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December 2017 Newsletter
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Presidents Letter -The Year in Review

Shawn Deane, Esq.
Vice President, Product Development
Dear NAMSAP Members: 

What a year it’s been in the Medicare Secondary Payer (MSP) industry and what a year we’ve had for NAMSAP! Personally, it’s been an honor to serve NAMSAP’s membership as your President. I want to thank everyone on the Board of Directors, the Advisory Council and all of the committee chairs for volunteering to make this such a great organization. I especially would like to thank the Executive Committee – consisting of Gary Patureau, Greg Gitter, Rita Wilson and Christine Melancon. Their leadership, support and infectious enthusiasm this past year are beyond words.

We just wrapped up Board elections, and in 2018 we’ll have a new member: Rasa Fumagalli, Director of Compliance at NuQuest. Ciara Koba was re-elected to her second term on the Board. Please join me in congratulating them both on their election.

I want to take a moment to thank Tom Spratt for all of his dedication and guidance as a Board member. Tom decided not to run for another term on the Board, but he is a dear friend to NAMSAP and will remain closely involved on the education committee. Tom is an independent consultant with more than 40 years of experience in the insurance industry including 18 years specializing in MSP compliance. His main focus is assisting clients in the settlement of complex or costly claims, both Workers' Compensation and Liability, especially where there are disputes which warrant apportioning all the exposures, including the future medical and the MSA if one is warranted. His expertise spans all state and federal statutory jurisdictions, as well as Employer Liability suits. Tom first joined NAMSAP in 2003 and has been involved in NAMSAP committees since 2007 through the Ethics and Standards Committee and more recently since 2012 chairing the Education Committee. Tom began serving on the Board of Directors in 2012. We thank you Tom, for all of your service on the Board and the continuing service to NAMSAP.

We look forward to rolling out our Medicare Set Aside Certified Consultant (MSCC) training program in 2018. Our revamped program will be the most comprehensive test preparatory system for the MSCC exam. This year, at our annual conference we will also allow attendees to sit for the MSCC exam. Speaking of the annual event, with such a great turnout this past year in Baltimore, we’ve decided to again hold the conference in Baltimore next fall. Specific dates and venue will issue shortly.

We are excited to have launched our partnership with RED BOOK© where we offer a special discount to NAMSAP members. If you haven’t yet signed up, please visit the following link to learn how this essential tool can assist MSA professionals: NAMSAP looks forward to offering its members additional resources in 2018.

As I look back on a great year and look forward to next year, I am reminded that our upcoming NAMSAP webinar will do the same for MSP compliance! On Tuesday, January 17th, we’ll kick-off our NAMSAP webinar series with a year in review and look ahead to what 2018 may bring us. This webinar will be presented by:
  • Rita Wilson, CEO, Tower MSA Partners
  • Rasa Fumagalli, Director of Compliance, My NuQuest
  • Ciara Coba, Esq., Associate of the Medicare Compliance Group at Burns White
As the only national not-for-profit MSP organization that is 100% dedicated to education and advocacy in our industry we are so excited at what we’ve accomplished for our membership this past year and look forward to all we’ll do for you next year and beyond.

On behalf of the Board, NAMSAP looks forward to another great year of advocacy, cutting-edge information, more member-exclusive resources and the best Annual event yet. Most importantly, NAMSAP looks forward to serving the membership as the industry’s only MSP educational and advocacy group.


Have a wonderful and safe holiday.




Shawn Deane


NAMSAP Calls for Sensible Pharmacy Allocations in WCMSAs


NAMSAP urges CMS to align policy reallocations for opioids with evidence-based medicine when approving Workers' Compensation Medicare Set-Asides.  See the full press release her released by Business Wire.

NAMSAP Committee Efforts At a Glance

2018 Objectives

The National Alliance of Medicare Set-Aside Professionals (NAMSAP) is the only non-profit association exclusively addressing the issues and challenges of the Medicare Secondary Payer (MSP) program and its impact on Non-Group Health Plans (NGHP), i.e. workers’ compensation, liability and no-fault. Through the voluntary efforts of our members, NAMSAP is a forum for the exchange of ideas on all aspects of MSP compliance, and is a leading resource for information and news in this constantly evolving industry.

The collective knowledge of our members and their willingness to share expertise comes through in various fora: webinars, NAMSAP Advisor newsletter articles, NAMSAP committees and speakers’ bureau and NAMSAP’s Annual Educational Conference. This places NAMSAP at the forefront of the MSP industry in its ability to disseminate accurate and relevant information in a timely manner.   The result is an ongoing process of advocacy, collaboration and education without the financial burden of travel, expensive registration fees, etc.

A key component of NAMSAP’s value proposition to its membership is achieved through the proactive efforts of our committees. NAMSAP committees meet monthly via teleconference with each committee being led by 1 or more committee chair persons.  All committee co-chairs are part of NAMSAP’s advisory committee and provide key input to the board of directors in evaluating new business, new trends and new opportunities for the organization.  Committee co-chairs are also a source from which the board of directors’ nominating committee will seek new leadership for the organization. NAMSAP doesn’t function without our committees!

Below is a snapshot of each NAMSAP committee, its mission, the committee co-chairs who lead the group and the goals and objectives for 2018.

Rita M. Wilson, Chairman

Committee Mission
To oversee all marketing and public affairs activity for NAMSAP, including social media, press releases, email campaigns and the quarterly newsletter.

2018 Goals & Objectives
  • Coordinate with new management company to improve social media presence providing NAMSAP content into higher visibility.
  • Oversee website rewrite.
  • Prepare press releases as request to advance advocacy efforts on behalf of committees and NAMSAP board of directors.
  • Publish quarterly newsletter.
  • Participate with board of directors to finalize NAMSAP Speakers Bureau
  • Launch marketing campaign to MSCC class.
  • Work with NCSI in coalition efforts to support changes in opioids in CMS review process.

Gary Patureau, Co-Chair
Amy Bilton, Esq. CMSP
Committee Mission
To develop and distribute information grounded in evidence-based medicine, widely accepted best clinical practice, and / or additional criteria which can assist MSA and MSP practitioners in MSA preparation.

As an extension to the above, the mission of the EBM committee broadened in 2017, making it an extremely busy year for our team. Building off the momentum from 2016 when we met with CMS’ Office of Financial Management, we pushed forward in 2017 with educating stakeholders and pushing for Congressional interest in the issue to keep pressure on CMS to change its policy. The EBM committee compiled hundreds of CMS-approved WCMSAs, the results of which were in line with data compiled independently by the California Worker’s Compensation Institute.  Our goal was to demonstrate the extent of the problem and support our arguments for more responsible policy in WCMSA opioid allocations. The EBM committee compiled a list of options to address institutionalizing opioid misuse, and sent the suggestions to CMS.

2018 Goals & Objectives
  • Change CMS policy relative to allocations involving opioids within the first six months of the year; and
  • Present our final webinar in our series: “Opioids in the MSA”.
  • Build coalitions with interested groups and members of Congress to bring more focus on the WCMSA’s place in the opioid epidemic.  Examples of proposed coalition members would be: The CDC, the Surgeon General’s office, Congressional members, the National Council of Self-Insurers, The National Association of Nurse Life Care Planners, individual State Self-Insurers’ Associations, the California Worker’s Compensation Institute, and companies across the United States. Any assistance our members can bring to add stakeholders to the coalition is welcomed.
  • Solicit new members among both payer and vendor communities to advance the message of EBM.

Liability MSP Advisory Committee
William Delaney, Co-Chair
Tom Stanley, Co-Chair

Committee Mission
To collaborate and share information and to create awareness of the issues, challenges and opportunities unique to settling liability/personal injury cases with regard to MSP compliance.

2018 Goals & Objectives
  • Monitor CMS for additional information regarding LMSAs.
  • React to what CMS announces to prepare NAMSAP guidance either through written content or webinar - what this entails depends on what CMS announces.
  • Prepare and distribute the 2017 LMSA Best Practices document as needed.
  • Develop the Speakers Bureau to support NAMSAP’s ability to “spread the word” on LMSAs*
  • Seek new members with expertise and interest in the CMS LMSA process.
*This is a top priority for NAMSAP across all areas 
of MSP compliance.

Fran Provenzano, Chairman

Committee Mission
To bring greater accuracy and predictability to the CMS review process, and to the MSP industry globally, through anonymous data sharing and support for improved service levels.

2018 Goals & Objectives
  • Extend our focus on CMS responses that include opioids to provide ongoing evidence as to the actions of CMS to communicate to the beneficiary that opioids are appropriate over life expectancy.
  • Work with our members to monitor and dissect CMS’s pricing for Spinal Cord Stimulators and Intrathecal Pain Pumps as CMS migrates from standard pricing for these 2 items to a policy of jurisdictionally appropriate pricing across all states.
  • Solicit additional companies to participate in the exchange of CMS response data to better track CMS’s review policies.
  • Solicit new members to participate in all of the above.

Katie Fox, Co-Chair
Erin T. Collins, Esq.
Committee Mission
To monitor and evaluate applicable case law, CMS policy and federal / state legislation and regulations that affect the MSP industry, and to serve NAMSAP membership by keeping them apprised of such developments, and when applicable, to coordinate grass root efforts through strategic outreach at a local level.
2018 Goals & Objectives
  • Monitor and gather feedback on contractor change
  • SPARC Act reintroduction
  • UWC MSA bill - continue conversations with Doug Holmes
  • MAP litigation, evolving recovery right conversation nationally
  • CMS conversation regarding implementation of the re-review process
  • Investigate need for summer or fall “Take the Hill”
  • Rumors of new draft legislation to be introduced-monitor for content and impact

Michelle A. Allan, Esq.
Emily Grocoff, CMSP, MSCC
Committee Mission
To oversee membership recruitment and member benefits and to make recommendations to NAMSAP’s Board of Directors for different initiatives to enhance membership among both individual and partner members.

2018 Goals & Objectives
  • Increase NAMSAP individual and partner membership
  • Increase participation and membership among the primary payer community
  • Leverage alliances with other organizations, i.e. National Counsel of Self-Insureds, Association of Life Care Planners, individual state self-insured associations, etc.
  • Create a one page overview of member benefits for distribution among social media and posting on NAMSAP website
  • Host two social mixers at national conferences for NAMSAP members and potential members.

Leslie Schumacher, Co-Chair
Tom Spratt, Co-Chair
Committee Mission
To organize online education on topics of interest across the MSP industry.  Webinars may cover a variety of topics as needed and requested by our membership, examples include sessions on ethics, ICD-10 implementation, Medicare Advantage Plans, Evidenced-Based Medicine, Opioids in the MSA, the Commercial Recovery Center, Liability MSAs  and others.
2018 Goals & Objectives
Provide monthly webinars with potential topics as follows:
  • Opioids in the MSA - Part III
  • CRC Transition and Conditional Payment Update
  • WCRC Transition to New Contractor
  • Medicare Part C
  • MSA Cost Mitigation Strategies
  • Case Law Update
  • Official Disabilities Guideline - How, Where and When to Use?
  • LMSA Update 
  • Annual Ethics Update
  • Annual Year in Review -  Looking Back / Looking Ahead

Michelle A. Allan, Esq.


Gary Patureau
Committee Mission
To organize NAMSAP’s Annual Meeting and Education Conference each year. This includes planning the educational sessions and networking opportunities.
Highlights of the 2017 NAMSAP Annual Meeting and Educational Conference
  • Senator William Cassidy, MD (Louisiana)
  • John Albert, Senior Technical Advisor, CMS
  • Asst. Surgeon General, RADM Pamela Schweitzer, PharmD
  • Dr. Bradley Martin, PharmD, PhD, University of Arkansas
  • Doug Holmes, President, UWC, Inc.

 2018 Annual Conference Goals & Objectives

  • Increase CMS, CRC and WCRC industry participation by keeping in Baltimore
  • Implement MSCC and CMSP class / testing as part of conference agenda
  • Increase payer participation to drive conference agenda and deliver practical perspective in panel presentations
  • Increase clinical expert participation via CDC, Office of Surgeon General, etc. 

    In This Issue
     From the President

    Committee Reports


    Evidence Based Medicine

    Liability MSP Advisory

    Data and Development

    Policy Legislative



    Annual Conference












    Special Thanks to our 2017 Annual Educational Conference Sponsors!








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