NAMSAP Quarterly Newsletter
Volume 8, Number 1                                                                             February 2016
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Special Thank You 
To Our Professional Partners!
Silver Partners 
Bronze Partners 
Patureau, Deane, Gitter & Melancon
Elected to Lead Organization;
Board thanks Basista for his service and appoints Wilson to vacancy
Elmhurst, IL, January 26, 2016:  The Board of Directors of the National Alliance for Medicare Set-Aside Professionals elected the following officers for the 2016 year: 

Click Here to read the press release.
President's Letter
By: Gary Patureau, CWCP, CMSP
Executive Director/COO

NAMSAP Members:
As President of NAMSAP for 2016, I look forward to working with all of you. A prime objective for this year is to increase participation from our membership in the development of goals for the organization. As you all know the strength of any association is its members' investment in the strategic planning and implementation process. The 2016 Board of Directors and Committee Chairs are reaching out to the greater membership to increase membership, educational programing and professional development opportunities. We need your help to continue to positively influence the evolution of MSP compliance at the federal level.

Click Here to read the entire article.
Commercial Repayment Center
Conditional Payment Recovery Update

By: Shawn Deane, JD, 

       Assistant Vice President, Product Development
       ISO Claims Partners

This past July, the Centers for Medicare and Medicaid Services (CMS) announced that a portion of Non-Group Health Plan (NGPH) conditional payment recovery would transition to the Commercial Repayment Center (CRC). As of October 5, 2015, and going forward, the CRC took over recovery against insurance carriers and self-insureds when these entities are identified as the debtor. Debtor status is generally conferred to insurance carriers and self-insureds pre-settlement in Workers' Compensation (WC) and by default in No-Fault (NF) claims.

Click Here to read the entire article.
Will More States Implement Workers'
Compensation Drug Formularies in 2016?
Rita M. Wilson
       CEO, Tower MSA Partners

The implementation and use of a drug formulary is lining up to be one of the hottest trends in the workers' compensation system in 2016. Based on the four states that currently have them, formularies can reduce the use of risky medications, improve outcomes for injured workers and lower costs for payers - clearly, a win-win for all stakeholders.
Click Here to read the entire article.
CMS' Opioid Utilization Policies
By: Rasa Fumagalli JD, MSCC
      Director of Compliance, NuQuest
Opioid pain relievers continue to play a significant role in the national overdose death rate.  According to the January 1, 2016 Centers for Disease Control and Prevention (CDC) Morbidity and Mortality Weekly Report, approximately 47,000 deaths in 2014 were related to overdoses from  opioid pain relievers and heroin. This figure represents a 6.5 percent increase from the opioid overdose deaths reported in 2013. The most common drugs involved in the overdoses were the natural and semisynthetic opioids, such as oxycodone and hydrocodone.

Click Here to read the entire article.
Recent Developments from the SMART Act:
Pre-Settlement Final Demand Functionality and Liability Threshold
Heather  Schwartz Sanderson, Esq., MSCC, CHPE,
       CLMP, CMSP 
      Chief Legal Officer

The SMART Act, enacted on January 10, 2013, requires the Centers for Medicare and Medicaid Services (CMS) to continue to assess and reform certain aspects of the Medicare Secondary Payer Act (MSP) over time. We recently had two developments from CMS out of the SMART Act: 1) CMS has now made a functionality available via the Medicare Secondary Payer Recovery Portal (MSPRP) which will allow parties to obtain a final conditional payment demand prior to a final settlement, judgment, or award, and 2) CMS has assessed its threshold for liability settlements and determined that the current threshold of $1000 settlements or less do not require conditional payment reimbursement or reporting to CMS. Let's further delve into both developments and discuss any current or future impact it may have on claims handling. 
Click Here to read the entire article.
Deane, Melancon, Patureau & Wiswell
Reelected to Board of Directors 

The election for the National Alliance of Medicare Set-Aside Professionals (NAMSAP) occurred from early November until December 4, 2015. The Board of Directors, upon the consultation and involvement of its subsidiary committees, sets and implements policies and charts the general direction of the alliance in general while also ensuring proficient management. 88 voting-eligible members cast a ballot online. According to the NAMSAP bylaws (last amended 12/18/20141), the election results would determine the three (3) Category One (1) Directors for a three (3) year term beginning January 2016. Per the bylaws, a fourth seat that became vacant and was filled by board appointment is also up for election.

Click Here to read the press release.
Committee News

(Click the committee title to read report)

The NAMSAP Communications Committee would like to encourage you to submit an industry-related article for our upcoming newsletter. We are accepting submissions in the following categories: Legal, Legislative, and Medical. If you are interested in contributing to one of these categories, or have an idea for a new category, please contact Rita Wilson, Communications Committee Chair. She can be reached by email at


Click here for past newsletter editions!