Schedule/Sessions

SESSION 1 - Opioids in the MSA - How to Mitigate MSA Exposure and Maybe Even Save Lives

• Speakers:

• Amy E. Bilton, Nyhan, Bambrick, Kinzie & Lowry, P.C.

• Jennifer L. Miller, UFG Insurance

• Randy Rizor, The Physicians Spine and Rehabilitation Specialists of Georgia, P.C.

Opioid use and abuse has been a hot topic in the news recently, and for good reason.  From 2001 to 2013, US overdose deaths from prescription drugs increased 250%, with opioid deaths alone increasing 300% in that time.  The panelists will discuss the opioid epidemic; its impact on claims and Medicare Set-Asides; and how good claim handling early on can mitigate overall exposure.  The panelists will use specific examples and give real-life tips on how to effectively handle these tough cases.
 

Break

SESSION 2 - Aging Gracefully? The Senior Workforce and Impacts on Workers' Compensation

• Speakers:

• K. Martine Cumbermack, Swift, Currie, McGhee & Hiers, LLP

• Marcos Iglesias, Travelers

• LaRonda Razor, Utica National Insurance Group

• Francis X. Wickersham, Marshall Dennehey

The collective age of the workforce is rising and having a significant impact on workers’ compensation claims and their associated costs. Approximately 20% of today’s workforce is aged 65 or older, which is double the rate it was in the 1990’s. In 2016, the number of workers over the age of 55 is expected to be almost 40 million. While this group has fewer work injuries, they can also be more expensive. This session will address the challenges the aging workforce presents to the workers’ compensation industry from a medical, legal, and claims perspective, and will provide practical, cost-effective strategies for managing such claims.

SESSION 2 - Playing Against a Stacked Deck: Using Poker Theory to Better Manage Workers' Compensation

• Speakers:

• Lucy Jenkins, American BOA, Inc.

• James Moran, Nyhan, Bambrick, Kinzie & Lowry, P.C.

• Martin Pickett, Chubb

The theory, practice and skills required to play high level hold ‘em poker are often identical to the skills needed to effectively handle workers' compensation defense claims.  Poker players must make decisions - - whether to raise, call or fold - - based upon imperfect information.  Whether to settle or proceed to trial, accept or deny, which depositions to take and investigations to pursue, and the like, are all “bets” we are making on a claim.  The best strategies for both often involve probability, psychology, luck and budgetary acumen.  A great claims handler, like a great poker player, is part mathematician, part psychologist and part private detective. 
 

Break

SESSION 3 - Medicare Secondary Payer Compliance: The Critical Transition to the Commercial Repayment Center (CRC)

• Speakers:

• Mike Carney, Self Employed

• Maggie James, Self Employed

• Bennett Pugh, Fidelity Fiduciary Company LLC

As part of the continuing efforts to improve the Coordination of Benefits & Recovery (COB&R) program the Centers for Medicare & Medicaid Services (CMS) has transitioned a portion of the Non-Group Health Plan (NGHP) Medicare Secondary Payer (MSP) recovery workload from the Benefits Coordination & Recovery Center (BCRC) to its Commercial Repayment Center (CRC). The CRC has assumed responsibility for the recovery of conditional payments where CMS is pursuing recovery directly from a liability insurer (including a self-insured entity), no-fault insurer or workers’ compensation (WC) entity (referred to as “applicable plans”) as the identified debtor. This informative session will detail the important role of the CRC, as it works to identify and recover conditional payments, issues Conditional Payment Notices and Demand Letters and resolve disputes and appeals. Ben Pugh, a partner at Franco Signor LLC, will lead a diverse panel that includes Donna C. Shenesky from American Mining Insurance Group and John Costanzo from Coca-Cola, as they discuss the implications of this monumental shift in the way the government works to protect the vast Medicare trust fund. The audience will gain valuable insights into the best practices for navigating this very complex new system.
 

SESSION 3 - Workers' Compensation Alternatives - The Option and Non-Subscription Improving Outcomes and Results

• Speakers:

• Elizabeth Bailey, Waffle House, Inc.

• Chris Mandel, Self Employed

• William Pipkin, Austill, Lewis, Pipkin & Maddox, P.C.

This presentation will address alternatives to traditional workers' compensation and the exclusivity doctrine. A number of cases across the country have questioned these alternatives. The roundtable will address whether these options provide the competition needed to improve benefits to injured workers while balancing costs to employers. This session will explore how appropriate alternatives to workers’ compensation can foster innovation and competition benefiting both injured workers and employers. The panelists will promote discussion on whether these options promote free market alternatives to statutory workers compensation insurance which adequately ensure injured employees are treated respectfully and compensated fairly in the aftermath of an on-the-job injury. The discussion will address differences between what Oklahoma has done and what has been in place in Texas for years, as well as efforts to pursue similar alternatives in other states. The discussion will address the controversy over whether these alternatives encourage improved claims management and financing processes and whether they radically change the fundamentals or best practices of claims handling.  
 

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