Complying with Medicare: Everything You Need to Know for Your Workers' Compensation Case

Compliance with the Medicare Secondary Payer Act can be challenging and oftentimes can cause unnecessary delays to the settlement. This course will cover all three statutory requirements of the Medicare Secondary Payer Act: Reimbursement of Conditional Payments, Prohibition on Medicare from making payments post-settlement (the MSA), and Section 111 Reporting. Specifically, these statutory requirements will be examined in the setting of workers' compensation matters. In addition, the latest policy changes from CMS will be discussed in detail to give practitioners the most up-to-date information.

Learning Objectives: 

1. Review the April 2025 changes to Section 111 reporting for WCMSA amounts
2. Examine the April 2025 changes to the Amended Review process
3. Discuss the July 2025 changes to Zero-Dollar MSA submissions to CMS
4. Analyze the PAID Act and how it impacts Medicare Advantage Plans and Medicare Part D plans
5. Explore the Section 111 Civil Money Penalties effective October 2024