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Tower MSA Partners to Sponsor Workers’ Compensation Institute (WCI) – TV

August 1, 2017

Tower MSA Partners is sponsoring WCI-TV, the televised coverage of Workers’ Compensation Institute’s Workers’ Compensation Education Conference, and is dedicating its TV segments to examining opioids.

“Tower is pleased to partner with WCI to sponsor WCI-TV for the 3rd consecutive year and participate in the interview process throughout the conference. With opioid use in the forefront of issues facing workers’ compensation payers, we will explore prescribing habits, addiction and interventions from different disciplines within the system,” said Rita Wilson, CEO of Tower MSA Partners.

Some of the perspectives and industry leaders featured in Tower’s interviews are:

  • Claims Management – Carrie Struzynski, RN, LHRM, CHRM, MSN, PhDc, Quarterback/Senior Manager, Risk Management, Safety & Insurance, Randstad North America, Inc.
  • MSP Compliance – Dan Anders, Chief Compliance Officer, Tower MSA Partners
  • Peer Review – Mark Pew, Senior Vice President, PRIUM
  • Physician – Mel Pohl, MD, FASAM, Chief Medical Officer, Las Vegas Recovery Center
  • Pharmacy Benefit Management – Phil Walls, RPh, Chief Clinical & Compliance Officer, myMatrixx
  • Public Policy – Mark Walls, Safety National’s Vice President of Communications, and Kimberly George, Senior Healthcare Advisor, Sedgwick Claims Management Services

From its studios near the exhibit hall, WCI-TV’s programming will be aired throughout the conference area, in conference hotels’ guest rooms, on shuttles, WCI’s website, e-blasts, and on You Tube. It is produced by CNTV, a Winter Park, Florida-based company that delivers a news approach to the convention television business.

The 2017 WCI WCEC will be held August 6-9 at the Orlando World Center Marriott.

The full article may be found here.

U.S. District Court Declares CMS Practice of Over-Inclusive Reimbursement Demands to be Unlawful, but Withholds Injunction

May 19, 2017

Earlier this year, Tower MSA summarized the California Insurance Guarantee Association’s (CIGA) case challenging the Centers for Medicare and Medicaid Service’s (CMS) practice of claiming conditional payment reimbursement on a charge which includes mixed diagnosis codes.  Mixed diagnosis codes result in the charge including both treatment related and unrelated to the workers’ compensation injury.  See Federal Court Holds Against Medicare Practice of Over-Inclusive Reimbursement Demands.  In a further decision in this case issued on 5/3/2017 (Cali. Ins. Guar. Ass’n v. Price, No. 2:15-cv-01113-ODW (FFMx), 2017 U.S. Dist. Ct. LEXIS 67589), Judge Otis D. Wright, II, set-aside Medicare’s reimbursement claims against CIGA and issued a judicial declaration finding CMS’s practices pertaining to reimbursement unlawful, but stopped short of enjoining CMS from continuing these practices.

January Decision Finds in Favor of CIGA

The recent decision by the District Court follows an earlier 1/5/2017 decision from Judge Wright finding in favor in CIGA.  Key findings were as follows:

First, the Court held that because Defendants simply withdrew the reimbursement demands without renouncing their allegedly unlawful policy, no part of CIGA’s claims were moot.

Second, insofar as CIGA sought simply to challenge CMS’s blanket practice of seeking reimbursement from primary plans for the full amount of a charge that contained uncovered diagnosis codes, CIGA met its burden simply by identifying codes that all parties agree are uncovered.

Third, the Court held that one statutory “item or service” does not as a matter of law equate to whatever medical procedure(s) are billed for in a single line-item charge on a payment summary form; rather, a statutory “item or service” simply refers to one indivisible medical item, device, medical supply, or service, regardless of how it is billed.

Fourth, in the event that a single line-item charge contains one covered “item or service” and one uncovered “item or service,” CIGA does not have a responsibility to make payment for the uncovered “item or service” just because it was lumped together with a covered “item or service.”

Finally, the Court also notes what it did not decide. The Court did not decide: (1) whether the cost of a single indivisible “item or service” must be apportioned among multiple diagnosis codes; or (2) whether each individual line-item charge in this lawsuit in fact consisted of multiple “items or services.”

As a result of the January decision CIGA was entitled to relief which the Court attempted, without success, to have CIGA and CMS resolve between themselves. Consequently, CIGA requested an order vacating CMS’s reimbursement claim of $119,122, a judicial declaration that CMS’s billing practice is unlawful and a permanent injection prohibiting CMS from sending future reimbursement demands to CIGA based on the unlawful billing practice.

An example of this practice is where a Conditional Payment Summary Form includes one line item representing multiple divisible treatments such as a physician visit where the services provided were for hypertension, a flu shot and low back pain.  Only the low back pain is related to the work injury, but the charge listed on the Conditional Payment Summary Form is for all treatments, not just the low back pain.

Court Provides Judicial Declaration, but No Injunction Against CMS Practices

In response to CIGA’s request, the Court vacated CMS’s reimbursement claim of $119,122 and issued a judicial declaration that CMS’s billing practice is indeed unlawful.  The Court refused though to enjoin CMS from these billing and reimbursement practices.

While the Court went into an extensive explanation as to why an injunction would not be warranted, in Judge Wright’s words it comes down to the following:

. . . the Court is not confident that it possesses a complete understanding of how determinations regarding the contents of a line-item charge are, can, or should be made, and the Court is not inclined to issue a broad judicial declaration that might ultimately require the parties to adopt an inefficient and unworkable reimbursement process going forward.

The Court went on to note that primary plans (carriers and employers) now have an administrative appeals process available to them (The five level appeals process put in place as a result of the SMART Act) to appeal reimbursement claims, rather than first seeking relief in federal court, as was done in this case.

While the Court declined to issue an injunction, it nonetheless agreed to set the case for a bench trial (9/12/2017 trial date set) to gather further facts, likely related to how a line-item charge may be separated into divisible treatments such that the injury-related treatment only can be claimed for reimbursement. Based upon a review of the evidence presented at trial, the Court will decide whether to issue an injunction.

Tower MSA Analysis: Court’s Decision Attempts to Balance the Interests of CIGA and CMS

The Court here is understandably trying to balance the interests of CIGA in not being forced to reimburse CMS for charges unrelated to the claimed workers’ compensation injury, against the interests of CMS in not having its reimbursement processes disrupted.  If this case does go to trial, what Judge Wright will be looking for is a way to enjoin CMS from over-inclusive reimbursement demands without significantly impacting CMS’s ability to recover on legitimate claims.  

Ultimately, this may prove difficult for the Court unless CMS steps up and agrees to work with its recovery contractors to better filter its claims for reimbursement such that one line item on a Conditional Payment Summary Form only includes treatment related to the claimed injury, workers’ compensation or otherwise.  If CMS refuses to make these changes then the Court will either have to issue the injunction and force CMS’s hand or let the decision stand without the injunction.  Even if an injunction is not issued, this case should be persuasive to other courts and hopefully CMS when it is cited in disputes and appeals of CMS reimbursement claims which contain mixed diagnosis codes.  

Another question is whether depending upon the outcome of the trial, either party will appeal the District Court’s decision to the U.S. Court of Appeals.  CIGA may appeal as a result of the lack of an injunction or CMS may appeal if an injunction is the result of the trial or based upon the judicial declaration regarding its billing and reimbursement practices.  Tower MSA will continue to follow this important case and provide relevant updates.

Why is CMS Requesting Medical Records Which Are Not in My File and How Do I Respond?

April 21, 2017

Tower MSA understands the frustration when following submission of a Workers’ Compensation Medicare Set-Aside (WCMSA) to the Centers for Medicare and Medicaid Services (CMS) shortly thereafter you receive a request for additional medical records and prescription history which you thought was already provided! Indeed, in most cases you have provided all the relevant documents from your claim file, but what CMS is requesting are medical records and prescription histories outside of your claim file.

So why then is CMS requesting documentation for treatment and medications not even paid on the claim? What if the claimant has not even treated for the work injury in the last two calendar years, paid on the claim or not? What is the proper response to these CMS medical records requests?

CMS Rules Require Submission of All Injury Related Medical Records

CMS does not allow the employer or carrier to limit medical records in the MSA submission solely to records the employer, carrier or MSA submitter deem related to the work injury. Accordingly, CMS requires the production of records as defined in Section 10.7 of the CMS WCMSA Reference Guide which states as follows:

All medical records from all treating physicians for the last two years of treatment related to the claim, even if the WC carrier has not paid for the treatment and even if the treatment was long ago (emphasis added). Remember, CMS needs medical records for the last two years of treatment, which may not be within the last two calendar years. . .

. . . If the claimant has not been treated by any doctor for any reason within the last two calendar years, CMS generally needs all treating physicians to state when the last two years of treatment for any reason occurred. The treating physicians must also state, in writing, the specific condition/injury the claimant was last treated for, and any related therapy.

In response to these rules, an employer or carrier may argue that if the treatment was not paid on the claim then it should not be considered “related.” However, CMS defines related as any treatment occurring to the alleged injured body part or condition notwithstanding who pays for the treatment. For example, a carrier employer accepts responsibility for a shoulder injury in February 2015, but following a favorable IME report disputes ongoing medical care starting in November 2016. Assuming the claimant continued medical care for the shoulder injury, CMS will want to review those records.

That is not to say the employer or carrier cannot dispute the causal relatedness of the treatment in these medical records. While the IME itself will be insufficient on its own to dispute the care, a judicial decision after a hearing on the merits or a statement from the treating physician in which it is found that the ongoing treatment is unrelated to the claimed work injury, will in most cases be sufficient to exclude such care from the MSA.

Response Scenarios to CMS Requests for Medical Records

Below are several common scenarios in which CMS will likely request additional medical records, whether in the claim file or not, and how anticipation of this request can be addressed prior to submission of the MSA to CMS.

Scenario #1 – Open-ended medical care without ongoing treatment

Client provides Tower MSA with the last two years of medical records which match up with the dates of service in the claim payment history. The last available medical record for a 2/12/2015 date of service reports the claimant is to follow-up in three months. There is no indication in the claim file that the claimant sought further medical care post 2/12/2015. Once it is verified that the claimant indeed sought no further work-related medical care then through Tower MSA’s Physician Follow-up service, we will obtain a statement from the doctor confirming the last date of service and that all prescription medications, if any, were discontinued.

Scenario #2 – Open-ended medical care with ongoing treatment

Client provides Tower MSA with the last two years of medical records which match up with the dates of serve in the claim payment history. The last available medical record from a 2/12/2015 date of service reports the claimant is to follow-up in three months. There is no indication in the claim file that the claimant sought further medical care for the work injury. Communication with the claimant reveals though that the claimant has been receiving treatment which is related to the work injury although not paid on the claim. The requested medical records and prescription history (likely from the claimant’s pharmacy) will need to be obtained and submitted, although relevant legal defenses to the inclusion of care in the MSA based upon these records may be submitted as well.

Scenario #3 – Availability of Medical-Legal Reports versus treatment records

While this can occur in any jurisdiction (usually in the form of IME reports), California claims tend to have a greater prevalence of medical records containing QME, PQME or AME reports versus required treatment records. While such reports may be relevant to the MSA, they cannot make-up the sole basis of support for the allocation. Besides these type of medical-legal reports, we must provide CMS the treatment records upon which these reports are based.

Scenario #4 – Medical Records Containing Inconsistencies

There are situations where Tower MSA is provided updated medical records and prescription history but the records contain inconsistencies. Submitting an MSA to CMS with inconsistencies will either result in CMS issuing a Development Letter requesting additional documentation or CMS including treatments or medications that are actually no longer necessary.

For example, in one case referred to Tower MSA the medical records documented the treating physician giving a sample and prescribing Pennsaid 1.5%, an extremely expensive medication. On the other hand, the prescription history showed the Pennsaid had never been filled. We alerted the client and through our Physician Follow-up service was able to obtain a report from the physician confirming that as the trial of Pennsaid did not effectively manage the pain, it had been discontinued – $970,355 in MSA savings

In another example of a matter referred to Tower MSA, the medical records from two years before documented mention of a spinal cord stimulator as a potential treatment option for the claimant. The more recent medical records made no mention of a spinal cord stimulator as a potential treatment option Through Tower MSA’s Physician Follow-up service we were able to obtain a statement from the current treating physician that the SCS no longer is part of the claimant’s treatment plan – $187,822 in MSA savings.

Tower MSA Partners Works with Our Clients to Effectively Address Medical Records Issues Prior to CMS Submission

Tower MSA Partners’ MSA development process is uniquely designed to identify issues which may result in unnecessary medical care being included in the MSA and avoidance of post MSA submission Development Letters requesting additional medical records and prescription histories:

Prior to MSA report completion: Prior to completion of the MSA report we review the claim payment history and request from the client any dates of service listed on the history for which medical records are missing from the file. This is insures we start with a complete record of all treatment paid on the claim.

Post MSA report completion: Upon delivery of the MSA report we will advise our client of additional medical records likely to be requested if the MSA is submitted to CMS along with inconsistencies within the medical records and prescription histories and other opportunities to limit the MSA allocation.

With client approval Tower MSA’s Physician Follow-up service will obtain supplemental statements from treating physician(s) confirming last date of service, discontinuation of medications, clarification of ongoing medication use and whether certain treatments remain options for the claimant, i.e. spinal cord stimulator. The result is an MSA which will be expeditiously approved by CMS and an allocation that accurately reflects the claimant’s future work-related medical care.

Tower’s Physician Follow-Up service is provided at no charge when initiated as part of the MSA and CMS submission process.

For further information on Tower MSA Partners services please contact us at (888) 331-4941.

Tower MSA Partners Selects Patricia Smith as EVP, Clinical Operations

February 28, 2017

Patricia Smith, RN, BSN, MSCC, CDMS, CLCP has joined Tower MSA Partners as executive vice president of Clinical Operations. In this role, Smith reviews and monitors clinical trends related to Medicare coverage criteria within the confines of Medicare Secondary Payer compliance, develops clinical strategies to support company’s pre- and post-Medicare Set-Aside intervention workflow and manages all clinical and pharmaceutical oversight teams.

Most recently Smith served as senior vice president of Clinical Solutions Services for Examworks Clinical Solutions. In previous positions with MedAllocators, Concentra Integrated Services, Coventry Workers Compensation, and NuQuest Resources, she produced Medicare Set-Asides, Medical Cost Projections, and Life Care Plans.

“Pat has been involved with MSP compliance and MSAs in work comp for more than 14 years,” said Tower CEO Rita Wilson. “Her clinical expertise, track record of innovation and results-driven management philosophy make her a perfect fit to lead Tower’s clinically driven model to optimize the MSA and settlement.”

A graduate of the University of Maine with a bachelor’s of science degree in nursing, Smith holds several professional credentials. She is a Medicare Set Aside Consultant Certified (MSCC), a Certified Disability Management Specialist (CDMS), a Certified Life Care Planner (CLCP), and a legal nurse consultant. She is also a member of the National Alliance of Medicare Set Aside Professionals and International Association of Rehabilitation Professionals.

Tower MSA Partners CEO, Rita Wilson, Elected NAMSAP Treasurer

February 15, 2017

Tower MSA Partners CEO, Rita Wilson, who is a board member of the National Alliance of Medicare Set-Aside Professionals (NAMSAP), has been elected Treasurer of the organization. Full details on her election as well as the election of other board members to leadership positions is detailed in the following NAMSAP new release:

ELMHURST, Ill.–(February 2, 2017)–The board of directors of the National Alliance for Medicare Set-Aside Professionals has elected the following officers for 2017:

  • President: Shawn Deane, JD, MEd, MSCC, CMSP – assistant vice president of Product Development of ISO Claims Partners
  • Vice President: Greg Gitter, CMSP – president of Legacy Claims Solutions, Inc. (a Gitter Company)
  • Treasurer: Rita M. Wilson – CEO of Tower MSA Partners
  • Secretary: Christine Melancon, RN, CCM, MSCC, CNLCP, CMSP – vice president of Operations for EZ-MSA Services

“I am honored to be selected to represent NAMSAP as president,” said Deane. “We will build upon initiatives launched by last year’s outstanding President, Gary Patureau, and forge new opportunities to improve Medicare Secondary Payer services.”

Addressing the opioid epidemic remains a top priority, and NAMSAP will continue its efforts to persuade the Centers for Medicare and Medicaid Services (CMS) to follow its own Part D guidelines when reviewing and approving Workers’ Compensation Medicare Set-Asides (WCMSAs). NAMSAP will also monitor CMS’ selection of a new Workers’ Compensation Review Contractor and the evolution of the Commercial Recovery Center.

“Promoting payer participation in NAMSAP is another high priority,” Deane added. “We are delighted to add Beth Hostetler with Albertsons and Safeway to our board of directors and look forward to better representing the MSP goals for both payers and submitters.”

Other new board members are Amy Bilton with Nyhan Bambrick Kinzie & Lowry and Monica Williams, MWC Associates.

About NAMSAP

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 Statute and its impact on workers’ compensation and liability settlements. Through the voluntary efforts of our members, NAMSAP is a forum for the exchange of ideas and is a leading resource for information and news in this constantly evolving area of practice. The collective knowledge of our members and NAMSAP’s resources will provide attorneys, nurses, settlement planners, claims professionals, and others with the ingredients essential to their success.

Workcompcentral Highlights Tower MSA CEO Rita Wilson’s “Edge” in MSP Compliance Technology

December 20, 2016

Tower MSA Partners CEO, Rita Wilson, is the subject of a recent Workcompcentral article, Focus on Tech Has Guided MSP Compliance Co. CEOs Career, highlighting how Rita’s career in building better pharmaceutical and worker’s compensation technology systems led her to develop a Medicare Secondary Payer (MSP) technology platform which electronically integrates medical and cost-containment information.

In discussing why the MSP compliance technology platform is a difference maker for Tower MSA, Workcompcentral’s Emily Brill quotes Rita:

Tower MSA has differentiated itself by building out a software system that monitors and shares claim information from beginning to end, integrating medical and cost containment information for “continuity” and to avoid “reinventing the wheel” by scrambling to get information from separate sources.

The article further quotes Rita in explaining how the platform assists Tower MSA in providing MSP compliance services to its clients:

Our technology platform is able to track claim information all the way through, through the conditional payment research process, through the intervention process, through the MSA process. What we did was integrate this information and track it with one software application that allows us to measure the progress each month, and determine when the right time to finalize the MSA.

In understanding the benefits of Rita’s focus on technology in MSP compliance, Ms. Brill spoke to Ann Schnure, the former Vice-President of Risk Management for Macy’s, and also a strong proponent of the use of technology in claims handling, who said of Rita:

Wilson’s focus on technology has always given the CEO an edge.

Learn more about Tower MSA Partners Chief Executive Officer Rita Wilson,  connect with her on LinkedIn and view her blog posts on our MSP Compliance Blog.

To learn more about how Tower MSA Partners’ technology platform can give you an “edge” in Medicare Secondary Payer Compliance please contact Rita Wilson at rita.wilson@towermsapartners.com or 888.331.4941.

Tower MSA Partnership with American Airlines and PRIUM Yields Legacy Claim Settlements

December 8, 2016

In a widely acclaimed presentation at the recent 2016 National Workers Compensation and Disability Conference, Jennifer Saddy, Workers’ Compensation Director for American Airlines and Mark Pew, Senior Vice President of PRIUM, detailed the successful cooperation among American, PRIUM and Tower MSA to reduce pharmacy costs, litigation referrals and Medicare Set Aside costs ultimately leading to significant claim settlements.  Tower MSA is grateful to Jennifer and Mark for highlighting how Tower MSA’s Identification, Intervention and Involvement services were a key contribution to the success of this legacy claim reduction program.
 
For more information on American’s program please read the Risk & Insurance article Make a Decision and Move the Needle: American Airlines needed to take aggressive action to resolve 6,000 lingering workers’ compensation claims.

For more information on Tower MSA’s legacy claim reduction services please contact us at 888.331.4941 or info@towermsa.com.

Selecting the Right MSP Compliance Service Provider

June 30, 2016

Please take a moment to read Michael Stack’s article outlining qualities needed in selecting the right MSP compliance service provider.. Medicare Secondary Payer compliance is complicated and penalties can be high. There are a lot of components – Section 111 reporting, Conditional Payments, medical and pharmaceutical interventions, legal interventions, and Medicare Set Aside (MSA) preparation.

Typically these various activities are handled in silos, and time lags and errors can occur during the transfer to the next step. It’s easy to miss a data field or deadline.

In his article, Stack notes that:

“Effective MSP compliance includes a service provider that goes beyond the basics. These providers will offer services that allow members of the claim management team to focus on their job and provide information and resources to comply with Medicare regulations in workers’ compensation claims.”

Tower recognizes that Section 111, Conditional Payments, pre-MSA Triage, all interventions, and MSA preparation through CMS acceptance should occur in a continuous, unbroken process. That’s why we developed an all-inclusive MSP Automation Suite around compliance best practices. Our MSP Automation Suite drives the entire compliance process, automatically updates clients of each activity on the file, escalates medical and pharmacy issues, prompts for interventions and much more.

Claims close faster, quality and accuracy are assured and our clients enjoy smooth settlements. To learn more, contact us at info@TowerMSA.com or 888-331-4941.

 

Related posts on compliance:

Tower’s Medicare Secondary Payer (MSP) Compliance Countdown

The Year in MSP Compliance (2019)

How Do You Know Your MSP Compliance Data is Secure?

 

National Alliance for Medicare Set-Aside Professionals (NAMSAP) Names Tower MSA CEO Rita Wilson To Board

January 28, 2016

Elmhurst, IL, January 26, 2016: On Thursday, January 21, 2015, the Board of Directors of the National Alliance for Medicare Set-Aside Professionals elected the following officers for the 2016 year:

 

    • Vice President: Shawn Deane, JD, MEd, MSCC, CMSP – Assistant Vice President of Product Development of ISO Claims Partners

 

 

    • Secretary: Christine Melancon, RN, CCM, MSCC, CNLCP, CMSP – Vice President of Operations for EZ-MSA Services

 

“I am honored to have been selected by my fellow board members to represent them and our association as president,” said Patureau. “I look forward to working with our team of board members, committee chairs, management staff and all NAMSAP members to continue to strengthen our mission as the leading advocate for an efficient and effective Medicare Secondary Payer (MSP) compliance system. Following the steps of previous leaders and that of my predecessor Kim Wiswell, I am committed to promoting and growing our association, providing our members with the educational and networking opportunities they need for professional development as well as bolstering NAMSAP’s strategic goals”.

NAMSAP would like to thank Benjamin M. Basista, Esq., member of the Board of Directors since 2010 and most recently Vice President for his service to the organization. Basista is a shareholder with Dickie, McCamey & Chilcote, PC and Co-Chair of the firm’s Medicare Compliance Group, in which he concentrates his practice.

Immediate Past President Kimberly A. Wiswell, Director of Operations for MEDVAL, had this to say: “NAMSAP is a better organization thanks to Ben’s time, talent and expertise. Beyond his work on the legislative and bylaw side of the organization, Ben served as the liaison to the Membership Committee and was a consistent presence at all of our events providing his ideas, input, and enthusiasm. On behalf of the NAMSAP board we express our sincere appreciation for his service and wish him the very best in the future.”

In addition to electing officers, the NAMSAP board appointed Rita M. Wilson, CEO of Tower MSA Partners to the vacancy created by Basista’s departure. Ms. Wilson oversees all business development, sales, marketing and operational activities, IT systems development, and identifies new product offerings in support of MSP compliance. Within NAMSAP, she is Chair of the Communications Committee and a member of both the Data and Development Committee (DDC) and Evidence Based Medicine (EBM) Committee.

“Rita’s knowledge and experience in the industry as well as her commitment to NAMSAP make her an excellent addition to the overall team” said Patureau.

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 Statute and its impact on workers’ compensation and liability settlements. Through the voluntary efforts of our members, NAMSAP is a forum for the exchange of ideas and is a leading resource for information and news in this constantly evolving area of practice. The collective knowledge of our members and NAMSAP’s resources will provide attorneys, nurses, settlement planners, claims professionals, and others with the ingredients essential to their success.

Click here to download this press release.

National Alliance for Medicare Set-Aside Professionals (NAMSAP) Names Tower MSA CEO Rita Wilson To Board

Elmhurst, IL, January 26, 2016: On Thursday, January 21, 2015, the Board of Directors of the National Alliance for Medicare Set-Aside Professionals elected the following officers for the 2016 year:

 

    • Vice President: Shawn Deane, JD, MEd, MSCC, CMSP – Assistant Vice President of Product Development of ISO Claims Partners

 

 

    • Secretary: Christine Melancon, RN, CCM, MSCC, CNLCP, CMSP – Vice President of Operations for EZ-MSA Services

 

“I am honored to have been selected by my fellow board members to represent them and our association as president,” said Patureau. “I look forward to working with our team of board members, committee chairs, management staff and all NAMSAP members to continue to strengthen our mission as the leading advocate for an efficient and effective Medicare Secondary Payer (MSP) compliance system. Following the steps of previous leaders and that of my predecessor Kim Wiswell, I am committed to promoting and growing our association, providing our members with the educational and networking opportunities they need for professional development as well as bolstering NAMSAP’s strategic goals”.

NAMSAP would like to thank Benjamin M. Basista, Esq., member of the Board of Directors since 2010 and most recently Vice President for his service to the organization. Basista is a shareholder with Dickie, McCamey & Chilcote, PC and Co-Chair of the firm’s Medicare Compliance Group, in which he concentrates his practice.

Immediate Past President Kimberly A. Wiswell, Director of Operations for MEDVAL, had this to say: “NAMSAP is a better organization thanks to Ben’s time, talent and expertise. Beyond his work on the legislative and bylaw side of the organization, Ben served as the liaison to the Membership Committee and was a consistent presence at all of our events providing his ideas, input, and enthusiasm. On behalf of the NAMSAP board we express our sincere appreciation for his service and wish him the very best in the future.”

In addition to electing officers, the NAMSAP board appointed Rita M. Wilson, CEO of Tower MSA Partners to the vacancy created by Basista’s departure. Ms. Wilson oversees all business development, sales, marketing and operational activities, IT systems development, and identifies new product offerings in support of MSP compliance. Within NAMSAP, she is Chair of the Communications Committee and a member of both the Data and Development Committee (DDC) and Evidence Based Medicine (EBM) Committee.

“Rita’s knowledge and experience in the industry as well as her commitment to NAMSAP make her an excellent addition to the overall team” said Patureau.

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 Statute and its impact on workers’ compensation and liability settlements. Through the voluntary efforts of our members, NAMSAP is a forum for the exchange of ideas and is a leading resource for information and news in this constantly evolving area of practice. The collective knowledge of our members and NAMSAP’s resources will provide attorneys, nurses, settlement planners, claims professionals, and others with the ingredients essential to their success.