Tower MSA Partners Names Jesse Shade Director of Information Technology.

June 29, 2018

Tower created an extremely sophisticated technology to drive best practices for MSP compliance and seamlessly link everything from Section 111 reporting through conditional payments, interventions, and MSA preparation and closure. The technology is complex on our end to make things easier for our customers, and it takes an expert to manage and constantly improve it. So, we are delighted to announce that Jesse Shade has joined Tower to do just that. For more information, click here Tower MSA Partners Names Jesse Shade Director of Information Technology.

Tower CEO and NAMSAP President Rita Wilson and other NAMSAP officers warned employers about MSAs allocating for opioids when speaking at the National Council of Self-Insurers (NCSI) last week.

June 22, 2018

Tower CEO and NAMSAP President Rita Wilson and other NAMSAP officers warned employers about MSAs allocating for opioids when speaking at the National Council of Self-Insurers (NCSI) last week.

Tower MSA Partners’ Rita Wilson and Other NAMSAP Directors Discussed Opioids and MSAs at the National Council of Self-Insurers Conference

Proposed PAID Act Intends to ID Medicare Part C, Part D and Medicaid Enrollees for Insurers

June 1, 2018

US Capitol dome

On 5/18/2018, the Provide Accurate Information Directly Act (or the proposed PAID Act) was introduced in Congress for the purpose of allowing settling parties an easy method to identify if a claimant is enrolled in a Part C or D plan or Medicaid.  The bill, H.R. 5881, sponsored by U.S. Rep. Gus Bilirakis R-Fla and U.S. Rep. Ron Kind, D-Wisc, requires the Centers for Medicare and Medicaid Services (CMS) to share information on not only whether a claimant is a Medicare beneficiary, but also whether the claimant is enrolled in a Part C Medicare Advantage (MA) Plan, Part D Prescription Drug Plan or Medicaid.  It also requires CMS to provide the identity of the MA or Part D Plan or state Medicaid program in which the claimant is or was enrolled.

The catalyst for this legislation comes from stepped up efforts by these various plans and programs, especially by MA Plans, to seek reimbursement from settling parties. MA Plans have largely prevailed against insurance carriers in seeking reimbursement under the Medicare Secondary Payer Act which has led to a heightened awareness of the potential for such claims and the need to identify claimants enrolled in such plans and programs prior to settlement.

While liability and no-fault carriers and workers’ compensation plans are now on notice of the potential for such reimbursement claims, there presently exists no universal method to identify a claimant’s enrollment status, short of asking the claimant.  Accordingly, the bill provides a solution by requiring CMS to share such enrollment information.

A review of the proposed PAID act shows the enrollment information would be shared through the Section 111 Mandatory Insurer Reporting query process.  In short, along with identification of whether a claimant is a Medicare beneficiary, the query response would also provide whether the claimant is or has been enrolled in a MA or Part D Plan or a state Medicaid program for the past three years and the name of the plan or program.  The insurance carrier or self-insured entity would then be able to readily contact the Part C or D plan or Medicaid program to resolve any claim for reimbursement.

The bill was referred to the Committee on Ways and Means and the Committee on Energy and Commerce for further action.  Tower MSA Partners will provide updates on the legislation when warranted.