   2. Allocations and Calculating MSA Amounts
   3. Medical Care to Include in the MSA
   4. Preparing MSA Proposals
   5. Tips for Successful Submissions
   6. Funding, Monitoring and Administration
6. Understanding How Medicaid Impacts the Case
   2:15 - 3:15, Susan V. Mason
   1. Medicaid Overview and Rights of Recovery
   2. Medicaid Resolution in Personal Injury Cases: Process and Procedure
   3. Identifying Liable Third Parties as Primary Payers
   4. Working with Medicaid Agencies
   5. Protecting Medicaid's Future Interest
7. The Medicaid Secondary Payer Statute and CMS 2390-F - New Requirements
   3:30 - 4:00, Susan V. Mason
8. Paralegal Ethics
   4:00 - 5:00, Casey Fundarek
   1. Obligations Towards Third Parties
   2. Avoiding UPL
   3. Communication with Client
   4. Maintaining Client Confidentiality

Accreditation Details:

CASEY FUNDAREK is the Medicare Secondary Payer compliance attorney for Sharpline Allocations, Inc. She oversees all Medicare conditional payment matters and Medicare Set-Aside re-review and amended review defenses, and develops Medicare Set-Asides, Medical Cost Projections, and Zero Medicare Set-Aside evaluations. Ms. Fundarek guided clients through their Medicare-related issues for the past four years, helping them understand their liability, use all available defenses and mitigate future medical exposure for both workers’ compensation and liability claims. She attends claim review and other client meetings to provide strategic insight on the Medicare-related issues. Ms. Fundarek received her Bachelor of Science degree from Texas Christian University and her Juris Doctor degree from Valparaiso University School of Law. When she is not tackling Medicare issues, Ms. Fundarek enjoys taking care of her three labs and designing knit caps.

SUSAN V. MASON is an attorney at First Review, Inc., and is licensed to practice law in Pennsylvania and Ohio. Her legal work for 20+ years has focused on workers’ compensation litigation. For the last 15 years, she has also concentrated her practice in the evolving field of Medicare Set-Asides and compliance with the Medicare Secondary Payer Statute. She is a certified Medicare Set-Aside Consultant (MSCC). Ms. Mason has litigated hundreds of workers’ compensation cases from trial to appeal. Her clients have included international and national employers, insurance carriers, and third-party administrators. She also provides Medicare compliance consulting, Medicare Set-Aside allocation reports, submissions to CMS, and conditional payment search and negotiations for employers, employees and both plaintiff and defense attorneys across the country when the Medicare Secondary Payer Act (MSP) applies to a settlement as a result of a claimant’s age, Social Security entitlement, or the value of the settlement. Ms. Mason is a graduate of Chatham University and the Widener University School of Law. She is a member of the Allegheny County Bar Association, the Pennsylvania Bar Association, and is an active member of the National Alliance of Medicare Set-Aside Professionals (NAMSAP).