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Medicare Secondary Payer Enforcement: A Billion Dollar Dilemma for Injury Carriers and Health Plans
Recorded On March 31 @ 1:00 pm - 2:00 pm EDT
The government’s recent efforts to enforce MSP rules have already had indirect impacts on payments owed to carriers and self-insured entities by the federal government. New regulations announced in October 2019 will establish additional penalties for liability, no-fault and workers’ compensation carriers who fail to cooperate. Claim adjusters’ and subrogation adjusters’ lack of familiarity with MSP rules has also exposed their companies as targets in at least 150 class-action lawsuits attempted by firms that claim to represent Medicare Advantage plans. The government provides resources to assist Medicare Advantage plans in MSP enforcement and has indicated an intent to audit plans to make sure the resources are used. However, very few health subrogation professionals are familiar with or making full use of the resources.
Presenter: Brian Bargender – Humana
Brian Bargender is an internal consultant with Humana, one of the country’s largest Medicare Advantage organizations. Brian has helped to lead Humana’s efforts to clarify and enforce the Medicare Secondary Payer (MSP) rules that pertain to Medicare Advantage and Medicare Prescription Drug plans. He is also responsible for monitoring trends that may impact subrogation and MSP recovery efforts, developing new cost avoidance and payment recovery projects and advising operational leaders regarding subrogation and MSP issues. Brian has 17 years of experience in leading and improving health benefit subrogation and MSP operations. He is frequently invited to speak with liability, no-fault and workers’ compensation carriers to explain emerging MSP issues. He holds a Certified Subrogation Recovery Professional (CSRP) designation from the National Association of Subrogation Professionals and previously served as both a co-chair of NASP’s Wisconsin chapter and a health track leader for NASP’s Annual Conference.