What is Medicare Secondary Payer?

Medicare Secondary Payer (MSP) describes when the Medicare program does not have primary payment responsibility for medical items and services under an insurance claim. When the Medicare program is a secondary payer, this means that another entity (e.g., liability insurer, no-fault insurer, or workers’ compensation insurer) has responsibility for paying for such items and services before Medicare.

Who Does Medicare Secondary Payer Apply To?

Medicare Secondary Payer compliance applies to Group Health Plans (a health plan offered by an employer or employee organization which provides health coverage to employees and their families), Non-Group Health Plans (liability insurance, including self-insurance, no-fault insurance, and workers’ compensation insurance), Medicare beneficiaries, insurance claims professionals, providers, suppliers, physicians, and attorneys.

What is MSPA?

The Medicare Secondary Payer Accreditation course, or “MSPA”, is a professional certification achieved by individuals who successfully complete the 9-hour MSPA curriculum. Sanderson Firm and WorkCompCollege have partnered to launch an MSP certification for 2024 and beyond, leveraging Sanderson Firm’s unparalleled expertise in the MSP compliance space and WorkCompCollege’s on-demand virtual educational platform which has successfully facilitated numerous other certifications for the insurance industry.

MSPA is comprised of nine (9) virtual, on-demand learning modules covering Medicare Secondary Payer topics such as Medicare Set-Asides, Medicare conditional payments, and mandatory insurer reporting as required by Section 111 of the Medicare, Medicaid, and SCHIP Extension Act of 2007 as applicable to workers’ compensation, general liability, and no-fault payers/plans.

WHAT CLASSES ARE OFFERED UNDER THE MSPA PROGRAM?

1. Medicare Secondary Payer Introduction

2. Medicare Set-Asides, Part 1

3. Medicare Conditional Payments, Part 1

4. Medicare Mandatory Insurer Reporting (Section 111 Reporting), Part 1

5. Medicare Secondary Payer Case Law

6. Medicare Set-Asides, Part 2

7. Medicare Conditional Payments, Part 2

8. Medicare Mandatory Insurer Reporting (Section 111 Reporting), Part 2

9. Settlements with Medicare Beneficiaries & Reasonable Expectation Claimants

Who Was MSPA Designed For?

MSPA is designed for workers’ compensation, general liability, and no-fault claims/legal professionals and for those working within and around the Medicare Secondary Payer community, which includes insurance claims personnel, attorneys, paralegals, nurses, and even those simply interested in learning more about Medicare Secondary Payer law and compliance. MSPA makes MSP approachable, meaning even those without any prior experience will benefit from completing the MSPA course.

Where Do I Register for the MSPA Course?

Please visit https://workcompcollege.com/medicare-secondary-payer-accreditation/ to register.

DOES MSPA QUALIFY FOR CE CREDITS?

For licensed lawyers and/or nurses, you may be eligible to receive continuing education credits for successfully completing the MSPA course. For licensed lawyers, any request for CLEs must be made by you to your state bar association, and your state bar association reserves the right to decline to grant CLE credits. Similarly, for licensed nurses, any request for CEs must be made by you to your state board, and your state board reserves the right to decline to grant CE credits. When submitting such requests to your state bar association and/or state board, we recommend providing a copy of your MSPA Certificate of Completion; documentation requirements may vary.

How is This Certification Different Than Other MSA/MSP Certifications?

-MSPA is the most modern and flexible certification currently available in the MSP space. Students of MSPA may take the course anywhere, anytime on any device at his/her own pace. This alleviates unnecessary time off and time away from work and thus significantly benefits the student as well as his/her employer.

-MSPA curriculum is updated regularly. Students of MSPA will be able to network and receive updates from MSPA faculty regularly.

-MSPA students will not be required to write a Medicare Set-Aside (MSA) at the end of the course to receive certification. MSPA recognizes that the industry has evolved much beyond just MSAs, and the MSPA certification is designed to provide a comprehensive understanding across not just MSAs, but also conditional payments, and Section 111 Reporting.

How Do I Successfully Complete the Course?

Each of the nine learning modules include an instructional video, transcription, presentation materials and a quiz to verify comprehension. Upon completion of all nine modules, students will then complete a 100-question Final Exam. Students do not need to “pass” each module’s individual quiz (e.g., scoring 70% or higher on each quiz), but students must finish with an overall GPA of 80% or higher (including the result from the final exam) to receive the MSPA certification.

Will My Certification Expire? If So, How Do I Re-Certify?

The MSPA certification remains valid for a period of two (2) years. Thereafter, students must re-certify by obtaining six CE’s within the WorkCompCollege platform and/or attending certain Sanderson Firm webinars.

WHAT ARE THE COSTS ASSOCIATED WITH THE INITIAL COURSE AND RE-CERTIFICATION?

Initial registration for the full MSPA course (including all modules, quizzes, Final Exam, designation, and continuous course updates) is available for $1,195.00. For group purchases of 5 or more (e.g., if purchasing for a number of claims professionals for your organization), or for public entities (e.g., state or local governments, public schools, etc.), please contact us for custom pricing.

Re-certification every two years is available for $600.00.

What Are the Benefits of MSPA?

• Comprehensive course curriculum organized by topics, including Medicare Set-Asides, Medicare conditional payments, and mandatory insurer reporting as required by Section 111 of the Medicare, Medicaid, and SCHIP Extension Act of 2007

• On-demand curriculum where students may proceed at a pace most convenient for their busy schedules

• Virtual curriculum where students and/or program directors save time and money associated with regular travel expenses

• Approachable curriculum which is perfect for all MSP knowledge levels; no advanced knowledge is required

• Regular Updates posted to the website as part of continuing education

• Ability to Communicate Directly with course professors if questions arise

If I have questions about the MSPA course, who do I contact?

For inquiries, please e-mail legal@sandersoncomp.com.