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Speaker Information:

Michelle A. Allan, Partner, Gordon & Rees

Michelle A. Allan is a Partner in the Pittsburgh office of Gordon & Rees and is a member of the Medicare Compliance practice group. She focuses on Medicare issues that arise in the resolution of workers’ compensation, longshore, Jones Act, and general liability claims.

Allan has been instrumental in successfully settling tens of thousands of cases nationwide involving Medicare Secondary Payer issues. Her work includes preparing Medicare Set-Aside Arrangements and having the same approved by the Centers for Medicare and Medicaid Services. Allan makes recommendations on how best to consider and protect Medicare’s interests while also balancing her clients’ interests in claims not requiring Medicare approval. In addition, Allan negotiates Medicare conditional payments and has saved her clients millions of dollars in conditional payment reimbursements.

Allan is a recognized national presenter on Medicare Secondary Payer issues, and frequently lectures on the topic of Medicare compliance to insurance carriers, self-insured businesses, third-party administrators, law firms, and other professional organizations. She is also a 2011 inductee to The Legal Intelligencer’s prestigious class of Lawyers on the Fast Track.

While attending law school, Allan served as an extern for the United States Magistrate Judge Ila Jeanne Sensenich in the United States District Court for the Western District of Pennsylvania. Prior to attending law school, Allan worked as a journalist, reporting daily news for the Pittsburgh Tribune-Review.


Daniel Anders, Esq., MSCC, Chief Compliance Officer, Tower MSA Partners

Daniel M. Anders, Esq., is the Chief Compliance Officer for Tower MSA Partners where he oversees the Medicare Secondary Payer (MSP) compliance program. In this position, Anders is responsible for ensuring the integrity and quality of all MSP compliance services and products. Based upon his 14 years of experience in working with employers, insurers, TPAs, attorneys and claimants, Anders provides education and consultation to Tower MSA clients on all aspects of MSP compliance. He also regularly offers expert guidance on Tower MSA’s MSP Compliance Blog, has been featured in “Leaders Speak” on WorkCompWire and is regularly quoted on WorkCompCentral in regard to MSP matters.


 Amy E. Bilton, Esq., MSCC, CMSP-F, Attorney, Nyhan, Bambrick, Kinzie, & Lowry

Amy E. Bilton, Esq., is a shareholder, Medicare Secondary Payer professional, and workers’ compensation defense trial attorney at the Chicago law firm of Nyhan, Bambrick, Kinzie & Lowry. She received her B.A. from the University of Michigan and J.D. from DePaul University College of Law. She also has her Medicare Secondary Payer Consultant certification (MSCC) through the International Commission on Health Care Certification and Certified Medicare Secondary Payer Fellow (CMSP-F) certification.


Bilton is a frequent lecturer in workers’ compensation and all aspects of Medicare Secondary Payer compliance, as well as in the intersection of the opioid epidemic with both of these areas of law. She serves on the boards of: the National Alliance of Medicare Set-Aside Professionals, for which she is the current vice president and co-chair of the Evidence-Based Medicine committee; the International Commission on Healthcare Certification, for which she serves on the Board of Commissioners for the Medicare Set-Aside Consultant Certified (MSCC) certification; and the Illinois Workers’ Compensation Medical Fee Advisory Board. Bilton is also a member of the Chicago Bar Association, Illinois State Bar Association, Illinois Workers’ Compensation Lawyers Association, American Bar Association, California Coalition on Workers’ Compensation, DRI and the National Council of Self-Insureds.


Chris Carpenter, President, Case Management Solutions, Inc. 

Chris brings over 25 years’ experience in the Workers’ Compensation and Liability industry providing sales, account management, leadership, and operational oversight. Her diverse experience within the managed care industry has allowed her to work with numerous insurance companies, third party administrators and self-insured employers throughout the country assisting them in developing cost effective claim management outcomes.  In addition to providing complex claim solutions, Chris also has twelve years of direct experience working with clients to address Medicare Secondary Payer compliance.  She enjoys working collaboratively buildinging strong client relationships and strives to bring value to her clients while ensuring quality in delivery of all services provided by Case Management Solutions. Chris is a member of National Alliance of Medicare Set-Aside Professionals, National Council of Self-Insurers and active in The Alliance of Women in Workers’ Compensation, RIMS and Kids Chance. Chris grew up in the Chicago area, resides in Kansas City with her family and graduated Cum Laude from Illinois State University.


John V. Cattie, Jr., Founding Member, Cattie, PLLC

John V. Cattie, Jr. is one of the nation’s most well-respected MSP legal scholars.  Cattie received his BA from the University of North Carolina and his JD/MBA from Villanova University.

Cattie has personally reviewed or overseen the review of over 10,000 distinct fact patterns. Federal and state court opinions such as Smith v. Marine Terminals of ArkansasTye v. Upper Valley Medical Center, and Doe v. Company X cite his analysis favorably. In each case, his client’s future medical exposure was minimized or extinguished based on how Cattie analyzed the MSA issue. In the Doe case, that difference amounted to a 90% or almost $900,000 reduction in future medical exposure for his client. The Doe Court stated the following in its opinion: “The Court finds that Mr. Cattie’s analysis is more credible [than his opponent’s] in the liability context.”

Cattie is the Founding Member of Cattie, P.L.L.C. His law firm is dedicated to extinguishing a client’s future medical exposure under the MSP Act. He focuses his law practice on MSA issues, providing legal opinions regarding MSA requirements, a client’s future medical exposure under the MSP Act and proper MSA funding.


Lavonya Chapman, Medicare Secondary Payer Compliance Counsel, Optum Settlement Solutions

As Medicare Secondary Payer Compliance Counsel at Optum Settlement Solutions, Lavonya Chapman is a consultant on Medicare Secondary Payer (MSP) claim compliance issues, including Mandatory Insurer Reporting, ICD injury code reporting, Conditional Payment Resolution, Medicare Set-Aside Allocations, CMS approval and professional administration.

Prior to joining Optum in 2014, Chapman served as director of MSP compliance for Arthur J. Gallagher & Company for 14 years. She was also the claim director for a new liability captive in which nearly all the claimants/plaintiffs were Medicare beneficiaries or dual eligible. Additionally, Chapman has experience in private law practice, litigating medical malpractice, premises and auto liability claims as well as workers compensation cases. She taught pharmacology many years at the University of Alabama at Birmingham, and was a utilization review and HIPAA consultant for the Alabama Hospital Association.

Chapman presents on all aspects of the Medicare Secondary Payer Act as it pertains to claim compliance involving all type of claims. She is a licensed registered nurse, an attorney licensed in both Alabama and Florida, and a certified Medicare Secondary Payer Professional


Jacqueline Cipa, Medicare Secondary Payer Operations Team Lead, Division of Medicare Secondary Payer Operations

Jacqueline Cipa started her career with CMS in 2010 after graduating with her Master of Public Health from the University of Pittsburgh. The majority of her time at CMS has been spent in the Office of Financial Management working with Medicare Secondary Payer (MSP) in multiple capacities. Cipa has both breadth and depth of experience, having been or currently performing as a project lead and a subject matter expert across several diverse areas, among other roles. She has led the development and execution of several new procurements, implemented quality improvement projects, and mentors newer staff. In 2015, Cipa became the MSP Operations Team Lead. The team she leads oversees the operations of the Benefits Coordination and Recovery Center (BCRC) and the Commercial Repayment Center (CRC).

Cipa was originally a chemist from Pittsburgh, PA. She lives with her husband and daughter on several acres of land along with their cats and chickens and yes, she was once a Jeopardy! champion.


Annie M. Davidson, MSP Compliance Counsel, Examworks Clinical Solutions

Annie M. Davidson is a MSP Compliance Counsel for ExamWorks Clinical Solutions. Ms. Davidson has comprehensive experience in the areas of Medicare Secondary Payer (MSP) Act compliance and Medicaid recovery in liability, no‐fault, and workers’ compensation matters. Davidson provides high‐quality legal analysis to ensure the integrity and quality of ExamWorks Clinical Solutions’ Medicare Secondary Payer compliance services and related products. Additionally, Davidson is a nationally recognized expert on MSP issues who presents regularly at local and national conferences.

Davidson is admitted to practice law in the State of Minnesota and the United States District Court for Minnesota. Prior to her work with ExamWorks Clinical Solutions, Davidson practiced as an insurance defense litigator with a Minneapolis law firm. In that position, Davidson gained significant experience handling workers’ compensation, liability, and no‐fault cases and coordinated the firm’s policies for handling Medicare requirements.

Davidson is a member of the American Bar Association, the Minnesota State Bar Association, the Ramsey County Bar Association, and the National Alliance of Medicare Set‐Aside Professionals. Davidson graduated cum laude from William Mitchell College of Law and received her Bachelor of Arts degree from the University of Minnesota, Twin Cities. In her free time, Davidson plays recreational sports and is active in local community affairs.


William Delaney, Partner, Nyhan, Bambrick, Kinzie, & Lowry

William Delaney is a partner at Nyhan, Bambrick, Kinzie & Lowry in Chicago, focusing on Medicare Secondary Payer compliance and workers’ compensation defense. Delaney holds certifications as a Medicare Set-Aside Certified Consultant (MSCC) and a Certified Medicare Secondary Payer Specialist - Fellow (CMSP-F). He is an active member of the National Association of Medicare Set-Aside Professionals (NAMSAP), has spoken on multiple occasions at NAMSAP seminars and conferences, and is currently co-chairman of the Liability Medicare Set-Aside Advisory Committee.

Previously, Delaney was a litigator for 18 years with Hartford Financial Services Group concentrating in workers’ compensation and general liability. He was also with a private firm concentrating on plaintiff’s personal injury litigation for six years. He served as a law clerk to Justice Marvin D. Dunn of the Illinois Appellate Court, Second District. Delaney graduated from the University of Notre Dame and holds a law degree from New England Law|Boston. He is admitted to practice law in Illinois.


Ted Doyle, MA, AHFI, CFE, CIFI, Vice President, Healthcare Markets, Performant Financial Corporation and Adjunct Instructor, Southern Utah University 

Ted Doyle is a senior leader in healthcare administration and payment integrity for both the private and public healthcare sectors with over 30-years related experience. His background includes the Centers for Medicare and Medicaid Services (CMS) with over 12 years in a variety of senior leadership positions, predominately in policy administration, financial systems and payment integrity. Doyle’s background also includes the responsibility of managing both the Los Angeles and Miami field investigative offices, as well as working directly with CMS partners, law enforcement agencies, and stakeholders to prevent healthcare fraud and ensure payment integrity. He has developed innovative and leading-edge analytics that significantly reduce healthcare administrative costs through the enhanced detection of fraudulent, wasteful, and abusive claims. Doyle has worked diligently towards the expansion of domestic and international market strategies for payment integrity services and solutions.

Doyle is an Accredited Health Care Fraud Investigator (AHFI), Certified Fraud Examiner (CFE), Licensed Private Investigator, Certified Insurance Fraud Investigator (CIFI), and experienced project manager. 


Rasa Fumagalli, CMPS Candidate, MSP Compliance Attorney, Nyhan, Bambrick, Kinzie, & Lowry

Rasa Fumagalli holds a law degree from IIT’s Chicago Kent College of Law with an undergraduate business degree from the University of Illinois. She is admitted to practice law in the State of Illinois. Fumagalli has spent over twenty years specializing in workers’ compensation insurance defense work in the Chicago area. She has worked for private firms, as well as in an in-house counsel capacity for several insurance companies.

In addition, Fumagalli has significant experience in the area of Medicare Secondary Payer compliance in both a private law firm setting and in a vendor setting. She has worked as the Director of Compliance and Quality Assurance for Protocols and more recently as the  VP of MSP Compliance and Customer Relations for NuQuest. Fumagalli has returned to her law firm roots and is currently working as an MSP compliance attorney at Nyhan Bambrick Kinzie & Lowry in Chicago.

Fumagalli utilizes her extensive experience in handling workers’ compensation cases when it comes to consulting with clients about Medicare Secondary Payer (MSP) compliance issues.  She is a frequent author of the legal updates posted to various blogs and often speaks to various insurance organizations and Bar Association groups on MSP compliance.

Fumagalli has been an active member of the National Alliance for Medicare Set-Aside Professionals (NAMSAP) organization since 2009. Over the years, she has served on the Communications Committee, and has frequently contributed to the NAMSAP Newsletter. She is an active member of the Evidence Based Medicine Committee, a current co-chair of the Communications Committee and a former co-chair of the Liability Committee.  She also serves on the NAMSAP Board of Directors. 


Casey Fundarek, Esq., MSCC, MSP Compliance Attorney, Sharpline Allocations

Casey Fundarek is the Medicare Secondary Payer Compliance Attorney for Sharpline Allocations. 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. 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.

Fundarek received her Bachelor of Science from Texas Christian University and her Juris Doctor from Valparaiso University School of Law. When she is not tackling Medicare issues, Fundarek enjoys taking care of her three labs and designing knit caps.


Greg Gitter, CMSP-F, President, Gitter & Associates, Inc. 

Greg Gitter is the President of Gitter & Associates, Inc., a firm specializing in negotiating resolution of High-Exposure Workers’ Compensation claims for excess carriers, employers, insurance companies and any other parties involved in Workers’ Compensation claims. Gitter has been involved in the Workers’ Compensation arena for 16 years in various capacities including claims adjusting, investigations and management of claims staff. He has extensive experience working within the California Workers’ Compensation system as well as intimate knowledge of Jones Act and U.S. Longshore & Harbor law.

Over the years, Gitter directed his focus on the impact of Long Term, High Exposure, Complex and Catastrophic Workers’ Compensation claims, and he developed a specialized skill set and specific strategies to identify and resolve these claims to the mutual benefit of all parties involved.


Jean Goldstein, Senior MSP Compliance Counsel, MEDVAL

Jean Goldstein is the Senior MSP Compliance Counsel for MEDVAL. She is a licensed attorney admitted to practice in the State of Maryland, with over fifteen years of diverse legal experience in Medicare Secondary Payer compliance, class action litigation, estate planning, elder law, and administrative proceedings.

With a keen understanding of Medicare Secondary Payer compliance, Goldstein is often consulted to offer insight, direction, and training to insurance carriers, self-insured entities, third-party administrators, and law firms.  Her focus is on Medicare issues involving liability, no-fault, and workers’ compensation claims and finding settlement solutions in the best interest of all parties. Goldstein is also a nationally recognized blogger and author on Medicare Secondary Payer compliance and claims management.

Prior to joining MEDVAL, Goldstein worked in the public sector, at the Maryland Office of the Attorney General. She received a Bachelor of Arts from Goucher College and her Juris Doctor Degree from the University of Baltimore School of Law. Goldstein is an active member of NAMSAP’s Policy and Legislative Committee and the Liability MSP Advisory Committee.


Beth Hostetler, RN, CMSP, Director of Medicare Services, Albertson's Companies

Beth Hostetler is a nurse with over twenty-five years experience in the field of disability management and cost containment services in Workers Compensation. She has a Bachelor of Science in Nursing from Case Western Reserve University. She has been a certified Life Care Planner and is currently a Certified Medicare Set-Aside Allocator, and Certified Medicare Secondary Payer Professional.

Her experience includes nearly fifteen years as Branch Manager in the Healthcare Division of Crawford & Company as well as several years as owner of her own company which provided case management, life care planning and Medicare Set-Aside services.

Presently, Hostetler is the Director of Medicare Services in the Corporate Risk Management Department of Albertson’s Companies, which is one of the largest food and drug retailers in North America. She has developed Albertson’s internal MSP Compliance program for Workers Compensation which includes policy and procedure for MMSEA Section 111 reporting, conditional payment identification and resolution and the MSA program. Hostetler routinely provides internal training on Medicare Secondary Payer compliance and all aspects of the MSA process.


Jennifer Jordan, CMSP-F, Special Counsel, Louisiana Association of Self-Insured Employers

Jennifer Jordan is a nationally recognized expert on the subject of Medicare Secondary Payer (MSP) compliance. Formerly Chief Legal Counsel and co-founder of MEDVAL, she currently serves as special counsel for the Louisiana Association of Self-Insured Employers (LASIE). For nearly 20 years, Jordan has regularly spoken at industry and educational events nationally, authored articles for both industry publications and legal resources, been designated as an expert witness in MSP litigation and been cited in judicial opinions. In conjunction with extensive structured settlement experience, Jordan is focused on finding settlement solutions and resolving claims with the best interest of all parties, not just Medicare, in mind.

Jordan is Editor-in-Chief of The Complete Guide to Medicare Secondary Payer Compliance, published annually by LexisNexis since 2010, and is the recipient of a 2010 Workers’ Compensation Notable Person Award and Top 25 Workers’ Compensation Blog Awards from 2009 through 2014 from LexisNexis.

She currently serves on the board of a number of organizations such as the Larson’s National Workers’ Comp Advisory Board, WorkCompCentral Comp Laude Advisory Board, Friends Research Institute, and the Medicare Secondary Payer Charitable Foundation. She was named to the WorkCompCentral President’s Honor Roll in 2015 for her contributions to the industry and received a Best Blogs award in 2016 and 2017 from WorkersCompensation.com.

Jordan received her J.D. from the University of Baltimore, School of Law where she was a member of the Law Review and Editor-in-Chief of the University of Baltimore Intellectual Property Law Journal. She received her MBA from the University of Baltimore, Robert G. Merrick School of Business and B.A.s in Economics and Fine Arts from Virginia Tech.


John Kane, AIC, CMSP, MSCC, Medicare Program Director, Liberty Mutual

John Kane serves as the Medicare Program Director for the Liberty Mutual Group.  As a twenty-five year employee with Liberty Mutual, Kane has served in a variety of claim positions including Liability and Workers’ Compensation including Regional Claims Manager for Integrated Disability Management and Loss Portfolio Risk Manager. He has been actively engaged in MSP compliance over the last fifteen years. He developed Liberty Mutual’s Centralized Medicare Department and is responsible for Vendor Management, Quality Assurance, MSP Compliance and a liaison to Public Affairs to advocate for CMS reform.

Kane is active member of the Medicare Advocacy Recovery Coalition (MARC). He is also a member of the National Alliance of Medicare Set Aside Professionals. He is an instructor for the Certified Medicare Set-Aside program. Prior to Liberty Mutual, Kane worked in the financial sector as a financial planner with a degree in Business Management. He has an Associate in Claims (AIC), Medicare Set-Aside Consultant Certified (MSCC) designation,and Certified MSP Professional (CMSP). 


Shawn Kelderman, Senior Compliance Analyst, Society Insurance

Shawn Kelderman recently assumed the role of Senior Compliance Analyst at Society Insurance, after working as a Claims Manager for over 15 years.  The role was developed to ensure compliance with Medicare and other industry developments. Her background includes managing claims in the Midwest. Kelderman is a graduate of University of Iowa. She resides in Wisconsin. 


Ciara Koba, Esq., Partner, Gordon & Rees

Ciara F. Koba is a Partner in the Pittsburgh office of Gordon & Rees and is a member of the Medicare Compliance Group. Koba is an attorney and licensed registered nurse with significant general and surgical nursing experience and she brings a unique understanding of the healthcare industry to the resolution of Medicare issues. She focuses her practice on Medicare Secondary Payer Compliance issues that arise in the resolution of workers’ compensation, longshore, Jones Act, Federal Employers Liability Act and general liability claims and she has been instrumental in settling tens of thousands of cases nationwide involving Medicare issues. Her work includes MMSEA Section 111 Mandatory Insurer Reporting, Medicare Compliance Audits, Medicare Conditional Payment resolution, and the preparation of Medicare Set-Aside Allocations.

Koba is a recognized national presenter on Medicare Secondary Payer compliance topics and frequently lectures to insurance carriers, self-insured businesses, third-party administrators, law firms and professional industry organizations.

She graduated from Duquesne University School of Law, cum laude, in 2011. While there, she founded the university’s first Health Law Society and served as its president. Koba received a Bachelor of Science in Nursing from Duquesne University in 2006.


Porter Leslie, President, Ametros

Porter Leslie is the President of Ametros. Leslie directs the growth of Ametros and works with its many partners and clients. He built his career leading customer-focused businesses in the healthcare and financial services industries. Prior to Ametros, he worked in investment banking, private equity and corporate development.

Leslie earned a B.A. in Economics from Columbia University, as well as an MBA from the Wharton School and an M.A. from the Lauder Institute at the University of Pennsylvania. Leslie is fluent in Spanish and Portuguese and resides in Boston with his wife, Ruth, and son, Camilo.


Will Lindahl, MBA, CLPF, Executive Director, CPT Institute

Will Lindahl is the Executive Director for CPT Institute, established in 1994. CPT Institute operates in forty-eight states and is the nation’s leading national charity providing Master Trusts, which include Settlement Management Trusts, Special Needs Trusts, and Minors Trusts.

Lindahl has been helping settlement professionals, attorneys and settlement consultants mitigate government benefit issues affecting insurance and workers’ compensation settlements for the past twenty years. CPT Institute has established over ten thousand trusts in its twenty-four-year history, and has developed one of the lowest cost non-profit trust programs in America.


Jeff Lucas, Health Policy Advisor, Senator Bill Cassidy

Jeff Lucas took on the role as Health Policy Advisor at the United States Senate in July 2017. Previously, he served as a legislative correspondent, legislative assistant, and as an intern at the United States House of Representatives. Lucas received his B.S. degree from Indiana University Bloomington.

 

 


Kenneth Paradis, Chief Executive Officer, Chronovo

Kenneth Paradis began his career as a Special Assistant Attorney General for the Massachusetts Compensation Trust Fund. As Chief of Staff for the Massachusetts Department of Labor, he led initiatives on the Job Training Partnership Act funds, the Division of Industrial Accidents policies, and the daily work of 11 state agencies.

After developing this insider's perspective on government and insurance, Paradis has co-founded and led several insurance services enterprises in various specialties including Social Security Disability advocacy (Crowe Paradis/Advocator Group), Medicare Secondary Payer compliance (Crowe Paradis/ ISO Claims Partner), Professional Administration (Ametros), and his current structured settlement enterprise, Chronovo. 


Rachel Paul, MSCC, Senior Claims Attorney, Midwest Employers Casualty

Rachel Paul has been with MECC for 10 years. She has over twenty-two years’ experience as a practicing attorney in both the private and public sector. Paul's legal experience includes work as Assistant Attorney General, litigating workers’ compensation cases, and representing the Missouri Second Injury Fund. She has additional expertise in settling complex high-value workers compensation claims.

She earned her certification as a Medicare Set-Aside Certified Consultant (MSCC) and is a graduate of New York University and Washington University Law School.


Fran Provenzano, RN, BSN, CDMS, CCM, CLCP, MSCC, President and CEO, Medicare Set-Aside Specialists, Inc. 

Fran Provenzano, BSN, is the President and CEO of Medicare Set-Aside (MSA), Specialists, Inc. She formed the company in 2002 and it has flourished under her guidance. MSA Specialists has been accepted as a national provider of MSAs by several major insurance carriers as well as some of the top Third Party Administrators.

Provenzano is a highly sought speaker on MSAs. She has addressed the National Conferences of Legal Nurse Consultants, several national education seminars on MSA instruction and many evaluation criteria/education sessions for Claims Adjusters. She earned her RN license and BSN Degree. Within the hospital setting, she has served in virtually all phases of the nursing field from the operating theater, through patient education, Lamaze Instruction and discharge planning.

In the late 1980s, Provenzano directed her talents toward Disability Management, obtaining her Certified Disabilities Management Specialists (CDMS). She was among the first nurses to obtain Certified Case Manager (CCM) Certification followed shortly thereafter by her Life Care Planning Certification (CLCP). Most recently, she once again was among the first in the nation to earn the Medicare Set-Aside Consultant-Certified (MSCC) designation.


Jake Reason, Vice President, Medicare Set-Aside Services, EK Health 

Jake Reason, has over seventeen years experience working in the workers’ compensation industry with fourteen of those years spent directly in the Medicare Set-Aside arena.  He has worked on more than 50,000+ set-side allocations and has worked successfully with many national insurers, employers, and third-party administrators.

His prior experience in the workers’ compensation industry includes time spent working as a Senior Claims Examiner, Vocational Rehabilitation Counselor and a Litigation Case Manager for a plaintiff’s law firm.  Additionally, during the course of his time working in the MSA industry, Reason has had exposure to numerous catastrophic claims.  These claims include traumatic brain injuries, paraplegic and quadriplegic injuries, amputations, serious crush and de-gloving injuries and burn cases.  In assessing these cases, Reason has worked with a number of clinical specialists and has the relevant resources required to produce accurate and coherent future medical allocations.

A graduate of Pepperdine’s Graziadio School of Business & Management, Reason holds NASD Series 6, 7, and 63 securities licenses from the National Association of Securities Dealers and a State of California Life and Health Insurance Agent license.


Kate Riordan, MSCC, Director, Medicare Secondary Payer Initiatives, ISO Claims Partner

Kate Riordan is the Director of Medicare Secondary Payer (MSP) Initiatives at ISO Claims Partners. She has well over five years of experience in completing Medicare Set-Asides and obtaining CMS approvals, with a concentration in California claims.

Riordan graduated Bowdoin College and Suffolk University Law School and is a Medicare Set-Aside Certified Consultant.

 


Melanie S. Schafer, Associate, Medicare Compliance Group, Gordon & Rees

As an Associate of the Medicare Compliance Group at Gordon & Rees, Melanie S. Schafer’s practice focuses on the resolution of Medicare compliance issues that arise in the settlement of workers’ compensation and general liability claims. 

Prior to joining Gordon & Rees, Schafer worked as an associate in another national Medicare practice group and as a consulting attorney concentrating on Medicare compliance issues in institutional settings. She also handled liability claims for insurance company clients as an Associate at an insurance defense firm in Pittsburgh.

Schafer received her J.D. from the University of Pittsburgh School of Law in 2012. While at the university, she was a Dean’s Scholar and member of the Health Law Society. In addition, she served as a Certified Legal Intern in the Low Income Tax Clinic, worked with Southwestern Pennsylvania Legal Services and participated in the JHF Jonas Salk Medical Ethics Fellowship. In addition to her J.D., she earned an M.A. in English Language and Literature from the University of Michigan in 2012, where she taught English to undergraduates prior to leaving the Ph.D. program in order to attend law school. She also earned an M.A.T. in English Education from the University of Pittsburgh in 2004, and a B.F.A. in Classical Music Performance from Carnegie Mellon University in 2001.

Schafer is licensed to practice law in Pennsylvania, the United States District Court for the Western District of Pennsylvania, and the Third Circuit.


Nancy Schulz, CMSP, Director-Managed Care, Acuity Insurance

Nancy Schulz is Director-Managed Care at Acuity Insurance, a large regional property and casualty insurer located in Sheboygan, Wisconsin.  She serves as the central expert and coordinator of all Managed Care Programs by directing and managing their technical components, as well as the relationships with vendor partners.  Nancy is the Chair of Acuity’s Medicare Oversight Committee.

Schulz has extensive insurance experience in multi-line property and casualty underwriting as well as claims resolution.  She holds a B.A. from McKendree University and Lean Six Sigma Black Belt from Villanova University.  Her professional designations include AIC, AIM and CMSP.


Lesley Schumacher, RN, CRRN, CCM, CLCP, CNLCP, MSCC, CMSP, CMSP Fellow, President, PlanPoint

For over 10 years, Leslie Schumacher has been involved in Medicare Secondary Payer Compliance. Schumacher is a Registered Nurse who actively holds Certified Life Care Planner and Certified Nurse Life Care Planner as well as Medicare Set Aside Consultant Certified and Certified Medicare Secondary Payer Professional credentials. A graduate of Drexel University, she also holds the following additional certifications: Certified Case Manager, Certified Rehabilitation Registered Nurse, Legal Nurse Consultant Certified, Medicare Secondary Payer Professional and Certified Nurse Life Care Planner.

Shumacher maintains professional affiliations with the National Alliance of Medicare Set Aside Professionals (NAMSAP), American Association of Legal Nurse Consultants (AALNC), International Association of Life Care Planners (IALCP) and International Association of Rehabilitation Professionals (IARP). Schumacher has been elected as Board Member of both IARP and the IALCP; she is former chairperson of the Education Committee and current Board Member of NAMSAP as well as former ICHCC (International Commission for Health Care Certification) Commissioner of Medicare Set Aside Allocations. She has also participated as an instructor of Medicare Set Aside education with the University of Florida.

Shumacher  is currently President of PlanPoint, a national provider of Medicare Set Aside Allocations as well as all other aspects of Medicare Secondary Payer compliance. Her unique and engaging speaking style coupled with her extensive experience in nursing, Life Care Planning and Medicare Secondary Payer compliance has made Schumacher a featured speaker at industry conferences nationwide.


Rear Admiral Pamela Schweitzer, PharmD, BCACP, Retired, Chief Pharmacy Officer, Centers for Medicare and Medicaid Services

Rear Admiral (RADM) Pamela Schweitzer, PharmD, BCACP, served as the Assistant Surgeon General and Chief Pharmacist Officer of the United States Public Health Service (PHS).  As Chief Pharmacist Officer, RADM Schweitzer was responsible for providing leadership and coordination of PHS pharmacy programs and professional affairs for the Office of the Surgeon General and the Department of Health & Human Services. RADM Schweitzer has served in varied assignments in the Indian Health Service (IHS), Veterans Administration (VA), as well as with the Centers for Medicare and Medicaid Services (CMS).

She received her Bachelor’s degree in Biological Sciences from California State University Fullerton (CSUF), earned her Doctor of Pharmacy from the University of California San Francisco (UCSF) School of Pharmacy, completed an Ambulatory Care/Administrative Residency at University of California Irvine Medical Center and is a Board Certified Ambulatory Care Pharmacist (BCACP). 

RADM Schweitzer has been recognized for her leadership contributions including receiving the American Pharmacists Association Distinguished Federal Pharmacist Award (2014), the USPHS Mary Louise Anderson Leadership Award (2012), IHS Senior Pharmacist of the Year Award (2013), the University of California San Francisco (UCSF) School of Pharmacy 2015 Distinguished Alumnus of the Year.


Jennifer Shymanski, CMSP-F, Director of Implementation and Strategy, NuQuest

Jennifer Shymanski, NuQuest’s Director of Implementation and Strategy, holds a law degree from Northern Illinois University College of Law and a Bachelor of Arts in Political Science from the University of Wisconsin - Stevens Point. She is admitted to practice law in the State of Wisconsin.

Prior to joining NuQuest in March of 2010, she spent over ten years at Nationwide Insurance working with both workers compensation and personal liability claims teams. 

Shymanski utilizes her extensive experience in claim handling and negotiation to lead the NuQuest Settlement Consultant Team in working with clients to choose the correct products and services for their needs and to support and advise them throughout the settlement process. One of Shymanski’s  primary focuses is on assisting clients in designing, implementing and monitoring their Medicare Secondary Payer compliance programs.


Rita Wilson, CEO, Tower MSA Partners, LLC

 As CEO of Tower MSA Partners, LLC, Rita Wilson oversees all business development, sales, marketing and operational activities, IT systems development, and identifies new product offerings in support of Medicare Secondary Payer Compliance.

Wilson gained a wealth of expertise in information technology solutions, process driven workflow and metrics, and data analytics while holding leadership positions in pharmacy software development, pharmacy benefits management and workers’ compensation managed care companies for more than 20 years.

Prior to co-launching Tower MSA Partners in 2011, she founded and ran Select MRI, LLC, a diagnostic company, and Speedy Re-employment and Medicare Set Asides, an MSP compliance company. Previously, Wilson built out the operational and technology model for another startup, DirectCompRx, Inc., a subsidiary of Fiserv, Inc., ultimately becoming its CEO.

Before moving into the workers’ compensation industry, Wilson spent 15 years in software development for retail pharmacy and PBM serving as Director of Research and Development for QS/1 Data Systems. Wilson obtained a Bachelor of Science degree, summa cum laude, from Presbyterian College in Clinton, SC and completed graduate studies at Converse College in Spartanburg, SC. She has served in member and/or board of director capacities with the American Society for Automation in Pharmacy (ASAP), the National Council for Prescription Drug Programs (NCPDP), Health Level 7 (HL7), and the National Council of Self-Insurers (NCSI).

Wilson is a member of the National Association of Medicare Set Aside Professionals (NAMSAP),where she serves as a member of its Board of Directors, as chairman of its Communications Committee and as a member of the Data and Development and Evidence Based Medicine committees.


Kimberly Wiswell, CMSP, Vice President, Managed Care Operations and Team Excellence, CLARA Analytics

 Kimberly Wiswell has been engaged in the workers’ compensation managed care and occupational health services industries since the late 1970’s, with a focus on Medicare Secondary Payer compliance since 2005. She currently serves as the Vice President of Managed Care Operations at CLARA analytics.

 

Prior to joining CLARA  she was a Vice President at MEDVAL, responsible for product management, and also managed operations for four years, building a technological infrastructure to facilitate the company's growth. She previously co-founded and served as Managing Director over CompProjections Medicare Set-Asides, under CompPartners. Prior to that, she served as Sr. Vice President, Operations over the Medicare Set-Aside and Specialty Network division of Coventry HealthCare’s First Health Priority Services sub-division.

 

Wiswell has extensive knowledge and experience in the area of workers’ compensation managed care including Medicare set-asides, medical bill review, systems analysis/ development, medical coding and reimbursement, and occupational health administration. She has provided consulting services to the CMS, the California Workers' Compensation Institute, and a number of state agencies and associations. Wiswell presents at industry conferences, seminars and training sessions concerning Medicare Secondary Payer Compliance, medical cost management, and provider coding and reimbursement. She is a member and past president of the Board of Directors for the National Alliance of Medicare Set-Aside Professionals (NAMSAP); she sits on the faculty for WorkCompCentral’s WorkCompSchool; and serves as the Fee Schedule Committee Chair for a California legislative advisory body composed of top risk managers and select attorneys who advocate for industry insurance defense and related workers’ compensation legislation.


Kathleen Wyeth, Managing Assistant General Counsel, AF Group

Kathleen Wyeth is Managing Assistant General Counsel for AF Group, responsible for coordinating all Medicare compliance throughout the enterprise and overseeing the protection of Medicare’s interests in all settlement.  She is the current co-leader of the CLM Workers' Compensation Advisory Board and has co-authored the Michigan Chapter of The Complete Guide to Medicare Secondary Payer Compliance, published by LexisNexis.  

She has presented on Medicare topics at the National Association of Medicare Set-Aside Professionals conferences, the CLM & Business Insurance Workers’ Compensation Conference, the National Workers’ Compensation Defense Network Fall Conference and the Michigan Association of Justice Winter Conference. Wyeth obtained her Juris Doctorate from the University of Detroit Mercy, and has spent 17 years working in the insurance industry.

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