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Exclusive Webinar: How Humana Enforces the MSP Statute After Settlement

In a recent interview with Brian Bargender, a Consultant for Subrogation, MSP and Other Payer Liability at Humana, one of the country’s largest Medicare Advantage (MA) organizations, he tackled the most common questions we receive regarding how the Medicare Secondary Payer (MSP) Statute is enforced after settlement and provided insight into the MSP Act from the perspective of a Medicare Advantage plan.

Now, we’re hosting an upcoming webinar, ‘How Humana Enforces the MSP Statute After Settlement’ on November 21st at 2:00 PM EST with Brian and Shawn Deane, Ametros’ General Counsel and leader of the legal team, for a closer look into how Humana collects the data they need to make important coverage or denial decisions for injured parties with Workers' Compensation Medicare Set Asides (WCMSAs) and liability settlements.​​​​​​​​​​​​​​​​​​​​​

Webinar Broadcast Details


How Humana Enforces the MSP Statute After Settlement

Date: Thursday, November 21st

Time: 2:00 PM EST

***This event will be recorded and shared with all registrants following the event***

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The Centers for Medicare and Medicaid Services (CMS) have repeatedly explained that MA and Prescription Drug Plans (PDP) should enforce the MSP rules or face potential penalties. Therefore, it is becoming more important than ever for the industry to be aware of how these plans are finding out about and tracking settlements and how to best protect injured parties’ Medicare benefits both before and after settlement.

But how is Humana able to make accurate coverage determinations, enforce MSP Statute, or issue post-settlement subrogation letters when CMS does not forward most Medicare Set Aside (MSA) details to MA and PDP Plans?

In this webinar you’ll learn:

  • Common FAQs regarding Humana coverage, denials, and subrogation
  • Brian’s background and how his role impacts decision made at Humana
  • How Humana determines when to issue subrogation letters for services post-settlement
  • How Humana enforces MSP Statute​​​​​​​
  • How Humana collects the data they need and what specific data is obtained from CMS & other sources​​​​​​​

 

Presenters

Brian Bargender

Brian is an internal consultant at Humana, one of the country’s largest Medicare Advantage organizations. In recent years, Humana has been heavily involved in efforts to clarify and enforce the Medicare Secondary Payer rules that pertain to Medicare Advantage.

Brian has 15 years of experience in leading and improving health benefit subrogation and MSP operations. In this role he dedicates considerable attention to identifying and monitoring trends that may impact subrogation and MSP recovery efforts, developing new cost avoidance and recovery projects and advising operational leaders regarding subrogation and MSP issues.

Shawn Deane

Shawn is General Counsel and leads the legal team at Ametros. He has over a decade of experience practicing law and in Medicare Secondary Payer (MSP) compliance as an industry thought leader. He was previously Vice President of Medicare Compliance & Policy at ISO Claims Partners. Prior to that he practiced insurance defense litigation and healthcare law.

He has been heavily involved with the National Alliance of Medicare Set Aside Professionals (NAMSAP), having served as chair of the webinar and education committees, on the Board of Directors, and was past President in 2017. He was also former executive committee member with the Medicare Advocacy Recovery Coalition (MARC). Shawn is faculty for the Certified Medicare Secondary Payer Professional Program (CMSP).

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