On February 7, 2013, William D. Wiles, Shareholder and Head of the Medical Malpractice Defense section at Hiersche, Hayward, Drakeley & Urbach, P.C., hosted a Medicare/Medicaid Compliance Program for a select group of more than 40 defense attorneys, insurance professionals and mediators located throughout the state of Texas.
The program was presented by Rafael Gonzalez, Director of Medicare Compliance and Post Settlement Administration for Gould & Lamb of Bradenton, Florida. An author and nationally recognized expert on Medicare Compliance, Mr. Gonzalez addressed the legal requirements of the Medicare Secondary Payer Act (MSPA), the federal government’s aggressive enforcement of MSPA in order to raise revenue and offset some of the costs associated with the Medicare/Medicaid program and the creation and administration of special needs trusts. Mr. Gonzalez pointed out that annually, 104 million Americans receive benefits totaling $1.2 trillion from the combination of Survivor, Disability, Old Age and Medicare Benefits.
MSPA establishes a mandatory reporting system and compliance requirement for lawyers, insurance companies and self-insured entities that process and settle workers compensation and liability claims for Medicare/Medicaid beneficiaries. Failure to comply with the statute and adequately take into account, and satisfy, the past and future interests of Medicare/Medicaid can result in enormous penalties and fines for individual lawyers, insurance companies and businesses involved in the settlement or payment of claims. MSPA constitutes a massive, and potentially punitive, effort by the federal government to recoup part of the $1.2 trillion paid annually to Medicare/Medicaid beneficiaries.
The State Bar of Texas certified the program for 6 hours of continuing legal education credit and 6 hours of continuing education credits were awarded to insurance professionals. The sentiment of those attending was best summed up in a post conference comment by several participants:
“Thanks for the truly excellent presentation at the seminar in Dallas on Medicare, Medicaid and Special Needs trusts. Probably one of the most informative legal seminars I have attended in 41 years of practice. Exciting presentation about a complex and risk-laden topic. Thanks to Dick Wiles and his staff for hosting this excellent presentation. Kind regards,
Dave McCue and Bruce Pauley
McCue Pauley, P.C.”