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Educational Conference Speaker Information
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Speaker Information:

John P. Albert, Senior Technical Advisor, Division of Medicare Secondary Payer Operations Office of Financial Management, Centers for Medicare & Medicaid Services

John Albert has worked for the Centers for Medicare and Medicaid Services (CMS) for 31 years, primarily on Medicare Secondary Payer (MSP) and Coordination of Benefits & Recovery policy and opertions.  Mr. Albert is currently serving as the Contracting Officer Representative for the Commercial Repayment Center (CRC) contract with Performant Financial, Inc. within the Division Medicare Secondary Payer Operations, which is responsible for oversight of the all MSP coordination of benefits and recovery policy and operations for CMS.  In addition to the CRC, other contracts overseen by the Division include the Benefits Coordination & Recovery Center contract and the Workers Compensation Review Contract.


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.


Rose Arellano, Performant Corporation 

Rose Arellano is the Director of Outreach Recovery of Health Care for Performant Corporation. Rose is Six Sigma-trained and CMMI certified with 22 years of health care billing and recovery experience, including more than 18 years in operations management. Ms. Arellano has been involved with two contractors for the Medicare Secondary Program and is subject matter expert in the CRC program, NGHP and GHP. Ms. Arellano uses her strong communication skills to foster collaboration between the CRC and the stakeholder communities to identify solutions to complex problems. Ms. Arellano specializes in contract management, process improvement, risk management, issue resolution, resource management and development, and relationship management.


Brian Bargender, CSRP, Internal Consultant, Humana

Brian Bargender is an internal consultant with Humana, one of the country’s largest Medicare Advantage organizations.  In recent years, he has helped to lead Humana’s efforts to clarify and enforce the Medicare Secondary Payer (MSP) rules that pertain to Medicare Advantage and Medicare Prescription Drug plans.  He is also responsible for monitoring trends that may impact subrogation and MSP recovery efforts, developing new cost avoidance and payment recovery projects and advising operational leaders regarding subrogation and MSP issues.

Bargender has 16 years of experience in leading and improving health benefit subrogation and MSP operations.  He holds a Certified Subrogation Recovery Professional (CSRP) designation from the National Association of Subrogation Professionals and has served as both a co-chair of NASP’s Wisconsin chapter and a health subrogation education track leader for NASP’s annual national conference.


 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.


Jim Brady, Program Director, BCRC

Jim Brady has 30 years of Medicare experience. He is currently the Program Director for the Benefits Coordination and Recovery Center (BCRC) with overall responsibility for all functions under that contract.  Mr. Brady has led the BCRC since the inception of the program.

 

 

 


Todd Brown, Practice Leader Compliance and Regulatory Affairs, Medata Inc. 

Mr. Brown has over 30 years of experience in the workers' compensation industry, creating standards for reporting information to state regulatory commissions. His experience includes establishing informal dispute resolution processes and reducing the volume of claims in formal resolution. In addition, Brown has facilitated claims audit programs for insurance agencies in compliance with standards and reserving practices. Brown is a graduate of Baylor University in Texas and has completed graduate programs for the IAIABC's Workers' Compensation College and the Govenor's Executive Development Program. 


Marci Cooke, Project Director, MSPIC

Marci Cooke is the Project Director for the Medicare Secondary Payer Integration Contractor (MSPIC) for the Centers for Medicare & Medicaid Services (CMS) Coordination of Benefits & Recovery (COB&R) program. The MSPIC is responsible for making sure that all components supporting the COB&R program function successfully together. The MSPIC performs the following functions on the program – Program and Project Management, Change and Release Management, Program Help Desk, Business Analysis, Testing and Technical Writing, Security Oversight, Quality Assurance Oversight, and Outreach and Education. The MSPIC will be providing an overview of the Workers’ Compensation Medicare Set Aside Portal.


Shawn Deane, JD, MEd, MSCC, CMS, General Counsel, Ametros

Shawn Deane is vice president of Medicare / Medicaid compliance and policy at ISO Claims Partners where he concentrates on all facets of Medicare Secondary Payer (MSP) compliance. Before joining ISO Claims Partners, he practiced healthcare law and insurance defense. Shawn is on the executive committee as treasurer of the Medicare Advocacy Recovery Coalition (MARC) and was the 2017 president of the National Alliance of Medicare Set-Aside Professionals (NAMSAP). He has attained the Medicare Set-Aside Certified Consultant (MSCC), as well as the Certified Medicare Secondary Payer Professional (CMSP) certifications. Shawn is a member of the Massachusetts Bar and is licensed in both state and federal courts in Massachusetts.


Frank Fairchok, Vice President, Medicare Compliance Reporting and Development, Optum Settlement Solutions

Frank Fairchok has more than 30 years of business experience in the financial, telecom, and workers’ compensation industries working for companies on the Global 500 list, including AT&T, Orange SA, and UnitedHealth Group. He has been involved with MMSEA Section 111 compliance since 2010 and is recognized as a subject matter expert in the industry.

Fairchok holds a bachelor’s degree in Technology Management from St. Petersburg College and resides in Tampa, Florida.


Jeremy Farquhar, Senior Product Consultant, ISO Claims Partners

 

Jeremy Farquhar has over 17 years of Medicare/MSP related experience. Through his work on CMS’ COBC and BCRC contracts, Jeremy served as the technical lead for the Section 111 process from its inception in 2009 through 2018.  He was responsible for oversight of the COBC/BCRC EDI team, served as the first point of escalation for all Section 111 related issues and was a regular presenter on CMS’ Section 111 town hall teleconferences. Presently, Jeremy is a Senior Product Consultant with ISO Claims Partners providing support for all aspects of Sec. 111 reporting, processes and technical guidance.

 


Robert J. Finley, Partner, Hinshaw Law

Robert Finley's diverse, national civil defense litigation and trial practice concentrates on complex tort and employment matters involving catastrophic, fatal and brain/psychological injury cases. Finley's cover-every-detail preparation model is complimented by an aptitude for creativity and adaptability to initiate practical solutions in risk and litigation management which help his clients achieve preferred results and meet their financial goals. He has a substantial amount of experience with jury trials, representing clients in mediations and arbitration hearings, and appellate practice, and has been admitted pro hac vice in multiple courts throughout the country.

In addition, Finley counsels interested parties on Medicaid and Medicare reimbursement under property/casualty, no-fault, and workers compensation insurance plans including conditional payment resolution, Medicare Part C and D recovery claims, future medical settlement considerations, Section 111 reporting compliance/monetary penalties, statutory private causes of action, and related regulatory matters.

He counsels in all aspects of workplace injury cases, including workers' compensation defense, post-settlement petitions and judgment enforcement actions, subrogation recovery, employers' liability and excess coverage interests, as well as matters before the Illinois Workers Compensation Insurance Compliance Division.

Finley handles commercial causes of action between insurers and medical providers based upon breach of contract, fraud, bad faith, and statutory payment laws or plans.

Finally, he represents both professional and amateur sports organizations in litigation and transactional matters. 

Finley joined Hinshaw in 2003 and became a partner in 2008. He chairs the firm's Social Media for Trial Committee and developed Social Media Intelligence for Trial at Hinshaw & Culbertson (SMITHc) for obtaining and using social media evidence at trial.

While attending DePaul University College of Law, Finley was selected to study abroad at University College Dublin School of Law (Ireland), where he concentrated in comparative and European Union law studies and volunteered with a Dublin-based law firm in its litigation sector.

Prior to pursuing a career in law, Finley worked in the sports radio industry as a producer and reporter covering major spectator events, including the Super Bowl, NBA Finals, Kentucky Derby, U.S. Open Golf Championship, NCAA men’s and women’s basketball tournaments, and the 1996 Summer Olympics in Atlanta.


Heather Hatch, JD, Partner, the Chartwell Law Offices

Heather Hatch is a workers’ compensation defense attorney with more than 18 years experience. Heather is currently a partner with The Chartwell Law Offices, LLP in Palm Beach Gardens, Florida. Her primary areas of focus are workers’ compensation defense, employment related defense, general liability, foreclosure actions on behalf of lenders and Medicare Compliance. Heather attended Georgetown University in Washington D.C. where she received a degree in Political Science and Languages. She then attended Wittenburg University in Springfield, Ohio where she received a bachelor of arts. And lastly, Ms. Hatch received her juris doctorate in 2000 from the University of Florida College of Law. Hatch is a member of the Florida Bar, Tennessee Bar, American Bar Association, United States District Court for the Northern, Southern and Middle Districts of Florida, The United States Court of Appeals for the Eleventh Circuit, the Palm Beach County Bar Association, NAMSAP and FAWL. In addition, Ms. Hatch is fluent in French and literate in German.


Kathleen Hunter, Director of Correspondence Processing, BCRC

Kathleen (Keenie) Hunter has over 17 years of Medicare Secondary Payer experience. She began her Medicare career as an MSP examiner with Empire Medicare in Syracuse, NY and  later became the Supervisor of the NGHP Recovery staff at Empire. When the MSPRC was launched in 2006, Hunter became the Manager of the GHI Syracuse staff and went on to serve as the MSPRC Policy Specialist.  In 2013, she was made the Director of Correspondence Processing for the BCRC where she currently serves today.

 


Loyd Hudson, Integrated Disability Manager, American Electric Power Company

Loyd Hudson is an Integrated Disability Manager for AEP’s Absence Programs. Loyd is active in disability management and has 22 years of experience in American Electric Powers' integrated disability management program consisting of sick leave, parental leaves, military leaves, workers’ compensation, long term disability, FMLA, and ADA.

Loyd currently serves as the Vice President of the Ohio Self Insurers, and is the Former President and current Board Member of the West Virginia Self Insurers, the Former President and current Board Member of the National Counsel of Self Insurers, a Board Member of the Louisiana Self Insurers Association, and has served as past President of the Virginia Self Insured Association. 


Renee Jones, CWF Manager, BCRC

Renee Jones has 17 years of MSP experience, beginning as a Call Center Advocate in 2002 for the Coordination of Benefits Contractor (COBC). She was hired as an Analyst for the CWF Auditing department that is responsible for the processing of ECRS Assistance Requests from various Medicare Contractors to ensure the appropriate MSP status of files in the Common Working File. Renee was promoted as the Senior Business Analyst for the CWF Auditing department in 2013, when GHI was awarded the Benefits Coordination and Recovery Center (BCRC) contract. She also serves as the CWF department's Subject Matter Expert, Trainer and Project Lead for all various CWF related work types and projects, including Phase 4 of the System Consolidation project for the Benefits Coordination and Recovery System (BCRS). Jones was promoted in 2017 to BCRC CWF Manager.


Jennifer Jordan, JD, CMSP-Fellow, Counsel, LASIE

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 at counsel for the Louisiana Association of Self-Insured Employers (LASIE). For nearly 20 years, Ms. 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, Ms. Jordan is focused on finding settlement solutions and resolving claims with the best interest of all parties, not just Medicare, in mind. Ms. 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.

Ms. 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, MSCC, CMSP, Medicare Program Director, Liberty Mutual Insurance

John Kane serves as the Medicare Program Director for the Liberty Mutual Insurance.  As a twenty-eight year employee with Liberty Mutual John 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 Centralized Medicare Department and is responsible for Vendor Management, Quality Assurance, MSP Compliance and a liaison to Public Affairs to advocate for Medicare reform.  

Kane is an active member of the Medicare Advocacy Recovery Coalition (MARC) and former member of the Property Casualty Insurer Medicare Task Force Committee.  He serves on the National Alliance of Medicare Set Aside Professionals Board of Directors and participates in panel discussions at the annual conferences. John is an instructor for the Certified Medicare Set-aside Professional & Fellow program educating attorneys, nurses, risk managers and case managers on Medicare Secondary Payer (MSP) compliance.

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) and Certified MSP Professional (CMSP) & Fellow designations.

Kane volunteers as a Liberty Leader in the local community that focuses on affordable housing and transition to work. He is also involved with volunteer work with young adults with disabilities to create inclusive social and recreational opportunities.


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.


Rachel LaMontagne, Partner, Shutts & Bowen 

Rachel LaMontagne is a Partner in the Class Action and Mass Litigation Group of Shutts & Bowen, LLP. Rachel maintains a diverse legal career, with a focus on personal injury protection litigation in the class action setting, as well as actions arising under the Medicare Secondary Payer Act.

Rachel serves as lead counsel for various insurance carriers with regard to defense of primary payers’ claims for reimbursement of conditional payments under the MSPA. In addition to defense on the merits, Rachel also defends against class certification of these MSPA matters.

Ms. LaMontagne received her JD from St. Thomas University School of Law in Miami, Florida and has been admitted to practice in Florida since 1996. She is admitted to practice before the Florida Supreme Court, the United States Court of Appeals for the Eleventh Judicial Circuit, the United States Bankruptcy Court for the Southern District of Florida and the United Stated District Courts for the Southern, Middle and Northern Districts of Florida.


Roger Larue, Director, Secretary/Treasurer & Mediator, maps

Roger Larue is a Director, Secretary, and Treasurer of maps and a Member in charge of special projects. He is admitted to practice in Louisiana, Florida and the United States Supreme Court. During 45+ years of law practice, Mr. Larue represented both defendants and plaintiffs in civil litigation. Mr. Larue was first chair in numerous jury trials. As all trial attorneys, he experienced, first hand, the uncertainty of jury trials. He is now using his trial experience and knowledge to help others determine what issues, facts and witnesses are important to a demographically representative jury. He has conducted over seventy five jury focus groups in the southeast United States. In each case the party involved has learned something unforeseen, yet extremely important about their case.

Mr. Larue is the President, Lead Lien Compliance Officer, and Member of maps Lien Resolution Services LLC. While continuing to mediate on a regular basis, he has concentrated his professional time on studying, writing and speaking on issues surrounding the Medical Lien issues including the Medicare Secondary Payer Act and their effect on personal injury claims. He has given numerous lectures and prepared articles pertaining to Federal and State lien resolution issues. Mr. Larue has authored several articles on other lien/reimbursement issues including ERISA, Medicaid and the rights of Medicare Part C Plans. He is often consulted by attorneys and adjusters on lien resolution/reimbursement issues. He and his staff work very closely with CMS and others on lien resolution issues involved in personal injury class action claims. He served as an Adjunct professor at Tulane University Law School on negotiation and mediation advocacy skills for over ten years.


 Jason D. Lazarus, J.D., LL.M., CSSC, MSCC

Jason Lazarus is a founding Principal and Chief Executive Officer of Synergy Settlement Services.  Synergy offers healthcare lien resolution, Medicare secondary payer compliance services, pooled trust services, settlement asset management services and structured settlements.  He is also a founding Principal and President of Multi-Claimant Solutions which offers lien resolution and MSP compliance services for mass torts.  Lastly, Lazarus is the managing partner and founder of the Special Needs Law Firm; a Florida law firm that provides legal services related to public benefit preservation, liens and Medicare Secondary Payer compliance. 

Lazarus received his B.A. from the University of Central Florida and his J.D. with high honors from Florida State University. He received his LLM in Elder Law with Distinction from Stetson University College of Law.  He is a Medicare Set Aside Consultant (MSCC) certified by the International Commission on Health Care Certification.  His written work has been cited, as authoritative on Medicare compliance, by the Supreme Court of Florida and the United States Southern District of Florida.  


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.


Jack Meligan, RSP, BCFE, MSCC, CMSP-F, The Plaintiff's MSA & Lien Solution

Jack Meligan is the founder and president of Settlement Professionals, Inc. (“SPI”), a national plaintiff-only settlement planning firm, and founder and managing member of The Plaintiff’s MSA & Lien Solution, LLC (“PMLS”), a national plaintiff-only Medicare and MSP Compliance and lien resolution service firm, and founder and managing member of Settlement Capital Advisors, LLC (“SCA”), a premier investment advisory firm for injury victims, trial attorneys and select others. In addition, Meligan is the founding president of the Society of Settlement Planners (SSP), an association of settlement planners, structured settlement specialists, and special needs settlement-planning attorneys from around the country advocating for settlement planning as a process to uncover and plan for the needs of injury victims and their families.

Since 1985, Meligan has been a pioneer of the financial planning, structured settlement, and now settlement planning industries. Meligan has assisted a multitude of plaintiffs and their attorneys across the U.S. in major, high-dollar catastrophic injury cases, with pre-settlement intelligence and negotiation strategies, lien settlement strategies and resolutions, and then post-settlement comprehensive settlement planning using multiple, diverse products and strategies. At trial, Jack assists to defeat improper annuity testimony.

In 2015, he obtained the Certified Medicare Secondary Payer Professional (CMSP) credential, and his Fellow designation in 2018 (CMSP-F). The CMSP-F credential is designed to identify those professionals who work within the workers’ compensation and liability insurance industry such as insurance claims adjusters, attorneys, personal injury and special needs attorneys, life care planners, disability and rehabilitation management specialists, structured settlement professionals, and case managers who have demonstrated extensive knowledge regarding the development and application of the Medicare Set-Aside Allocation (MSA) process.

In 2014, Meligan obtained the Medicare Set-Aside Certified Consultant (MSCC) credential. The MSCC credential is designed to identify those professionals who have achieved specific pre-approved training in Medicare Set-Aside trust arrangements and have demonstrated a breadth of knowledge regarding the development and application of the Medicare Set-Aside trust arrangement process. Additionally, this credential is designed to express to the consumer that the person holding the MSCC credential has agreed to come under scrutiny of a certifying review board (CHCC), to be peer reviewed, and to adhere to a set of standards governing ethics and professional behaviors.

Since 2003, Meligan has been an innovator in designing and implementing solutions for the tax dilemma that plaintiffs encounter when settling substantial taxable damage tort cases. He is also a Board-Certified Forensic Examiner (BCFE) in the field of annuity testimony, as well as one of the first Registered Settlement Planners (RSP) in the country.


Steven J. Miller, CMSP-F, MSPharm, DPh, RPh, CEO, PharmacyMSA.com

Steven J. Miller, C.M.S.P.-F, MSPharm, D.Ph., R.Ph, is the CEO of PharmacyMSA.com, a provider of a pharmacy benefit services for MSA specialists throughout the United States, including drug utilization reviews, pharmacy benefit administration, and medication therapy management for geriatric patients and injured worker., Dr. Miller is active in development of cost containment programs for MSA proposals, pharmacy formulary review and analysis,  provider interventions, and managed care pharmaceutical reimbursement programs. He is a clinical pharmacist with many years’ experience in managed care workers compensation, commercial, Medicare, and Medicaid pharmacy benefit consulting.  He is also a part-time dispensing pharmacist with Walgreens.

Miller has served in several capacities with many types of managed care organizations and has made numerous regional, national, and international presentations on pharmaceutical care and cost-effectiveness, including medication issues for the elderly, cost-effective drug therapies, and pharmaceutical benefit management. He currently serves on the board of directors of the National Alliance of Medical Set Aside Professionals (NAMSAP), service a three year term. He also serves on several pharmaceutical manufacturers’ advisory boards, and on the editorial advisory board of ODG/ODG Treatment publications for the Work Loss Data Institute. He graduated with his B.S. in pharmacy from the University of Iowa and his M.S. in Pharmacy Practice from the University of Maryland.


Suzanne Novak, MD, PhD, President, Austin Outcomes Research Inc. 

Suzanne Novak, MD, PhD is a board certified anesthesiologist. Her PhD is in Pharmacy Administration, with a specialty in pharmacoeconomics and outcomes research from the University of Texas at Austin. She is president of Austin Outcomes Research, Inc., a healthcare consulting and utilization review firm with multiple national carriers and legal firms as clients. She is the lead author of the Pain Chapter of the ODG Treatment Guidelines. Dr. Novak is also a clinical assistant professor at the College of Pharmacy at the University of Texas at Austin where she is active in the Pharmacy Practice Division.

 


Angel Pagan, EDI Director, Technical Lead, BCRC

Angel Pagan has 18 years of Medicare experience. He began his career with the Coordination of Benefits Contractor (COBC) in 2001 and then with the Medicare Secondary Payer Recovery Contractor (MSPRC) in 2006.   Angel was the MSPRC supervisor for several years before taking the position of MSPRC Quality Assurance Officer in 2011.  In 2013, GHI was awarded the BCRC contract and Angel served as its MSP Policy Specialist from 2013 to 2018 overseeing the BCRC’s Change Management and Training departments.  Angel is currently the BCRC EDI Director and technical lead for the MMSEA Section 111 reporting process.

 


Paul W. Pasche, Esq., Attorney, Brady, Connolly & Masuda, PC

Paul W. Pasche received his bachelor’s degree in psychology at Valparaiso University in 1988, and his juris doctorate in 1991 at the Valparaiso University School of Law. Since then, he has handled the preparation and litigation of Illinois workers' compensation, appellate, social security disability and Medicare compliance matters—during his first ten years of practice on behalf of claimants and since 2001 for the defense.

Pasche is a partner in the firm of Brady, Connolly & Masuda, P.C. which specializes in the defense of Illinois employers in workers' compensation and civil related matters. Mr. Pasche has practiced before the Illinois Workers' Compensation Commission, Illinois Circuit and Appellate Courts, the Illinois Supreme Court, U.S. District Court for the Northern District of Illinois, and the U.S. Circuit Court of Appeals for the Seventh Circuit.

Representative cases where Mr. Pasche successfully prevailed on behalf of his clients include Gilbert v. Sycamore Mun. Hospital, 156 Ill.2d 511, 622 N.E.2d 788 (1993) and Travelers Insurance v. Precision Cabinets, Inc., 2012 IL App (2d) 110258WC, 967 N.E.2d 856 (2012).

Pasche is active professionally as a member of the Illinois State Bar Association, Illinois Association of Defense Trial Counsel, Workers' Compensation Lawyers Association, and NAMSAP. Pasche is a frequent lecturer and author on workers' compensation and Medicare compliance issues for bar associations, professional organizations, insurance companies, and civic groups.


Louis Porrazzo, Esq., Director of Conditional Payment Services, ExamWorks Clinical Solutions

Louis Porrazzo, Esq. is the Director of Conditional Payment Services for ExamWorks Clinical Solutions, the nation’s leading provider of Medicare Secondary Payer Compliance solutions. With over a decade of experience with Medicare Secondary Payer Compliance, Lou oversees ExamWorks Clinical Solutions overall Conditional Payment and Treasury investigations, disputes, and appeals programs. As a former
defense attorney in Massachusetts, Porrazzo has extensive experience in relation to liability, workers’ compensation, and other insurance‐related claims.

Porrazzo provides regular Medicare Secondary Payer training and presentations at for client across the country, and is a regularly featured presenter for ExamWorks Clinical Solutions national webinar series.

He is MSCC Certified and is a member of the Defense Research Institute. He has received his certification as a workers’ compensation professional from the Michigan State CWCP program. He is also a member of NAMSAP and the American Bar Association.

Porrazzo obtained his Bachelor of Science in Business Administration from Stonehill College, with a major in Marketing and a minor in Economics. He received his Juris Doctor from Suffolk University Law School and is a member of the Massachusetts Bar.


Fran Jacoby Provenzano, RN, BSN, CDMS, CCM, CLCP, MSCC, President, MSA 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.

Fran 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.

Fran 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, Ms. 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.


The Honorable Robert G. Rassp

The Honorable Robert G. Rassp is a graduate of Loyola Law School class of 1981. He previously earned two undergraduate degrees from the University of California at Irvine in 1978 at age 20.

While practicing law as an attorney, Judge Rassp handled workers’ compensation and Social Security disability cases since 1981 and was the principal of his own law firm from 1983 until April 15, 2018. On April 16, 2018, Judge Rassp was appointed as a workers’ compensation administrative law judge and assigned to the Los Angeles WCAB District office. In 2017, Judge Rassp was appointed as an adjunct professor of law at Pepperdine University School of Law in Malibu, California teaching workers’ compensation law as an upper division class.

In addition to his law practice, Judge Rassp was the Chair of Friends Research Institute’s West Coast Institutional Review Board for fifteen years. In September, 2005, Judge Rassp was appointed as a member of the Friends Research Institute’s Board of Directors and in October 2008, Judge Rassp was named Chairman of the Board of Directors for FRI, effective January 1, 2009.

In addition to his duties as an attorney and medical ethicist, Judge Rassp was appointed as a member of the State Bar Workers’ Compensation Law Section Executive Committee in April 1998 and became its Chair in 2000–2001. Judge Rassp was reappointed as a member of the Workers’ Compensation Law Section Executive Committee in May 2003 and is currently an advisor to the Committee.

Judge Rassp is the author of The Lawyer’s Guide To The AMA Guides and California Workers’ Compensation (LexisNexis® Matthew Bender) which is a widely used medical-legal treatise and updated every year since its first edition in 2006. In addition, Judge Rassp was a contributing author to The Complete Guide to Medicare Secondary Payer Compliance (LexisNexis). He is the editor-in-chief of the two-volume treatise, Rassp & Herlick, California Workers’ Compensation Law, Seventh Edition (LexisNexis) that was completely revised and updated in 2014, and annually thereafter.

Judge Rassp is a member of the LexisNexis® Calif. Workers’ Compensation Editorial Board and is a member of the sub-committee for WCAB Noteworthy Panel Decisions. He is also a member of the Larson’s National Workers’ Compensation Advisory Board.


Melissa Running, MSPIC

Melissa Running is a member of the Medicare Secondary Payer Integration Contractor (MSPIC) team for the Centers for Medicare & Medicaid Services (CMS) Coordination of Benefits & Recovery (COB&R) program. The MSPIC is responsible for making sure that all components supporting the COB&R program function successfully together. The MSPIC performs the following functions on the program – Program and Project Management, Change and Release Management, Program Help Desk, Business Analysis, Testing and Technical Writing, Security Oversight, Quality Assurance Oversight, and Outreach and Education. Ms. Running will be presenting the overview of the Workers’ Compensation Medicare Set Aside Portal.


Leslie Schumacher, RN, CRRN, CCM, LNCC, CLCP, CNLCP, MSCC, CMSP, 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.

Schumacher 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). Leslie has been elected as Board Member of both IARP and the IALCP; she is former chairperson of the Education Committee and current 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.

Schumacher 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 her a featured speaker at industry conferences nationwide.


Leta Sharkey-Laugle, MS, NCC, CDMS, CRP, CLCP, MSCC, President, Medical Settlement Advantage Expert, Inc.

Leta Sharkey-Laugle has over 20 years of successful experience as both a Vice Present of Settlement Services for a F. A. Richard and Associates (FARA) and as a business owner and she later merged her company with another, as a partner and VP from 2016 to 2018 post-merger. 

She has served on the ICHCC MSCC Board for many years and the most recent past-Chair of the ICHCC MSCC and she remains on this Board to date.  She has also been a nationally recognized speaker and considered an expert in her field in court in several states.

Prior to entering the insurance arena, she was a successful business owner / psychotherapist, in Pennsylvania, with two office locations. Her background in psychological counseling has been of great benefit in working with the disabled population. In the latter part of her career, her role has been to monitor, supervise and ensure effective/optimal delivery of services that include: Medical Case Management, Vocational Rehabilitation, Utilization Review, Medicare Set-Asides, Life Care Planning and other associated MSP Compliance Services. 

Laugle's responsibilities include cost containment, including profit and loss for these businesses.  She wrote the California Utilization Review (UR) Manual for FARA; allowing FARA to successfully pass the CA State Utilization Review Audit the first time without penalty/revision. 

Using all her years of experience and transferrable skills, Laugle is now specializing in services for the disabled veteran. She continues to provide consultations and other services for the legal and insurance community on request that are within my skill set.  


Paul Sighinolfi, Senior Managing Director, Ametros

Paul H. Sighinolfi is the Senior Managing Director at Ametros, providing thought leadership, leading regulatory and policy initiatives, and providing meaningful strategic direction and insight.

Prior to Ametros, he was the Executive Director and Chairman of the Maine Workers’ Compensation Board. Previously, he was a partner at Rudman & Winchell, where he was a member of the firm’s litigation department and directed the workers’ compensation practice group. In his practice he represented both plaintiffs and defendants, and coauthored Maine Employment Guide: Workers’ Compensation.

Sighinolfi was a member and Chair of the Board of Bar Overseers, an appointment by the Maine Supreme Judicial Court. He was also appointed to the Lawyers’ Fund for Client Protection, where he was the Fund Chair.

He is a fellow of the American Bar Association, College of Workers’ Compensation Lawyers, was on the Executive Committee of the Southern Association of Workers’ Compensation Administrator, and served on the board of the International Association of Industrial Accident Boards and Commissions (IAIABC). Sighinolfi earned his master’s degree at Trinity College in Hartford, Connecticut and his law degree at the Columbus School of Law at Catholic University of America, in Washington, D. C.


Patricia Smith, RN, BSN, MSCC, CDMS, CLCP, Executive Vice President of Clinical Operations, Tower MSA Partners

From the time she was a young girl, Patricia (Pat) Smith wanted to be a nurse. She attended the University of Maine and obtained her BSN.  As a Registered Nurse, Smith had the opportunity to experience multiple facets of nursing that included medical-surgical; ICU; oncology; wound care; diabetic management; field case management; in-patient psychiatric care that involved running therapy sessions for adults and adolescents; and home care.  Experiencing these diverse situations provided invaluable knowledge that has assisted her greatly over the years.

Smith moved to sunny Florida in 1982 and to the workers’ compensation environment in 1998 when she accepted a position as a Telephonic Case Manager.  Working closely with the adjusters in both non-lost time and lost time claims to authorize appropriate and timely medical care for injured workers proved to be another unique learning opportunity!  She obtained her certification in disability management.

It was while working with the carrier that Smith was exposed to the world of Medicare Set-Asides.  In 2003 she took the position as a preparer of the MSA’s.  She obtained her certifications in life care planning, and Medicare set-asides.  She is proficient in the preparation of the MSA, Medical Cost Projections and Life Care Plans.

Over the years, she was promoted to Quality Assurance and Management duties.  In these roles she was responsible for developing and maintaining impeccable quality standards; hiring, training and educating clinical staff; developing and implementing policies and procedures to improve efficiencies and products; listening to the needs and desires of the customers to develop or adapt products to fit their needs; communicating effectively with clients to address any concerns.

Smith has recently joined the Tower MSA Partners team as Executive Vice President of Clinical Operations and reports her excitement and enthusiasm to work with this innovative premiere company.


Thomas Spratt, Vice President, Settlement Solutions

 

With more than 40 years of experience in the insurance industry, Thomas Spratt is an authority on issues related to Medicare compliance and Workers’ Compensation claims. As  Vice President – Settlement Solutions, Tom is responsible for the NuQuest Settlement Team.. He oversees assessment of clients’ Medicare compliance programs, training of claims staff and client settlement strategies for costly or complex cases involving both Workers’ Compensation and Liability. Tom is also conversant in Special Needs Trusts and their role in the settlement of high-exposure, disputed Workers’ Compensation and Liability matters.   Tom developed a ground-breaking and widely emulated Medicare Set-Aside compliance program for a national carrier. He has spoken on this subject at numerous national insurance industry conferences. Tom’s expertise spans all state and federal statutory jurisdictions, as well as employer liability suits.

Tom has a long record of active involvement in the insurance industry, serving on committees for the Workers’ Compensation Research Institute/WCRI, the Property Casualty Insurers Association of America/PCIAA and the Strategic Services on Unemployment and Workers’ Compensation/UWC. Tom also serves on committees for the National Structured Settlement Trade Association and the National Alliance of Medicare Set-Aside Professionals.  Tom currently chairs the Education committee for NAMSAP (National Alliance of Medicare Secondary Payer Professionals) and also serves on the faculty of the CMSP (Certified Medicare Secondary Payer designation program); it is the only program where both the law and allocations make up the curriculum.


Thomas Stanley, President, The Stanley Insurance Agency, Inc.

 

Thomas Stanley is the president of the Stanley Insurance Agency, Inc..  Since 2002, the Agency has provided full service WC Medicare Set-aside consultation to a varied clientele.  WCMSA services are a natural compliment to the settlement annuity services the Agency began providing in 1987.  Stanley hold the MSSC and CMSP certifications.  Recently, he was one of the first to complete the Masters in Structured Settlement Consulting program at the University of Notre Dame. Tom has an MBA in finance and economics.  Stanley currently serves on the NAMSAP Board of Directors. He is a native of Minnesota and now lives in Las Vegas, Nevada.

  


Will Sykes, Director, Call Center, BCRC

 

Will Sykes, from New York, is the director of the BCRC Call Center. He has over 15 years of contact center management experience specializing in Vendor Relationship and Workforce Management. Additionally, he has been involved with Medicare and specifically the Medicare Secondary Payer space since 2006.

 

 

 

 

 


Matt Walker, JD, CMSP, Attorney, Aleksy Belcher

 

Matt Walker is an attorney at the law firm of Aleksy Belcher in Chicago, Illinois. He received his B.A. at the University of Illinois at Chicago and his J.D. from The John Marshall Law School in Chicago. Matt represents injured workers throughout the State of Illinois in claims before the Illinois Workers’ Compensation Commission, the Circuit Courts and the Illinois Appellate Court. Matt also represents claimants before the Social Security Administration. 

 

Matt is a member of the National Alliance of Medicare Set-Aside Professionals, the Workers’ Compensation Lawyers’ Association, the National Organization of Social Security Claimants Representatives and the Kane County Bar Association. 


Monica Williams, RN, CCM, CRRN, LNC, MSCC, CMSP, CNLCP, MSP Manager, Innovative Claims Strategies

Monica Williams has over 20 years of Managed Care and Workers Compensation experience. She is the Medicare Compliance Manager for Innovative Claims Strategies (ICS) where she has oversight of Medicare Set Aside program which includes CMS legal submission and Conditional Payment Resolution. As Manager she has developed and implemented the Medicare Compliance Department internal workflow processes. She was formerly the District Manager for Georgia and then National Catastrophic Program Manager for Intracorp.

Monica is President of MWC, LLC consulting practice in State of Georgia which provides Complex Case Reviews, Medical, Catastrophic Field Case Management and Life Care Plans.

She is currently a member of NAMSAP Board, , Annual Conference Committee, Liability Committee and Co-Chair of Membership Committee.


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.


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