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NAMSAP July 2018 Newsletter
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NAMSAP Quarterly Newsletter

Volume 11, Number 2 | July 2018

IN THIS ISSUE:
•  Letter from NAMSAP President
•  2018 National Educational Conference Information
•  Webinar Highlights
•  Regulation Update
•  MSCC Pre-Certification and Re-Certification Course Now Available
•  Committee Updates


01 | Letter from NAMSAP President

  By: Rita Wilson
 
Chief Executive Officer
 
Tower MSA Partners

 

  Dear NAMSAP Members:

  I can hardly believe we are at the midpoint of 2018, yet when I look back on all that has been accomplished year to date, I am reminded of what a busy year it’s been for NAMSAP! Many of the initiatives that were just beginning as we started 2018 are now fully operational, bringing added value to our members and generating revenues that will drive future growth for NAMSAP.  Many thanks to Julie’s team at Association Management Services (AMS) and to the NAMSAP board of directors and committee leaders who are leading the charge to move our strategic goals forward.

One of the most exciting accomplishments finalized in Q2 was the release of NAMSAP’s MSCC Pre-Certification Educational Program.   Credentialed by the International Commission on Health Care Certification (ICHCC), the MSCC Training Program is designed for health care, legal or insurance claims professionals in the workers’ compensation system.   The program, developed by NAMSAP member experts, includes nine modules, as well as a separate peer-reviewed practicum, each designed to provide current information on policies, guidelines and current trends in Medicare Secondary Payer compliance.  Many thanks to those who participated in the development, preparation and delivery of this program!

 

As an added incentive to sign up for the course now, those who have completed NAMSAP’s MSCC course within the required period of time prior to the annual conference can arrange to take the MSCC test prior to conference start date at no additional charge.  For more information and to register, go to https://namsap.site-ym.com/news/409211/MSC-Pre-Certification--Recertification-Now-Available.htm.

 

Since our last release of NAMSAP Advisor, 3 webinars have been presented with recorded versions available for download to NAMSAP Members. Included were Dual Coverage & Special Needs Trusts, by Beth Hostetler, RN, MSCC (Albertson’s) and Will Lindahl, MBA, CLPF (CPT Institute), Dive Deeper into Drug Pricing, by Christine Melancon, RN, CCM, MSCC, CMSP, CNLCP, Brian Schumacher, CMSP, and Leslie Schumacher, RN, CRRN, CCM, CLCP, CNLCP, MSCC, CMSP, CMSP Fellow, and Uncovering the Concept of Conditional Payments, by Daniel Anders, Esq., MSCC and Shawn Deane, JD, MEd, MSCC, CMSP. 

Webinars scheduled for the remainder of 2018 are listed below and can also be found at http://www.namsap.org/events/event_list.asp?  Details and registration information for Opioids in the MSA – Intersection of Policy and Public Health, scheduled for August 21, 2018 is available at https://namsap.site-ym.com/events/EventDetails.aspx?id=1091101&group=

Webinar topics slated for the remainder of 2018 include:

  • Medicare Part C - September 18, 2018
  • MSA Cost Mitigation Strategies - October 26, 2018
  • Case Law Update - November 13, 2018      
  • Annual Ethics Update - December 18, 2018
  • Year in Review - January 15, 2019

In addition to the above, the Liability MSA Committee is working now to prepare a webinar that will provide a best practice recommendation with practical application for Liability settlements as we continue to wait for CMS to provide additional guidance regarding a formal review process.  An announcement with dates and registration will be announced as soon as available.

As noted in our last issue, one of the most exciting initiatives of 2018 has been to extend NAMSAP’s advocacy to CMS to stop the institutionalization of opioids over life expectancy that continues under its review process for WCMSAs. Through the leadership of Gary Patureau and Amy Bilton, the EBM Committee is aggressively seeking to extend national awareness of this issue through communication with national organizations and legislators, and also via direct dialogue with CMS.  As an extension of this effort, Amy, Gary and I had the opportunity to present at the annual conference of the National Council of Self-Insurers (NCSI) in June to explain to their membership what is happening under CMS’s WCMSA review, to communicate NAMSAP’s recommended policy changes in support of evidence based medicine and to ask for their support and involvement.  We received great feedback on our presentation and a commitment of continued support from NCSI.  We also had the opportunity earlier this month to dialogue with Alex Swedlow, Executive Director of California Workers’ Compensation Institute (CWCI) and Kim Wiswell (Medval) regarding their efforts to engage CMS in similar conversations regarding opioids CMS’s review process. The next step for NAMSAP is to engage legislators in a call to action.  This will occur with our August webinar, Opioids in the MSA:  Intersection of Policy and Public Health. You don’t want to miss this event!

As we look ahead to the NAMSAP 2018 National Educational Conference in Baltimore, MD on October 3-5, I hope everyone has taken advantage of the Early Bird Registration discount and secured a room at the beautiful, historic Lord Baltimore Hotel!  Conference Co-chairs Michelle Allen and Gary Patureau have engaged excellent speakers from all areas of the MSP industry.   With the newly implemented contractors for the WCRC and CRC, we anticipate active participation by CMS at this year’s conference.  We also expect involvement by legislators who are leading our charge on opioids, and by our own member experts from both the payer and service provider communities. Please make plans now to join us in Baltimore (https://namsap.site-ym.com/page/2018AnnualConference)!

Other activities completed in Q2 and remain ongoing as we continue into Q3, include the following:

  1. www.NASMAP.org website refresh project to revamp our current website to better represent us as a vibrant, action oriented, driven organization.
  2. Completion of a new NAMSAP BOD orientation training program for all BOD and Advisory Committee. 
  3. Final implementation of a robust educational platform in conjunction with EdTek to support the MSCC training program. 

As we finalize preparation for the annual conference, continue our webinar series and complete our web refresh project, Q3 is set to be our busiest quarter of the year. Look for information on all upcoming events via ListServ emails and get registered early.  There is no better organization than NAMSAP to lead the MSP industry in advocacy and education through the collaborative efforts of its members, and there is no better time to join than today.

The involvement and support of every member is key to a strong finish to 2018.

In the words of Winston Churchill, “Difficulties mastered are opportunities won.”


NAMSAP Wants to See You at the 2018 National Educational Conference

NAMSAP is now accepting registrations and sponsors for the 2018 Annual Meeting to be held in Baltimore, MD at the Lord Baltimore Hotel, October 3-5, 2018.

Early additions to the annual conference agenda include the following:

  • An update on new CMS policy guidance as it unfolds for LMSAs
  • An analysis from the industry on our new WCRC and CRC with history, key trends and differences. 
  • Participation by CMS, WCRC and CRC to share their to share their guidance as to best practices and expectations
  • For Medicare Advantage Plans, our experts will provide practice points to bring transparency to the communications process

The full agenda will be released soon - but make your plans NOW to attend.  We look forward to seeing you in Baltimore! 

EARLY BIRD REGISTRATION DEADLINE IS AUGUST 31, 2018

HOTEL BLOCK DEADLINE: SEPTEMBER 2, 2018


Partner Spotlights

PLATINUM SPONSOR

GOLD SPONSORS
        


02 | Webinar Highlights

 

AUGUST WEBINAR: Opioids in the MSA Part III
August 21, 2018 - 3:00 PM ET

NAMSAP is pleased to welcome Brett Baker (pictured far left), Health Policy Advisor for the U.S. Senate Finance Committee, and Jeff Lucas (pictured left), Health Policy Advisor Senator for Bill Cassidy, as they join Amy Bilton, Attorney, Nyhan, Bambris, Kinzie & Lowry, and Gary Patureau, Executive Director, LASIE, for the Part III webinar series "Opioids in the MSA."

The webinar will discuss national legislation focusing on the opioid epidemic and potential opioid policy recommendations in MSP compliance OR (in the MSA).

This is an important webinar you don't want to miss - register now!

LEARN MORE ABOUT WEBINARS >

 

 


Partner Spotlights

SILVER SPONSORS

    

       


03 | Regulation Update

 

MSA Alternatives in 2018
By: John V. Cattie, Jr., Founder, Cattie, PLLC

"The pessimist complains about the wind; the optimist expects it to change; the realist adjusts the sails." William A. Ward

When asked to write an article about Medicare Set-Aside (MSA) alternatives in 2018, I had to pause. At a glance, it seems to be a very simple request. However, it’s not as simple of a request as one might think as winds have been shifting in the MSA world.

The MSA issues are much more complex than a decade ago. Is the claim accepted or denied? Are we talking about workers’ compensation (WC) or liability insurance? Did the MSA reviewer based the report on medical records or legal analysis? Do we ask Medicare to review/approve the MSA or steer clear of the federal government? The MSA winds have changed direction.

The term ‘Medicare Set-Aside’ or ‘MSA’ means different things to different people. For some, the MSA is the report indicating how much money needs to be set aside to comply with the Medicare Secondary Payer (MSP) Act. For others, the MSA is the account holding the amount of money being set aside, preventing Medicare from paying certain medical bills prematurely. To truly write an article discussing MSA alternatives, it needs to account for both MSA concepts: 1) the report identifying the proper dollar amount; and 2) the vehicle or method being chosen to ensure Medicare is not billed prematurely. Only then can we harness the MSA winds blowing in 2018.

Historically, there were no MSA alternatives. To figure out the MSA issue, you would hire an outside MSA vendor or nurse allocator to review medical records when a claim met workload review thresholds established by the Centers for Medicare & Medicaid Services (CMS). That review led to a calculation of what future medical expenses were anticipated to be incurred which were related to the compensable workers’ compensation claim and typically covered by Medicare. Then, the settling parties instructed the claimant to open an interest-bearing checking account and manage the account themselves after CMS approved the MSA figure. It seemed like all MSAs went to CMS for review and approval back in the day.

For some cases, this remains a viable path forward in 2018. Often, though, this process yields undesired results. First, thousands of these MSAs each year will be overfunded or underfunded, a result often discovered only when CMS disagrees with the MSA amount. That leads to the second result: the vendor or nurse who calculated the MSA is not willing to stand behind its conclusion. With no assurance that the MSA is correct, parties relying on that vendor or nurse’s professional opinion are left with the unsatisfying result of leaving the claim open. Claimants continue to treat with physicians they don’t necessarily want to see. Employers/carriers continue to pay, leaking more medical and indemnity dollars than they wish. The process turns into a Gordian Knot, impossible to untie even if the parties wanted to untie it. All due to that improper MSA calculation.

The WC industry has become more sophisticated. It now knows there is no MSA requirement. It knows there is no requirement to have CMS review and approve an MSA figure. It now knows claims can be resolved without MSAs. It now knows that MSA alternatives exist.

Click here to read more about MSA calculations, and vehicle, funding, and administrative options.


Partner Spotlights

 

BRONZE SPONSORS

       

          

    
      The Hartford


04 | MSCC PRE-CERTIFICATION AND RE-CERTIFICATION COURSE NOW AVAILABLE

 

NAMSAP is pleased to announce the release of a new Medicare Set-aside Consultant Certified (MSCC) course. The MSCC credential identifies professionals who have undergone specific pre-approved training in MSA arrangements and have agreed to adhere to a set of standards governing ethics and professional behaviors. 

“The new MSCC course advances NAMSAP’s mission to provide timely and pertinent education to our industry,” said NAMSAP President Rita Wilson.  “Many changes have taken place in our industry over the past few years and our MSCC course has been revamped to include the most recent information and perspectives available, providing the student with the sound groundwork necessary to become a certified professional.”

Credentialed by the International Commission on Health Care Certification (ICHCC), the MSCC Training Program is designed for health care, legal or insurance claims professionals in the workers’ compensation system.   The program includes nine modules, as well as a separate peer-reviewed practicum, each designed to provide current information on policies, guidelines and current trends in Medicare Secondary Payer compliance.  Modules include:

  • Overview of MSP Compliance
  • CMS Policy Memos                  
  • The Players in the MSA        
  • Structured Settlements            
  • Administration & Custodial Accounts          
  • Medicare Conditional Payments/Electronic Reporting
  • Development of the MSA Allocation Cost Projection

“NAMSAP has long been regarded as the industry leader in Medicare Secondary Payer education and advocacy,” said ICHCC CEO, Dr. Robert May, III.  “The ICHCC is proud to work with NAMSAP to advance MSCC education nationally."

The on-line course can be purchased as a complete course or in individual modules, and NAMSAP members receive a discount. For fees and more information, please go to www.NAMSAP.org . 

About ICHCC
The International Commission on Health Care Certification provides internationally recognized certifications in life care planning, disability evaluation, and Medicare.  Based in Midlothian, Virginia, the organization may be reached at https://ichcc.org or 804-378-7273. 


05 | COMMITTEE UPDATES

 

NAMSAP's committees are hard at work pushing forward the association's strategic goals.  Below is a list of the committees and just a few of their latest highlights - we encourage you to contact the co-chairs to volunteer your expertise as part of the committee.

  • Annual Meeting Committee
    • Michelle Allan, mallan@grsm.com
    • Gary Patureau, Gary@Lasie.org
    • Highlights: The committee continues to finalize the convention agenda to bring you a strong line-up of speakers and topics that are vital to your professional development.  The committee is also working to expand NAMSAP's reach to potential sponsors and supporters. 
  • Communications Committee
    • Rasa Fumagalli, ref@nbkllaw.com
    • Rita Wilson, rita.wilson@towermsa.com
    • Highlights: The committee has supported the launch of the MSCC program and continues to work on the refreshing of the association website and logo redesign.
  • Data and Development Committee
  • Evidence Based Medicine Committee
    • Gary Patureau, Gary@Lasie.org
    • Amy Bilton, aeb@nbkllaw.com
    • Highlights: The committee continues work on the opioid initiative and is working with the NAMSAP staff to form an email template for members to easily send to their Congressional delegation.
  • Liability MSP Advisory Committee
    • William Delaney, wad@nbkllaw.com
    • Thomas Stanley, tomstanley@cox.net
    • Highlights: The committee recently met and reviewed CMS' response and will use this guidance to develop "best practices."
  • Membership Committee
  • Policy & Legislative Committee
    • Dan Anders, daniel.anders@towermsa.com
    • Katie Fox, Katie.fox@francosignor.com
    • Highlights: The committee has reviewed the Provide Accurate Information Directly (PAID) Act (HR 5881) which mandates the sharing of certain information between CMS and settling parties, specifically whether the beneficiary is enrolled in MA, Part D, of the Medicaid Program.  The committee drafted a letter which the board approved in support of the Act to be sent to the authors of the legislation.
  • Webinar Committee
    • Shawn Deane, sdeane@iso.com
    • Leslie Schumacher, lschumacher@planpointmsa.com
    • Highlights: The committee continues work to develop educational webinars that are current and relevant to our industry and your profession.

 

National Alliance of Medicare Set-Aside Professionals
620 Florida St., Suite 210 | Baton Rouge, LA 70801

P: 225-454-6164 | F: 225-344-1132
www.namsap.org | info@namsap.org

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