Christine Hummel, Esq. is the President and founder of Hummel Consultation Services, a legal consultation practice specializing in the application of the Medicare Secondary Payer Act. An active attorney with licensure in the state of Colorado, she earned her Juris Doctor from the University of Denver in May 2000. In 2002 Christine opened her own firm, which recently celebrated its seventeenth continuous year of operation. With twenty years of experience, Christine is a published author and popular speaker on a wide array of topics related to Medicare compliance. Christine has significant experience working with the Centers for Medicare and Medicaid Services in regarding applicability of the Medicare Secondary Payer Act to liability settlements. She is a member of the American Bar Association, the Colorado Bar Association, and includes with her legal experience work in Medicaid, probate, and elder law. Christine volunteers her free time by giving presentations on the roles of women throughout multiple time periods in history.
Medicare Secondary Payer Act: New CMS Rules and Case Law for Liability and No Fault Settlements
CLE Credits earned: 2 GENERAL (or 2 LAW & LEGAL for WA state)
The Medicare Secondary Payer act (MSP) was enacted on December 5, 1980. Despite being federal law for over thirty-five years, many attorneys still struggle with ensuring their settlements fully comply with the statute’s three basic requirements: ensure Medicare remains secondary to settlement proceeds, reimbursement of Medicare’s conditional payment amount, and report the settlement via the Section 111 reporting requirement.
Since 2009, the Centers for Medicare and Medicaid Services (CMS) has methodically stepped up its enforcement of the MSP statute in all liability settlements. The most recent changes to CMS enforcement came in Fall 2017 when CMS took steps to ensure Medicare does not make any accident-related medical payments post-settlement.
This course is co-sponsored with myLawCLE.
Key topics to be discussed:
• When is your settlement primary to Medicare?
• 2017 changes to the Common Working File and Educational Outreach to Medical Providers
• The impact of Aetna vs Guerrera on Medicare Part C lien searches
• This CLE will include a detailed discussion of new policy/procedures anticipated by CMS in late 2019/early 2020
Date / Time: February 7, 2020
• 2:00 pm – 4:00 pm Eastern
• 1:00 pm – 3:00 pm Central
• 12:00 pm – 2:00 pm Mountain
• 11:00 am – 1:00 pm Pacific
Choose a format:
• Live Video Broadcast/Re-Broadcast: Watch Program “live” in real-time, must sign-in and watch program on date and time set above. May ask questions during presentation via chat box. Qualifies for “live” CLE credit.
• On-Demand Video: Access CLE 24/7 via on-demand library and watch program anytime. Qualifies for self-study CLE credit. On-demand versions are made available 7 business days after the original recording date and are view-able for up to one year.
myLawCLE seeks accreditation for all programs in all states. (Accreditation for paralegals sought thru NALA and NFPA paralegal associations.) Each attending attorney/paralegal will receive a certificate of completion following the close of the CLE program as proof of attendance. In required states, myLawCLE records attorney/paralegals attendance, in all other states attorney/paralegal is provided with the approved CLE certificate to submit to their state bar or governing association.
- Automatic MCLE Approvals
All myLawCLE CLE programs are accredited automatically either directly or via reciprocity in the following states: AK, AR, CA, CT, FL, HI, ME, MO, MT, ND, NH, NM, NJ, NY, WV, and VT. (AZ does not approve CLE programs, but accepts our certificates for CLE credit.)
- Live Video Broadcasts
Live video broadcasts are new live CLE programs being streamed and recorded for the first time. All of these programs qualify for “Live” CLE credit in all states except NV, OH, MS, IN, UT, PA, GA, SC, and LA —these states require in-person attendance to qualify for “Live” CLE credit.
- “Live” Re-Broadcasts
“Live” Re-broadcasts are replays of previous recorded CLE programs, set on a specific date and time and where the original presenting speakers calls in live at the end of the event to answer questions. This “live” element allows for “live” Re-broadcast CLEs to qualify for “Live” CLE credits in most states. [The following states DO NOT allow for “live” CLE credits on re-broadcast CLEs: NV, OH, MS, IN, UT, PA, GA, SC, and LA]
Many states allow for credit to be granted on a 1:1 reciprocal basis for courses approved in another mandatory CLE jurisdiction state. This is known as a reciprocity provision and includes the following states: AK, AR, HI, CT, FL, ME, MO, MT, ND, NH, NM, VT, NJ, NY, and WV. myLawCLE does not seek direct accreditation of live webinars or teleconferences in these states.
Section I: Overview of the Medicare Program and Medicare Secondary Payer Act
a) What is Medicare
b) Qualifying for Medicare
c) Three basic statutory requirements of the Medicare Secondary Payer Act
Section II: Section 111 Reporting
a) Who reports?
b) When do you report?
c) What do your report?
d) Penalty for failing to report: Notice of Proposed Rule Making anticipated by October 2019
Section III: Medicare’s Conditional Payment
a) Traditional Medicare: Parts A and B
i. Difference between the Benefits Coordination Recovery Contractor and the Commercial Repayment Center
ii. Compromise Requests
iii. Waiver Requests
iv. The Final CP Process
b) Medicare Part C and D plans
i. Statutory authority for Part C and Part D plans to assert a lien
ii. Key differences between Medicare A/B liens and Medicare C/D liens
iii. Case law discussion: In re Avandia, Humana cases, and Aetna vs Guerrera
c) Pitfalls and traps when conducting the Medicare conditional payment search(es)
d) Practice Tips
Section IV: The Medicare Set Aside (future medical allocation)
a) Statutory Authority for CMS’ position that your settlement is primary to Medicare
b) Case Law Discussion including the Aranki case and the Duff case
c) What medical treatment should be paid from settlement proceeds
d) Strategies for reducing the Set Aside allocation
e) October 2017 changes to the Common Working File
f) November 2017 educational outreach by CMS to the Medical Community and its impact on your clients
g) Notice of Proposed Rule Making anticipated by October 2019
h) Practice Tips