Rita Wilson, CEO of Tower MSA Partners will participate on the “Submission vs. Non-submission” panel at the National Alliance of Medicare Set-Aside Professionals’ 2016 Annual Meeting, September 14-15.
The panel will debate the pros and cons of submitting a Workers’ Compensation Medicare Set-Aside to the Centers for Medicare & Medicaid Services for review and approval and discuss alternatives to the submission process.
“The Medicare Secondary Payer Statute prohibits Medicare from paying for any service when primary responsibility belongs to another entity,” said Wilson. “Absent an enforcement provision, many payers voluntarily choose to prepare and submit an MSA for review by CMS in an effort to establish certainty.”
Whether submitted or not, Wilson says it is important to identify inappropriate medical and pharmacy treatment before MSA and settlement, and intervene to modify treatment.
“Too many injured employees take dangerous doses of opioids mixed with other pain medications,” she said. “Plus, pharmacy is typically the largest cost on an MSA. Staging claims to address unnecessary medical and inappropriate pharmacy treatment before the MSA is the right thing to do for both patient and payer.”
Joining Wilson on the panel are the Garretson Resolution Group’s John Cattie, Jr., Medval’s Jennifer Jordan, Chesapeake Employers Company’s Melinda Petit, NuQuest’s Robert Sagrillo, Midwest Employers Casualty Company’s Mark Sidney, and Safety National’s Mark Walls.
The panel is scheduled for Thursday, Sept. 15 at 1:30 p.m. during the annual meeting, which will be held in San Antonio, Texas. For details, please see http://www.namsap.org/page/2016AnnualMeeting.
About Tower MSA Partners
Headquartered in Delray Beach, Fla., Tower MSA Partners’ services include pre-MSA Triage, MSAs, physician peer reviews, CMS submissions, MSA administration, medical cost projections, life care plans, conditional payments, and Section 111 reporting. With more than 50 years combined experience in pharmacy, legal oversight and medical care, Tower proactively stages claims, working collaboratively with clients to identify issues and intervene to modify outcomes. Tower remains involved in the claims, through final resolution, MSA and/or other settlement. This model enables Tower’s clients to provide better care to injured workers, reduce claim and MSA costs, and obtain CMS acceptance of the MSA. For more information, visit www.towermsa.com and www.mspcomplianceblog.com.
View source version on businesswire.com: http://www.businesswire.com/news/home/20160901005134/en/Business Wire
Last updated on: 01/09/2016
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