It is the silent 800-pound gorilla in the room that has a direct impact on Medicare compliance—CMS’s Section 111 reporting law. As defense counsel are busy defending and settling the claim, their clients are reporting required claims info to Medicare which CMS then uses to help enforce its recovery rights. While defense counsel rarely pushes the Section 111 reporting buttons, they must understand how Section 111 reporting works and how it impacts larger compliance issues and settlement.
High workers’ comp Medicare Set-Aside (WCMSA) allocations continue to frustrate workers’ compensation insurers and prevent claim settlement. But counsel and their clients often have more options than they realize to lower WCMSA allocations and fight back against CMS.
Today, counsel and their clients face growing challenges regarding Medicare recovery claims—including a flurry of “double damages” lawsuits filed against insurers. Examine what counsel needs to know about Medicare, Treasury, and Medicare Advantage recovery claims from the workers’ compensation, liability, and no-fault perspectives with Verisk thought leaders Mark Popolizio, VP of MSP Compliance and Sid Wong, VP of Policy.
Mark Popolizio is the vice president of Medicare Secondary Payer (MSP) compliance for Casualty Solutions. He is a nationally recognized authority on Medicare Secondary Payer (MSP) compliance.
Mark practiced insurance defense litigation for ten years, concentrating in the areas of workers’ compensation and general liability. Since 2006, he has dedicated his practice exclusively to MSP compliance, working with insurers, self-insureds, third-party administrators, and other claims professionals in addressing MSP compliance issues.
Mark is a regularly featured presenter on MSP issues at national seminars and other industry events and has authored numerous national articles addressing several topics related to MSP matters, including a chapter in the California Bar CLE publication Special Needs Trusts: Planning, Drafting and Administration. He is also active with other industry groups, including the Medicare Advocacy Recovery Coalition (MARC), DRI (Defense Research Institute), and the National Alliance of Medicare Set-Aside Professionals (NAMSAP).
Sid Wong is vice president of Policy, Casualty Solutions, and he provides the highest level of client services—with a focus on meeting clients needs through various Medicare Secondary Payer compliance products and services. He is also responsible for assisting clients with effectively navigating Medicare compliance issues.
Prior to joining Verisk, Sid worked for a small general practice firm in New Hampshire where he received his JD from Franklin Pierce Law Center (now UNH School of Law). Sid is a member of the Massachusetts, New Hampshire, and New York Bar.