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Educational Conference Speaker Information
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NAMSAP is proud to feature the following line-up of industry experts for this year's conference.

 

John P. Albert
Senior Technical Advisor, Division of Medicare Secondary Payer Operations Office of Financial Management, CMS

CMS Fireside Chat, Wednesday, October 7, 2020, 4:15 p.m.

John Albert has worked for the Centers for Medicare and Medicaid Services (CMS) for 31 years, primarily on Medicare Secondary Payer (MSP) and Coordination of Benefits & Recovery policy and opertions.  Mr. Albert is currently serving as the Contracting Officer Representative for the Commercial Repayment Center (CRC) contract with Performant Financial, Inc. within the Division Medicare Secondary Payer Operations, which is responsible for oversight of the all MSP coordination of benefits and recovery policy and operations for CMS.  In addition to the CRC, other contracts overseen by the Division include the Benefits Coordination & Recovery Center contract and the Workers Compensation Review Contract.

   

Michelle Allan
Partner, Gordon & Rees

WCRC + Documentation and Evidence, Wednesday, October 7, 2020, 8:00 a.m.

Michelle A. Allan is a Partner in the Pittsburgh office of Gordon & Rees and is a member of the Medicare Compliance practice group. She focuses on Medicare issues that arise in the resolution of workers’ compensation, longshore, Jones Act, and general liability claims.

Allan has been instrumental in successfully settling tens of thousands of cases nationwide involving Medicare Secondary Payer issues. Her work includes preparing Medicare Set-Aside Arrangements and having the same approved by the Centers for Medicare and Medicaid Services. Allan makes recommendations on how best to consider and protect Medicare’s interests while also balancing her clients’ interests in claims not requiring Medicare approval. In addition, Allan negotiates Medicare conditional payments and has saved her clients millions of dollars in conditional payment reimbursements.

Allan is a recognized national presenter on Medicare Secondary Payer issues, and frequently lectures on the topic of Medicare compliance to insurance carriers, self-insured businesses, third-party administrators, law firms, and other professional organizations. She is also a 2011 inductee to The Legal Intelligencer’s prestigious class of Lawyers on the Fast Track.

While attending law school, Allan served as an extern for the United States Magistrate Judge Ila Jeanne Sensenich in the United States District Court for the Western District of Pennsylvania. Prior to attending law school, Allan worked as a journalist, reporting daily news for the Pittsburgh Tribune-Review.

 

Daniel M. Anders, Esq., MSCC, CMSP-F
Chief Compliance Officer, Tower MSA Partners

Reference Guide Lesser Known Facts and Fallacies, Wednesday, October 7, 2020, 12:15 p.m.

Daniel M. Anders, Esq., is the Chief Compliance Officer for Tower MSA Partners where he oversees the Medicare Secondary Payer (MSP) compliance program. In this position, Anders is responsible for ensuring the integrity and quality of all MSP compliance services and products.

Based upon his 14 years of experience in working with employers, insurers, TPAs, attorneys and claimants, Anders provides education and consultation to Tower MSA clients on all aspects of MSP compliance. He also regularly offers expert guidance on Tower MSA’s MSP Compliance Blog, has been featured in “Leaders Speak” on WorkCompWire and is regularly quoted on WorkCompCentral in regard to MSP matters.

 


Brian Bargender, CSRP

Internal Consultant, Humana

MAO Panel, Tuesday, October 6, 2020, 11:30 a.m.

Brian Bargender is an internal consultant with Humana, one of the country’s largest Medicare Advantage organizations.  In recent years, he 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.

Bargender has 16 years of experience in leading and improving health benefit subrogation and MSP operations.  He holds a Certified Subrogation Recovery Professional (CSRP) designation from the National Association of Subrogation Professionals and has served as both a co-chair of NASP’s Wisconsin chapter and a health subrogation education track leader for NASP’s annual national conference.

   

McKenzie Bennett
Principal, Mehlman Castagnetti Rosen & Thomas

PAID Act, Tuesday, October 6, 2020, 3:00 p.m.

McKenzie Bennett joined Mehlman Castagnetti Rosen & Thomas in 2019 after serving in a number of influential health policy positions on Capitol Hill.

Most recently, Bennett was the Senior Health Policy Advisor for Senator Maggie Hassan (D-NH), a member of both the Senate Committee on Finance and the Senate Committee on Health, Education, Labor and Pensions (HELP). Prior to working for Hassan, Bennett was a Health Policy Advisor to former Democratic Leader Harry Reid (D-NV), spearheading his work on public health and women’s health, as well as coordinating the caucus strategy on such issues.

While working with Senator Hassan, Bennett led the development, planning and coordination of Hassan’s work on health care. Among her accomplishments was securing increased funding for New Hampshire, one of the states hardest hit by the opioid crisis, to help combat the crisis. McKenzie also worked on numerous bills to increase public health and provider tools to help patients addicted to opioids, including legislation to increase access to medication-assisted treatment and to improve care coordination.

Bennett also led Hassan’s work to address surprise medical bills, drafting legislation to protect patients from such bills and to resolve payment disputes between plans and providers. She has worked across the aisle and with several key stakeholders on this initiative.

During her time with Leader Reid, Bennett worked on a number of high-profile health care priorities, including helping to negotiate the passage of the $1.1 billion supplemental appropriations legislation to address the Zika virus in 2016. She also represented the Democratic Leader during several negotiations on health care issues. Bennett has extensive experience with the Senate budget process, including as part of a key group of Leadership and Committee staffers arguing before the Senate Parliamentarian during the budget reconciliation process related to the Affordable Care Act in 2015. She was also involved in the passage of the 21st Century Cures Act, the Comprehensive Addiction and Recovery Act, and several other pieces of legislation.

Bennett began her career on the Hill with Senator Sherrod Brown (D-OH), where she conducted research on health care issues, and then moved to the office of Senator Jim Webb (D-VA).

   

Amy Bilton, Esq., MSCC, CMSP-F
Shareholder, Nyhan Bambrick Kinzie & Lowry

WCRC + Documentation and Evidence, Wednesday, October 7, 2020, 8:00 a.m.

Amy E. Bilton, Esq. is a shareholder and workers’ compensation defense trial attorney at the Chicago law firm of Nyhan, Bambrick, Kinzie & Lowry. She received her BA from the University of Michigan, JD from DePaul University College of Law and has her MSCC certification. Ms. Bilton is a frequent lecturer on workers’ compensation, Medicare Secondary Payer issues and Medicare Set-Asides. In addition to being a NAMSAP member and legal committee chair, she is a member of the Chicago Bar Association, Illinois State Bar Association and Illinois Workers’ Compensation Lawyers Association. She has specific interest in bringing evidence-based medicine to MSAs.

 


Jim Brady

Program Director, BCRC

CRC and BCRC - Interplay and Differences, Tuesday, October 6, 2020, 1:30 p.m.

Jim Brady has 30 years of Medicare experience. He is currently the Program Director for the Benefits Coordination and Recovery Center (BCRC) with overall responsibility for all functions under that contract.  Brady has led the BCRC since the inception of the program. 

 

 

John V. Cattie, Jr.
Founding Member, Cattie, PLLC

Spotlight on Asbestos Claims, Tuesday, October 6, 2020, 4:00 p.m.

John V. Cattie, Jr. is one of the nation’s most well-respected MSP legal scholars.  Cattie received his BA from the University of North Carolina and his JD/MBA from Villanova University.

Cattie has personally reviewed or overseen the review of over 10,000 distinct fact patterns. Federal and state court opinions such as Smith v. Marine Terminals of ArkansasTye v. Upper Valley Medical Center, and Doe v. Company X cite his analysis favorably. In each case, his client’s future medical exposure was minimized or extinguished based on how Cattie analyzed the MSA issue. In the Doe case, that difference amounted to a 90% or almost $900,000 reduction in future medical exposure for his client. The Doe Court stated the following in its opinion: “The Court finds that Mr. Cattie’s analysis is more credible [than his opponent’s] in the liability context.”

Cattie is the Founding Member of Cattie, P.L.L.C. His law firm is dedicated to extinguishing a client’s future medical exposure under the MSP Act. He focuses his law practice on MSA issues, providing legal opinions regarding MSA requirements, a client’s future medical exposure under the MSP Act and proper MSA funding.

 
Lavonya Chapman
Medicare Secondary Payer Compliance Counsel, Optum Settlement Solutions

ETHICS: What MSP Professionals Need to Know, Wednesday, October 7, 2020, 1:15 p.m.

As Medicare Secondary Payer Compliance Counsel at Optum Settlement Solutions, Lavonya Chapman is a consultant on Medicare Secondary Payer (MSP) claim compliance issues, including Mandatory Insurer Reporting, ICD injury code reporting, Conditional Payment Resolution, Medicare Set-Aside Allocations, CMS approval and professional administration.

Prior to joining Optum in 2014, Chapman served as director of MSP compliance for Arthur J. Gallagher & Company for 14 years. She was also the claim director for a new liability captive in which nearly all the claimants/plaintiffs were Medicare beneficiaries or dual eligible. Additionally, Chapman has experience in private law practice, litigating medical malpractice, premises and auto liability claims as well as workers compensation cases. She taught pharmacology many years at the University of Alabama at Birmingham, and was a utilization review and HIPAA consultant for the Alabama Hospital Association.

Chapman presents on all aspects of the Medicare Secondary Payer Act as it pertains to claim compliance involving all type of claims. She is a licensed registered nurse, an attorney licensed in both Alabama and Florida, and a certified Medicare Secondary Payer Professional .


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Jacqueline Cipa
Medicare Secondary Payer Operations Team Lead, Division of Medicare Secondary Payer Operations, CMS

CMS Fireside Chat, Wednesday, October 7, 2020, 4:15 p.m.

Jacqueline "Jackie" Cipa started her career with CMS in 2010 after graduating with her Master of Public Health from the University of Pittsburgh. The majority of her time at CMS has been spent in the Office of Financial Management working with Medicare Secondary Payer (MSP) in multiple capacities. Cipa has both breadth and depth of experience, having been or currently performing as a project lead and a subject matter expert across several diverse areas, among other roles. She has led the development and execution of several new procurements, implemented quality improvement projects, and mentors newer staff. In 2015, Cipa became the MSP Operations Team Lead. The team she leads oversees the operations of the Benefits Coordination and Recovery Center (BCRC) and the Commercial Repayment Center (CRC).

Cipa was originally a chemist from Pittsburgh, PA. She lives with her husband and daughter on several acres of land along with their cats and chickens and yes, she was once a Jeopardy! champion.

  

Patrick Czuprynski, JD, MSCC
Director of Lien Resolution, NuQuest

Judge's Panel, Wednesday, October 7, 2020, 9:00 a.m.

Patrick Czuprynski is NuQuest’s Director of Lien Resolution. In addition to leading the lien resolution team, he represents debtors in conditional payment administrative appeals and negotiations through the Medicare Appeal Council and provides consulting services for settlements and Section 111 inquiries. MCzuprynski presents webinars on Medicare secondary payer compliance on behalf of NuQuest. He has also been published in the Illinois State Bar Association Workers’ Compensation Newsletter, the ISIA Newsletter, The National Alliance of Medicare Set-Aside Professionals publication, Workers’ Compensation Law, and the Maryland State Bar Association publication.

An attorney, licensed in Illinois, Czuprynski is a member of the National Alliance of Medicare Set-Aside Professionals, serving on the Legal Round Table, Policy and Legislation and Liability MSP Advisory committees. He holds a J.D. from Valparaiso University Law School, and a B.B.A from University of Wisconsin Green Bay.

 


Annie M. Davidson, Esq.

Senior MSP Compliance Counsel and Policy Strategist, ExamWorks Compliance Solutions

Hot Topics: Civil Monetary Penalties & LMSA, Tuesday, October 6, 2020, 9:00 a.m.

Annie M. Davidson is the Senior MSP Compliance Counsel and Policy Strategist for ExamWorks Compliance Solutions.

Davidson has comprehensive experience in the areas of Medicare Secondary Payer (MSP) Act compliance and Medicaid recovery in liability, no-fault, and workers’ compensation matters. Davidson provides high-quality legal analysis to ensure the integrity and quality of ExamWorks Clinical Solutions’ Medicare Secondary Payer compliance services and related products. Additionally, she is a nationally recognized expert on MSP issues who presents regularly at local and national conferences.

Davidson is admitted to practice law in the State of Minnesota and the United States District Court for Minnesota. Prior to her work with ExamWorks Clinical Solutions, she practiced as an insurance defense litigator with a Minneapolis law firm. In that position, Davidson gained significant experience handling workers’ compensation, liability, and no-fault cases and coordinated the firm’s policies for handling Medicare requirements.

She is co-chair of the Policy and Legislative Committee of the National Alliance of Medicare Set-Aside Professionals. Davidson graduated cum laude from William Mitchell College of Law and received her Bachelor of Arts degree from the University of Minnesota, Twin Cities. In her free time, Davidson serves on the board of a comprehensive non-profit mental health and human services organization, and practices meditation and Pilates.

 

Shawn Deane, JD, CMSP-F
General Counsel, Ametros

Prescription Drugs in Professional Administration, Tuesday, October 6, 2020, 4:00 p.m.

Shawn Deane is General Counsel and leads our 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). Deane is faculty for the Certified Medicare Secondary Payer Professional Program (CMSP).

Deane is a member of the Massachusetts Bar and is licensed in both state and federal courts in Massachusetts. His law degree is from the Massachusetts School of Law. He also holds a master’s in education from Cambridge College and undergraduate degree from Berklee College of Music. He resides north of Boston with his family and strives to live by the following: “Be Kind. Do Right. Serve Others. Work Hard. Have Fun.”

   

Ted Doyle, MA, AHFI, DFE, CIFI
Vice President, Healthcare Markets, Performant Financial Corporation

CRC and BCRC - Interplay and Differences, Tuesday, October 6, 2020, 1:30 p.m.


Ted Doyle is a senior leader in healthcare administration and payment integrity for both the private and public healthcare sectors with over 30-years related experience. His background includes the Centers for Medicare and Medicaid Services (CMS) with over 12 years in a variety of senior leadership positions, predominately in policy administration, financial systems and payment integrity. Doyle’s background also includes the responsibility of managing both the Los Angeles and Miami field investigative offices, as well as working directly with CMS partners, law enforcement agencies, and stakeholders to prevent healthcare fraud and ensure payment integrity. He has developed innovative and leading-edge analytics that significantly reduce healthcare administrative costs through the enhanced detection of fraudulent, wasteful, and abusive claims.

Doyle has worked diligently towards the expansion of domestic and international market strategies for payment integrity services and solutions. Doyle is an Accredited Health Care Fraud Investigator (AHFI), Certified Fraud Examiner (CFE), Licensed Private Investigator, Certified Insurance Fraud Investigator (CIFI), and experienced project manager.

 

 

David Farber
Partner, FDA and Life Sciences, King & Spalding

SMART Act - Where are we now?, Tuesday, October 6, 2020, 10:30 a.m.

David Farber specializes in litigation, regulatory matters, and public policy, with a focus on healthcare, Mediare and Medicaid issues for pharmaceutical and medical device companies, hospitals and pharmacies.  A member of King & Spalding's FDA, Life Sciences, and Healthcare, and Government Advocacy practices, Farber represents clients in healthcare litigation, False Claims Act cases and other commercial disputes, as well as in advocacy before Congress and federal agencies on coverage, coding, reimbursment and other issues.  He is a recognized national expert on Medicare Secondary Payer issues.

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Steve Forry
Director of Division of Medicare Secondary Payer Program Operations, CMS

CMS Fireside Chat, Wednesday, October 7, 2020, 4:15 p.m.

Steve Forry has served as the Division Director for MSP Operations at CMS since 2011.  Prior to his tenure at CMS, FOrry was a Software Project Manager at ViPS and a Computer Specialist at the Social Security Administration.

 


Rasa Fumagalli, JD, MSCC, CMSP-F
Director of MSP Compliance Services, Synergy Settlement Services

Amended & Re-Review, Wednesday, October 7, 2020, 11:15 a.m.

Rasa Fumagalli, JD, MSCC, CMSP-F is an Illinois-licensed attorney and the Director of MSP Compliance Services for Synergy Settlement Services. Prior to joining Synergy Settlement Services, Fumagalli worked as a workers’ compensation insurance defense attorney in the Chicago area. She has spent the last ten years focusing her practice on Medicare Secondary Payer compliance issues. As the former Director and VP of MSP Compliance for a national vendor, she has extensive experience in working with parties to effectuate settlements while addressing Medicare’s interests in a reasonable manner. her knowledge, experience and passion for navigating the intricacies of the Medicare Secondary Payer Act, supporting regulations and CMS allow her to provide valuable and pragmatic guidance in all stages of settlement discussions.

Fumagalli has been an active member of the National Alliance for Medicare Set-Aside Professionals (NAMSAP) organization since 2009. She is the current co-chair of the Communications Committee and a former co-chair of  the Liability Committee.

 

Jeanie Goldstein
Senior MSP Compliance Counsel, MEDVAL

Amended & Re-Review, Wednesday, October 7, 2020, 11:15 a.m.

Jean Goldstein is the Senior MSP Compliance Counsel for MEDVAL. She is a licensed attorney admitted to practice in the State of Maryland, with over fifteen years of diverse legal experience in Medicare Secondary Payer compliance, class action litigation, estate planning, elder law, and administrative proceedings.

With a keen understanding of Medicare Secondary Payer compliance, Goldstein is often consulted to offer insight, direction, and training to insurance carriers, self-insured entities, third-party administrators, and law firms.  Her focus is on Medicare issues involving liability, no-fault, and workers’ compensation claims and finding settlement solutions in the best interest of all parties. Goldstein is also a nationally recognized blogger and author on Medicare Secondary Payer compliance and claims management.

Prior to joining MEDVAL, Goldstein worked in the public sector, at the Maryland Office of the Attorney General. She received a Bachelor of Arts from Goucher College and her Juris Doctor Degree from the University of Baltimore School of Law. Goldstein is an active member of NAMSAP’s Policy and Legislative Committee and the Liability MSP Advisory Committee.

 
 

 

Rafael Gonzalez, Esq.
Partner, Cattie and Gonzalez, PLLC

CRC and BCRC - Interplay and Differences, Tuesday, October 6, 2020, 1:30 p.m.

As President of Settlement Solutions, Rafael Gonzalez is responsible for all aspects of Medicare and Medicaid compliance issues, including Mandatory Insurer Reporting, Conditional Payment Resolution, Medicare Set Asides, MSA Post Settlement Administration, Third Party Lien Reimbursement and Special Needs Trusts Administration.

Gonzalez has over 35 years of experience in the auto, liability, no-fault and workers’ compensation insurance industries. He has written extensively on liability, workers’ compensation, social security and Medicare/Medicaid issues and has taught these subjects at several law schools and medical schools in Florida. He continues to lecture throughout the country on these topics.

Gonzalez has been actively engaged in legislative matters concerning workers’ compensation, social security and Medicare/Medicaid at both the state and federal levels. He has attended hearings, testified before legislative committees and executive commissions, and served as a consultant to legislative and congressional staff. He received the Presidential National Service Award from President George W. Bush for his work on improving the Medicare Secondary Payer system and again by President Barack Obama for his work and support of the Affordable Care Act.

Gonzalez earned his Bachelor of Science from The University of Florida and his Jurisprudence Doctorate from Florida State University. He contributes regularly to a series on workers’ compensation, social security and disability and Medicare Set-Asides.

  

Beth Hostetler, RN, BSN
Director of Medicare Services, Corporate Risk Management, Albertsons Companies

MSP Wishlist, Wednesday, October 7, 2020, 3:45 p.m.

Beth Hostetler is a nurse with over twenty five years experience in the field of disability management and cost containment services in Workers Compensation. She has a Bachelor of Science in Nursing from Case Western Reserve University. She has been a certified Life Care Planner and is currently a Certified Medicare Set- Aside Allocator, and Certified Medicare Secondary Payer Professional. Her experience includes nearly fifteen years as Branch Manager in the Healthcare Division of Crawford & Company as well as several years as owner of her own company which provided case management, life care planning and Medicare set-aside services. Presently, she is the Director of Medicare Services in the Corporate Risk Management Department of Albertson’s Companies which is one of the largest food and drug retailers in North America. She has developed Albertson’s internal MSP Compliance program for Workers Compensation which includes policy and procedure for MMSEA Section 111 reporting, Conditional payment identification and resolution and the MSA program. She routinely provides internal training on Medicare Secondary Payer compliance and all aspects of the MSA process.

 

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John Jenkins, MSHS, MSHA
Health Insurance Specialist, CMS

CMS Fireside Chat, Wednesday, October 7, 2020, 4:15 p.m.

Over the last twenty years, John Jenkins has covered nearly every aspect of medical management, from direct patient care to combat hospitals. He has put the combined training and education from formal venues as well as performance into practice in the furtherance of his career. Now, he is using that knowledge to pass on to the next generation of medical personnel as an instructor. For many years, he provided emergency care for those in urgent need. Now, that experience coupled with formal education in the areas of healthcare administration and emergency management is available to help others.
 

 

Jennifer Jordan, JD, CMSP-Fellow, Counsel, LASIE
Counsel, LASIE

Due Process in MSP, Wednesday, October 7, 2020, 2:15 p.m.

Jennifer Jordan is a nationally recognized expert on the subject of Medicare Secondary Payer (MSP) compliance. Formerly Chief Legal Counsel and co-founder of MEDVAL, she currently serves at counsel for the Louisiana Association of Self-Insured Employers (LASIE). For nearly 20 years, Ms. Jordan has regularly spoken at industry and educational events nationally, authored articles for both industry publications and legal resources, been designated as an expert witness in MSP litigation and been cited in judicial opinions.

In conjunction with extensive structured settlement experience, Ms. Jordan is focused on finding settlement solutions and resolving claims with the best interest of all parties, not just Medicare, in mind. Ms. Jordan is Editor-in-Chief of The Complete Guide to Medicare Secondary Payer Compliance, published annually by LexisNexis since 2010, and is the recipient of a 2010 Workers’ Compensation Notable Person Award and Top 25 Workers’ Compensation Blog Awards from 2009 through 2014 from LexisNexis.

She currently serves on the board of a number of organizations such as the Larson’s National Workers’ Comp Advisory Board, WorkCompCentral, Comp Laude Advisory Board, Friends Research Institute, and the Medicare Secondary Payer Charitable Foundation. She was named to the WorkCompCentral President’s Honor Roll in 2015 for her contributions to the industry and received a Best Blogs award in 2016 and 2017 from WorkersCompensation.com.

Ms. Jordan received her J.D. from the University of Baltimore, School of Law where she was a member of the Law Review and Editor-in-Chief of the University of Baltimore Intellectual Property Law Journal. She received her MBA from the University of Baltimore, Robert G. Merrick School of Business and B.A.s in Economics and Fine Arts from Virginia Tech.

 

John Kane, AIC, MSCC, CMSP-F
Medicare Program Director, Liberty Mutual Insurance

MSP Wishlist, Wednesday, October 7, 2020, 3:45 p.m.

John Kane serves as the Medicare Program Director for the Liberty Mutual Insurance.  As a twenty-eight year employee with Liberty Mutual John has served in a variety of claim positions including Liability and Workers’ Compensation including Regional Claims Manager for Integrated Disability Management and Loss Portfolio Risk Manager. He has been actively engaged in MSP compliance over the last fifteen years.

He developed Liberty Mutual Centralized Medicare Department and is responsible for Vendor Management, Quality Assurance, MSP Compliance and a liaison to Public Affairs to advocate for Medicare reform.

Kane is an active member of the Medicare Advocacy Recovery Coalition (MARC) and former member of the Property Casualty Insurer Medicare Task Force Committee. He serves on the National Alliance of Medicare Set Aside Professionals Board of Directors and participates in panel discussions at the annual conferences. John is an instructor for the Certified Medicare Set-aside Professional & Fellow program educating attorneys, nurses, risk managers and case managers on Medicare Secondary Payer (MSP) compliance.

Prior to Liberty Mutual, Kane worked in the financial sector as a financial planner with a degree in Business Management.  He has an Associate in Claims (AIC), Medicare Set-Aside Consultant Certified (MSCC) and Certified MSP Professional (CMSP) & Fellow designations.

Kane volunteers as a Liberty Leader in the local community that focuses on affordable housing and transition to work. He is also involved with volunteer work with young adults with disabilities to create inclusive social and recreational opportunities.

 


Ciara F. Koba, Esq.
Partner, Gordon & Rees

NAMSAP President / Conference Emcee; HOT Topics - Civil Monetary Penalties & LMSA - Monday, October 6, 2020, 9:00 a.m.; CMS Fireside Chat - Tuesday, October 7, 2020, 4:45 p.m.

Ciara F. Koba is a Partner in the Pittsburgh office of Gordon & Rees and is a member of the Medicare Compliance Group. Koba is an attorney and licensed registered nurse with significant general and surgical nursing experience and she brings a unique understanding of the healthcare industry to the resolution of Medicare issues. She focuses her practice on Medicare Secondary Payer Compliance issues that arise in the resolution of workers’ compensation, longshore, Jones Act, Federal Employers Liability Act and general liability claims and she has been instrumental in settling tens of thousands of cases nationwide involving Medicare issues. Her work includes MMSEA Section 111 Mandatory Insurer Reporting, Medicare Compliance Audits, Medicare Conditional Payment resolution, and the preparation of Medicare Set-Aside Allocations.


Koba is a recognized national presenter on Medicare Secondary Payer compliance topics and frequently lectures to insurance carriers, self-insured businesses, third-party administrators, law firms and professional industry organizations.

She graduated from Duquesne University School of Law, cum laude, in 2011. While there, she founded the university’s first Health Law Society and served as its president. Koba received a Bachelor of Science in Nursing from Duquesne University in 2006.

   

Chris Lagnese
Vice President of Pharmacy and Managed Care, Ametros

Prescription Drugs in Professional Administration, Tuesday, October 6, 2020, 4:00 p.m.

Chris Lagnese began his career as a pharmacist, and has had over 25 years of of experience working with drug store chains and various pharmacy benefit management organizations. He now works on improving pharmacy and medical care programs for our members.

Lagnese graduated from Ohio State University, and resides in South Carolina. His two sons have become a medical doctor and engineer. He enjoys gardening, playing the guitar, and kayaking...just not all at the same time.

 
 

Brian MacAllister, AIC, MSCC, CMSP-F
Director, Conditional Payment, Liberty Mutual Insurance

Due Process in MSP, Wednesday, October 7, 2020, 2:15 p.m.

During his sixteen years with Liberty Mutual, MacAllister has held roles in both Liability and Workers' Compensation, with expertise in complex high exposure claims.  He was previously a Complex Technical Claims Specialist and Manager of a Critical Strategies Unit.  Currently, MacAllister is responsible for Conditional Payment Compliance, providing settlement consultation, and developing training.  He has a degree in Criminal Justice from Northeastern University, Associate in Claims (AIC), Medicare-Set-Aside Consultant Certified (MSCC), Certified Medicare Secondary Payer Professional Fellow Designation (CMSP-F), and is an active member of NAMSAP.
   

Christine Melancon, RN, CMSP-F
Director of Regulatory Compliance, CLARA Analytics

Amended & Re-Review, Wednesday, October 7, 2020, 11:15 a.m.

Christine Melancon currently serves as the Director of Regulatory Compliance at CLARA analytics, the leading provider of artificial intelligence (AI) technology in the commercial insurance industry. Previously, Melancon served as an Operations Strategist for Cobalt Compliance Partners, LLC and was the Founder and Vice President of Operations at EZ-MSA.

In the past, Melancon has served as Co-Chair of NAMSAP’s Education Committee and as a Board Member and Officer of the assocation. She enjoys educating others who desire to learn more about Medicare Secondary Payer Compliance issues and is a frequent speaker at various events, as well as an instruction for the Louisiana Association of Self-Insured Employers’ (LASIE) Certified Medicare Secondary Payer Professional Fellow (CMSP-F) Program.

Melancon is a graduate of Charity Hospital School of Nursing and the University of New Orleans. She has successfully transferred many years of clinical experience into a successful career in the Medicare Secondary Payer Compliance.

 


Steven J. Miller, CMSP-F, MSPharm, DPh, RPh

CEO, PharmacyMSA.com

Prescription Drugs in Professional Administration, Tuesday, October 6, 2020, 4:00 p.m.

Steven J. Miller, C.M.S.P.-F, MSPharm, D.Ph., R.Ph, is the CEO of PharmacyMSA.com, a provider of a pharmacy benefit services for MSA specialists throughout the United States, including drug utilization reviews, pharmacy benefit administration, and medication therapy management for geriatric patients and injured worker., Dr. Miller is active in development of cost containment programs for MSA proposals, pharmacy formulary review and analysis, provider interventions, and managed care pharmaceutical reimbursement programs. He is a clinical pharmacist with many years’ experience in managed care workers compensation, commercial, Medicare, and Medicaid pharmacy benefit consulting. He is also a part-time dispensing pharmacist with Walgreens.

Miller has served in several capacities with many types of managed care organizations and has made numerous regional, national, and international presentations on pharmaceutical care and cost-effectiveness, including medication issues for the elderly, cost-effective drug therapies, and pharmaceutical benefit management. He currently serves on the board of directors of the National Alliance of Medical Set Aside Professionals (NAMSAP), service a three year term. He also serves on several pharmaceutical manufacturers’ advisory boards, and on the editorial advisory board of ODG/ODG Treatment publications for the Work Loss Data Institute. He graduated with his B.S. in pharmacy from the University of Iowa and his M.S. in Pharmacy Practice from the University of Maryland.

 

Suzanne Novak, MD, PhD
President, Austin Outcomes Research

MSP Wishlist, Wednesday, October 7, 2020, 3:45 p.m.

Suzanne Novak, MD, PhD is a board certified anesthesiologist.  Her PhD is in Pharmacy Administration, with a specialty in pharmacoeconomics and outcomes research from the University of Texas at Austin.  She is president of Austin Outcomes Research, Inc., a healthcare consulting and utilization review firm with multiple national carriers and legal firms as clients.  She is the lead author of the Pain Chapter of the ODG Treatment Guidelines.

Dr. Novak is also a clinical assistant professor at the College of Pharmacy at the University of Texas at Austin where she is active in the Pharmacy Practice Division. 

   

Jennifer Pickard
Senior Director Risk Management, Walmart Stores

PAID Act, Tuesday, October 6, 2020, 3:00 p.m.

Jennifer Pickard is the Senior Director Risk Management for Walmart Stores, Inc.  She has served in this position since 2005, leading cross-functional teams to implement organizational strategies to drive performance.  She analyzes accident trend and industry data to develop and implement business strategies to eliminate or mitigate risks.  Pickard has worked with Walmart in Risk Management since 2006 and in workers comp claims since 1999.

Pickard received her BA in business administration from American Public University.

 

Mark Popolizio
Vice President, MSP Compliance and Policy, ISO Claims Partners

SMART Act - Where are we now?, Tuesday, October 6, 2020, 10:30 a.m.

Due Process in MSP, Wednesday, October 7, 2020, 2:15 p.m.

Mark Popolizio is the Vice President of MSP Compliance and Policy for ISO Claims Partners. He is a nationally recognized authority in Medicare Secondary Payer (MSP) compliance and has practiced insurance defense litigation for ten years concentrating in the areas of workers’ compensation and general liability.

Since 2006, Popolizio has dedicated his practice exclusively to MSP compliance working with carriers, self-insureds, TPAs and other claims professionals in addressing MSP compliance issues. He 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 MARC, DRI and NAMSAP.


Popolizio graduated Summa Cum Laude from Quinnipiac University in Hamden, Connecticut with Bachelor of Science degrees in Legal Studies and Sociology. He relocated to South Florida in 1992 to attend law school at Nova Southeastern University School of Law in Ft. Lauderdale, Florida. While at law school, Popolizio served as a Judicial Clerk to the late Honorable John D. Wessel (15th Judicial Circuit, Palm Beach County, Florida) and was a research assistant for Professor Leslie Larkin Cooney. He graduated from Nova in 1995 and is licensed to practice law in Florida and Connecticut.

  

Fran Provenzano, RN, BSN, CDMS, CCM, CLCP, MSCC
President, MSA Specialists, Inc.

MSP Wishlist, Wednesday, October 7, 2020, 3:45 p.m.

Fran Provenzano, BSN, is the President and CEO of Medicare Set-Aside (MSA), Specialists, Inc. She formed the company in 2002 and it has flourished under her guidance. MSA Specialists has been accepted as a national provider of MSAs by several major insurance carriers as well as some of the top Third Party Administrators.

Provenzano is a highly sought speaker on MSAs. She has addressed the National Conferences of Legal Nurse Consultants, several national education seminars on MSA instruction and many evaluation criteria/education sessions for Claims Adjusters. She earned her RN license and BSN Degree. Within the hospital setting, she has served in virtually all phases of the nursing field from the operating theater, through patient education, Lamaze Instruction and discharge planning.

In the late 1980s, Provenzano directed her talents toward Disability Management, obtaining her Certified Disabilities Management Specialists (CDMS). She was among the first nurses to obtain Certified Case Manager (CCM) Certification followed shortly thereafter by her Life Care Planning Certification (CLCP). Most recently, she once again was among the first in the nation to earn the Medicare Set-Aside Consultant-Certified (MSCC) designation.

 


Kevin Puckett
President/Owner, KP Underwriting, LLC

Rated Age, Tuesday, October 6, 2020, 5:00 p.m.

Kevin Puckett is President and Owner of KP Underwriting, LLC, an independent underwriting company that provides rated ages and decreased life expectancies for Life companies and Medicare Set-Asides. He has over 20 years of medical underwriting experience with multiple life companies. Puckett has his BBA in Business Administration and Biology from Eastern Kentucky University, an Associates designation from the Academy of Life Underwriting and his FLMI (Fellow, Life Management Institute).

He began his career with AEGON as a life insurance underwriter, but later moving into Structured Settlement and Rated Age underwriting. After 10 years with AEGON, Puckett was recruited by John Hancock to start their rated age program. After building the John Hancock program, he ventured out and started KP Underwriting, LLC. With KP Underwriting, Puckett has performed underwriting services for multiple life companies, including, writing underwriting manuals, auditing underwriting departments as well as performing expert witness testimony on life expectancy in multiple states.

Currently, Puckett and KP Underwriting, perform rated age services for a majority of the companies in the Medicare Set-Aside market.

   

Robert Sagrillo
President, National Accounts and Settlements Consulting, NuQuest

Hot Topics: Civil Monetary Penalties & LMSA, Tuesday, October 6, 2020, 9:00 a.m.

Robert Sagrillo is a highly respected professional in the Medicare Set-Aside arena and was one of the first Medicare Set-Aside advisors in the country. He is a recognized authority on a wide-range of subjects including estate planning and probate procedures, frequently lecturing before local, regional and national professional and legal organizations and authoring many publications on these issues.

 

 

Heather S. Sanderson, Esq., MSCC, CHPE, CLMP, CMSP
Chief Legal Officer, Franco Signor, LLC

SMART Act - Where are we now?, Tuesday, October 6, 2020, 10:30 a.m.

PAID Act, Tuesday, October 6, 2020, 3:00 p.m.

Heather Schwartz Sanderson is Chief Legal Officer for Franco Signor LLC, the nation's compliance authority for Medicare Secondary Payer (MSP) matters. She has lectured on MSP compliance to the workers’ compensation and liability insurance communities at conferences, associations, and individual offices nationwide. She is a regularly published author on court decisions and legislative reforms involving Medicare Set-Asides, conditional payments, and Mandatory Insurer Reporting issues. Understanding that compliance with the Medicare Secondary Payer Act can be at times complex and frustrating for those that handle claims with Medicare beneficiaries, Heather’s goal is to speak and write with the primary goal being simple and understandable solutions to compliance.

 

 

Jennifer Shymanksi, CMSP-F
Director of Implementation and Strategy, NuQuest

Spotlight on Asbestos Claims, Tuesday, October 6, 2020, 4:00 p.m.

Jennifer Shymanski, NuQuest’s Director of Implementation and Strategy, holds a law degree from Northern Illinois University College of Law and a Bachelor of Arts in  Political Science from the University of Wisconsin - Stevens Point. She is admitted to practice law in the State of Wisconsin.

Prior to joining NuQuest in March of 2010, she spent over ten years at Nationwide Insurance working with both workers compensation and personal liability claims teams. 

Shymanski utilizes her extensive experience in claim handling and negotiation to lead the NuQuest Settlement Consultant Team in working with clients to choose the correct  products and services for their needs and to support and advise them throughout the settlement process. One of Shymanski’s  primary focuses is on assisting clients in  designing, implementing and monitoring their Medicare Secondary Payer compliance programs.

 


Thomas Stanley, MSCC, CMSP

President, Stanley Insurance Services

Hot Topics: Civil Monetary Penalties & LMSA, Tuesday, October 6, 2020, 9:00 a.m.

Thomas Stanley is the President of the Stanley Insurance Agency, Inc. Since 2002, the Agency has provided full service WC Medicare Set-Aside consultation to a varied clientele. WCMSA services are a natural compliment to the settlement annuity services the Agency began providing in 1987. Stanley holds the MSSC and CMSP certifications. Recently, he was one of the first to complete the Masters in Structured Settlement Consulting program at the University of Notre Dame. Stanley has an MBA in finance and economics. He is a native of Minnesota and now lives in Las Vegas, Nevada.

 

 

Jeffrey C. Swann, Esq.
General Counsel, The Rawlings Group

MAO Panel, Tuesday, October 6, 2020, 11:30 a.m.

Spotlight on Asbestos Claims, Tuesday, October 6, 2020, 4:00 p.m.

Jeffrey Swann, Esq., oversees more than 25 attorneys in providing legal services both internally and to The Rawlings Group's clients. He is also involved in the company’s mass tort litigation activities. Prior to joining the company in 2005, he was an attorney with a major subrogation vendor and a local law firm.

Swann received his undergraduate degree from Vanderbilt University and his J.D. from the University of Louisville School of Law.

   

Marques Torbert
Chief Executive Officer, Ametros

Administration, Wednesday, October 6, 2020, 10:15 a.m.

Prior to Ametros, Torbert worked as an investor and consultant within the insurance and business services sector. He was previously the principal adviser to Millbrook, an Associate with Clarion Capital Partners (a middle market private equity firm), and an investment banker with Lazard Freres. He has been instrumental in working with multiple privately held organizations within the claims solutions management and managed care industries.

Torbert obtained his B.A. in Economics from Columbia University and his MBA from Harvard Business School. He is currently on the Board of Directors of Ametros Financial, and is also a member of the Board of Trustees for Merrimack College, as well as, University School, a private K-12 school in Cleveland. He currently resides in Boston with his wife Alexandra and (un)fortunately is also a Cleveland Browns fan.

 
Monica A. Williams, RN, CCM, CRRN, LNC, MSCC, CMSP, CNLCP
Manager, Medicare Compliance, Innovative Claims Strategies

ETHICS: What MSP Professionals Need to Know, Wednesday, October 7, 2020, 1:15 p.m.

Monica Williams has over 20 years of Managed Care and Workers Compensation experience. She is the Medicare Compliance Manager for Innovative Claims Strategies (ICS) where she has oversight of Medicare Set Aside program which includes CMS legal submission and Conditional Payment Resolution. As Manager she has developed and implemented the Medicare Compliance Department internal workflow processes. She was formerly the District Manager for Georgia and then National Catastrophic Program Manager for Intracorp.

Williams is President of MWC, LLC consulting practice in State of Georgia which provides Complex Case Reviews, Medical, Catastrophic Field Case Management and Life Care Plans.

She is currently a member of NAMSAP Board, Annual Conference Committee, Liability Committee and Co-Chair of Membership Committee.  

 

 

Aaron Winnell, CMSP
Vice President of Operations, Medivest

Administration, Wednesday, October 6, 2020, 10:15 a.m.

Aaron Winnell, CMSP is the Vice President of Operations for Medivest, a national MSP compliance company specializing in the professional administration of Medicare Set-Aside arrangements. He began with Medivest as a consultant hired to develop case management software tailored to requirements of MSA custodial services in 2006, and became Director of Professional Administration Services in 2011. He’s overseen general operations for Medivest since 2014.

Winnell is an alumni of Marshall University with a degree in Communications Electronics. He resides in Montverde, Florida with his wife and twin daughters.

   

Kimberly Wiswell, CMSP
Vice President, Managed Care Operations and Team Excellence, CLARA Analytics

Reference Guide Lesser Known Facts and Fallacies, Wednesday, October 7, 2020, 12:15 p.m.

Kimberly Wiswell has been engaged in the workers’ compensation managed care and occupational health services industries since the late 1970’s, with a focus on Medicare Secondary Payer compliance since 2005. She currently serves as the Vice President of Managed Care Operations at CLARA analytics.

Prior to joining CLARA  she was a Vice President at MEDVAL, responsible for product management, and also managed operations for four years, building a technological infrastructure to facilitate the company's growth. She previously co-founded and served as Managing Director over CompProjections Medicare Set-Asides, under CompPartners. Prior to that, she served as Sr. Vice President, Operations over the Medicare Set-Aside and Specialty Network division of Coventry HealthCare’s First Health Priority Services sub-division.

Wiswell has extensive knowledge and experience in the area of workers’ compensation managed care including Medicare set-asides, medical bill review, systems analysis/ development, medical coding and reimbursement, and occupational health administration. She has provided consulting services to the CMS, the California Workers' Compensation Institute, and a number of state agencies and associations. Wiswell presents at industry conferences, seminars and training sessions concerning Medicare Secondary Payer Compliance, medical cost management, and provider coding and reimbursement. She is a member and past president of the Board of Directors for the National Alliance of Medicare Set-Aside Professionals (NAMSAP); she sits on the faculty for WorkCompCentral’s WorkCompSchool; and serves as the Fee Schedule Committee Chair for a California legislative advisory body composed of top risk managers and select attorneys who advocate for industry insurance defense and related workers’ compensation legislation.


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