Medicare has redoubled the enforcement of its right of lien recovery under the Medicare Secondary Payer Act in injury claims and settlements. Do you know exactly when and how litigants must take Medicare's interests into account to ensure compliance and minimize its impact on settlement? This practical legal resource includes in-depth discussions on mandatory insurer reporting, Medicare conditional payments, and Medicare Set-Asides. Get practical guidance in resolution of Medicaid liens and the creation and administration of special needs trusts. Don't let MMSEA derail your injury settlements – order today!

1. Welcome and Program Overview
2. What Defines Medicare's Interest
3. When Do You Need to Consider Medicare's Future Interests?
4. What To Do When The Defendant/Insurer Insists On An MSA?
5. Getting Paid Faster (The Proper Methods For Interacting with CMS)
6. Challenging The Conditional Payment
7. Appeals
8. Litigation Regarding Medicare Conditional Payments (Frequently Called Medicare Liens)

Continuing Education Credits:   

Continuing Legal Education

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1. Welcome and Program Overview
   9:00 - 9:15, Paul K. Isaac
2. What Defines Medicare's Interest
   9:15 - 10:45, Benjamin M. Basista
   1. Brief Explanation of the Medicare Secondary Payer Act
   2. Mandatory Reporting For Insurers and Self-Insurers
      1. The SCHIPP Extension Act
      2. Penalty For Failure to Notify Medicare
   3. The Delay In Payment Arising Out Ambiguity
      1. Confusing Conditional Payment Rules with Medicare Set Aside Rules
      2. Distinguishing the Obligations
3. When Do You Need to Consider Medicare's Future Interests?
   11:00 - 12:00, Paul K. Isaac and Benjamin M. Basista
   1. Workers' Compensation Cases
   2. Liability Cases
4. What To Do When The Defendant Insurer Insists On An MSA?
   1:00 - 2:15, Paul K. Isaac
   1. What Are Your Options?
      1. The Medicare Manual
      2. New York State CPLR Section 5003-a
      3. Caselaw
5. Getting Paid Faster (The Proper Methods For Interacting with CMS)
   2:30 - 3:00, Robert R. Schweers
   1. Phone, Fax, or Third Party Private Contractor?
   2. The CMS Website (www.MSPRC.info)
6. Challenging The Conditional Payment
   3:00 - 3:30, Robert R. Schweers
7. Appeals
   3:30 - 4:00, Robert R. Schweers
8. Litigation Regarding Medicare Conditional Payments (Frequently Called Medicare Liens)
   4:00 - 4:30, Paul K. Isaac
   1. Merryfield v. United States, 2008 WL 906263 [D.N.J., 2008]
   2. United States v. Harrs, 2009 WL 89191 [N.D.W.Va., 2009]
   3. Big R. Towning, Inc v. Benoit, 2011 WL 43219 [W.D.La., 2011]
   4. Bradley v. Sebelius, 2010 WL 3769132 [11th Cir 2010]
   5. U.S. v. Stricker, US Dist Ct, ND Ala, CV-09-PT-2423-E, 2009
   6. Parra v. PacificCare of Arizona, Inc, US Dist CT, D Az, CV-10-008-DCB, 2011

BENJAMIN M. BASISTA joined Burns White, Attorneys at Law in 2004. He is an associate concentrating his practice in the area of Medicare compliance. Mr. Basista focuses his practice on addressing Medicare issues that arise in the resolution of workers' compensation, general liability, and FELA claims. He is retained as National Medicare Counsel and Advisory Medicare Counsel by a number of insurance carriers, third party administrators, and self-insured entities, including Class I and short line railroads, to advise on compliance matters regarding the Medicare Secondary Payer Statute. Mr. Basista is a frequent lecturer on the topic of Medicare compliance to insurance carriers, self-insured businesses, law firms and professional organizations. He has been named as industry Medicare counsel to the Association of American Railroads and has assumed the role of legislative chair for the National Association of Medicare Set-Aside Professionals. Mr. Basista earned his J.D. from the University of Pittsburgh School of Law, where he was a finalist for the 2003 Herman L. Foreman Labor Law Award, and his B.S. degree from The Pennsylvania State University. Previously, he served as a law clerk with the Hon. Paul F. Lutty in the Court of Common Pleas of Allegheny County and in the Pittsburgh office of the National Labor Relations Board. A native of Pittsburgh, Mr. Basista is admitted to practice law in the state of Pennsylvania.

PAUL K. ISAAC earned both his undergraduate and law degrees from Duquesne University in Pittsburgh, Pennsylvania. A strategic life planner, Mr. Isaac's years of experience allow him to anticipate a plaintiff's long-term financial needs. Mr. Isaac also holds a life and health insurance license, as well as securities licenses in Series 6, 63, 65, and 7. He is a member of the Society of Settlement Professionals, the Million Dollar Advocates Forum, the American Association of Justice (formerly ATLA), the New York State Trial Lawyers Association, the National Association of Medicare Set-Aside Planners, the New York State Bar Association, the Erie County Bar Association, and the New York State Academy of Trial Lawyers. During his time as a practicing attorney, Mr. Isaac helped several clients obtain large settlements and favorable verdicts. He has retired from practicing law and is presently the president of Paramount Settlement Planning, LLC. In addition to assisting plaintiffs with the strategies for handling settlements from all types of personal injury lawsuits, Mr. Isaac is experienced in navigating the intricacies of complicated life care cases in which Medicaid and Medicare benefits must be preserved. He is also experienced in negotiating all types of liens associated with personal injury cases and their settlements.

ROBERT R. SCHWEERS has focused his practice on Medicare compliance, lien negotiation, and resolution. After earning his B.A. degree from Duquesne University in 1991, Mr. Schweers entered Duquesne Law School and earned his J.D. degree in 1995. While in law school, Mr. Schweers worked as a law clerk for Harrington Schweers Datillo & McClelland, a Pittsburgh personal injury firm specializing in medical malpractice. His responsibilities primarily included legal research and writing projects, encompassing all phases of litigation support from drafting pretrial motions to appellate briefs.

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