Join Now Members Only
MONTANA SELF INSURERS' ASSOCIATION

August 2024 UPDATE

  • New MSA Rules & Civil Monetary Penalties for Incorrect Reporting - What You Don’t Know Can Hurt - Webinar 9/19 @ 10a MDT
  • Annual MSIA Member Survey – Coming To Your Email Soon!
  • MSIA Business & Annual Meeting 9/11 
  • – Sponsored by Browning, Kaleczyc, Berry & Hoven and Definiti Comp Solutions/Definiti Rx 
  • Governor’s Conference – 9/11 – 13 – Butte, MT
  • Welcome New MSIA Member - XcelABLE
  • Business Insurance Recognizes MSIA Member USI Insurance Services
  • Sad News – Passing of Judith Hosford

(Just a reminder that if you are on the July dues cycle, your MSIA Annual Dues are now due. You can mail a check, pay by credit card (go to Join Now (mtselfinsurers.org)) or after you contact us you can pay via ACH or Venmo. Not sure if you are on the July or January dues cycle? Contact us!) 

New MSA Reporting Rules & Penalties for Incorrect Reporting - What You Don’t Know Can Hurt - Webinar 9/19 @ 10a MDT

Effective next April, all WC settlement information involving a Medicare eligible person will be required to be reported to CMS – whether an MSA has been submitted or not. This requirement includes third party liability settlements where WC is also involved – regardless of the level of involvement. 

Starting next month October 11 CMS will start auditing information for incorrect/missing or incomplete reporting of required MSA information. CMS has announced they will perform random quarterly audits, using information from all of their databases to identify incorrect and incomplete required reporting. Penalties for incorrect/inaccurate/missing reports can be imposed as well. CMS has said they will not be imposing penalties until at least April 2025. However, this will likely give employers and carriers notice of how well or poorly they are reporting required information. 

When penalties are imposed, they can be significant, starting at a minimum of $250 per claim/day and moving to $1000 per claim/day (and those numbers will be adjusted based on inflation). The maximum penalty, with the inflation factor, is currently over $500,000 per claim. Penalties will be imposed prospectively only – from the date CMS recognizes the issue. Importantly, CMS will be using any information they have access to indicating a potential claim or settlement should have been reported and was or was not reported or reported correctly. 

Last week on August 1, CMS released new language to the WC Medicare Set Aside Self-Administering guide, impacting injured workers who are managing their MSAs. This applies to the individuals managing the MSA funds for medical payments that should go to pay for treatment and, as part of the MSA agreement, should not be paid by Medicare or the Medicare Advantage Plans (Part C or D) policies that may be in place. The new language requires your injured worker/Medicare beneficiary to notify any Medicare Advantage Plan carrier they may have of the settlement and the MSA. Medicare Advantage Plan coverage providers have the same statutory rights as Medicare as a secondary payer. That is, the Medicare Advantage Plan can deny, delay or cancel benefits to your injured worker, if the medical treatment should have been paid for by the WC MSA. 

What does it all mean? It’s complicated, complex and some parts are still moving. Self-insured employers and group plans (as well as carriers) now have responsibilities and potentially significant penalties for failing to report appropriately and timely. As well, your injured workers who have accepted a settlement including an MSA also have responsibilities and face potentially delayed or cancelled benefits, if they fail to meet those responsibilities. 

MSIA does not have all the answers – but we have members a who do. The very first MSIA CE Webinar, waaaaaaaay back in 2022 featured Allan Koba Compliance Solutions and MMIA on Navigating the MSA and Section 111 Reporting Requirements. Last year, Ametros provided Practicalities and Pitfalls of the MSA Process (Powerpoint decks for both presentations are available from MSIA)

This is the membership early-bird notification of this important Webinar, New Reporting Rules for MSAs – What You Don’t Know Can Hurt, presented by Heather Schwartz Sanderson of Sanderson Firm, PLLC. We have applied to the Department of Labor for CE credits for WC Claims Examiners and to the Commissioner of Securities and Insurance for Insurance Producers. The Webinar will be on Thursday, September 19, at 10a MDT and sponsorship slots are available to MSIA members. Sponsors receive recognition in every communication regarding the webinar throughout the country and on social media. Sponsors will be recognized during the Webinar as well. We have not formally announced this Webinar yet so website, on-line registration is not yet available, but will be soon! 

Heather Schwartz Sanderson of Sanderson Firm, PLLC will add to our knowledge at the next MSIA CE Webinar at 10a on September 19 – New Reporting Rules for MSAs – What You Don’t Know Can Hurt.

As always, MSIA members have access to unlimited seats to the Webinar as a benefit of membership. Heather Schwartz Sanderson is a nationally recognized legal expert in Medicare Secondary Payer (MSP) Compliance, known for her cutting-edge expertise, practical analysis, and industry advocacy. Her extensive legal experience includes federal class action litigation and state-level matters and contributing to MSP legislative reforms since 2011.

One thing is clear – Medicare issues, MSAs, CMS reporting and penalties and ongoing responsibility to protect the Medicare Trust Fund, as created by the Medicare Secondary Payer Act, are not going away. You don’t want to miss this important MSIA CE Webinar - New Reporting Rules for MSAs – What You Don’t Know Can Hurt - on September 19. Contact the MSIA office to reserve your seats – advance registration is required. 

Annual MSIA Member Survey – Coming Soon!

Every August, we ask you what is important in the Montana workers’ compensation system and what should be fixed. Your Annual Membership Survey will be coming soon. All responses are held with the strictest confidentiality – and your responses help guide us in our public policy positions and activity. Your voice is important and as experts in making the system work, we need to hear from you. 

  • Should we address the healthcare provider shortage by letting PA’s be treating physicians? 
  • Should MT law permit employer provided transportation to provide blanket WC coverage, even if the vehicle is being used for a family vacation? 
  • Should IME’s be permitted every 90 days and/or when the medical condition at issue changes? 
  • Are there aspects of the MT WC system that drive you batty?

These and other questions are part of the Survey this year. ALL RESPONSES ARE STRICTLY CONFIDENTIAL. Responses are due by September 1 and we will review the results during the Business & Annual Meeting on September 11. Please respond to the Annual Member Survey email when it comes and help us represent your interests! 

MSIA Business & Annual Meeting – 9/11 8:15a Copper King Hotel - Butte

Sponsored by Browning, Kaleczyc, Berry & Hoven and Definiti Comp Solutions/Defniti Rx

Governor’s Conference 9/11 – 13 Butte, MT

The 2024 MSIA Business & Annual Meeting sponsored by Browning, Kaleczyc, Berry & Hoven and Definiti Comp Solutions/Definiti Rx will start on Wednesday September 11 at 8:15a at the Copper King Hotel in Butte. 

We again kick off the Governor’s Conference with our guest speaker Amy Lee. Lee is a nationally recognized WC leader and researcher. She recently retired from the Texas Division of Workers’ Compensation and has started Steadfast Policy Strategies, which focuses on data to support public policy initiatives. Lee has lead efforts to use data to for public policymakers in making changes in the TX system. That leadership has lead to other states using the same kind of analysis and thoughtful approach to make changes as well – including Montana! 

Lee’s work is appropriately credited with being the catalyst for changes made in the Texas system. Her work helped change the Texas system from one of the most troubled in the country to one that should be emulated. As referenced above, some of Montana’s reforms are based on the changes TX implemented based on Lee’s work. Lee has been involved with WCRI, IAIABC, was a Fellow with the National Academy of Social Insurance and is a national speaker on WC systems and reform.

At our Business meeting, we will: 

  • Review and Approve last year’s meeting minutes
  • The Budget – last year’s results and this year’s proposal
  • Financial Results for the Association
  • Review the Annual Members Survey results and
  • Elect Board Members
  • Address anything you want to bring up

Three Board seats currently occupied by Dee Walcheck of Logan Health, Mike Marsh of Midland Claim Services and Vicki Evans of Montana Contractors Compensation Fund are up for election. While the three incumbents have indicated a desire to continue to serve, any member is eligible to serve. If desired, the Bylaws permit us to add an additional member to the Board as well, for a total of seven Board members. Under our Bylaws, membership elects Board officers and the Vice Chair and Secretary/Treasurer, currently occupied by Walcheck and Marsh respectively, will be elected this year. 

The 2024 MSIA Business & Annual meeting is sponsored by Browning, Kaleczyc, Berry & Hoven and Definiti Comp Solutions/Definiti Rx. Members will receive the meeting package via email prior to the meeting (hard copies will not be provided). If your company cannot attend the meeting, please provide your proxy for quorum purposes. All members, regardless of membership level have a voice and count towards a quorum. We now have almost 60 individual member organizations – we need more than half in attendance or by proxy to hold the meeting.

Governor’s Conference

The Governor’s Conference starts with the MSIA Annual Meeting. This year our meeting will be held in historic Butte, MT at the Copper King Hotel. Here is the registration and additional information link: 2024 Governor's Conference on Workers’ Compensation. 

This year’s theme for the Conference – Better Medical – Better Outcomes features a number of MSIA members. This is the most important Workers’ Compensation meeting in the state every year. The Conference attracts business, labor, medical professionals, plaintiff and defense attorneys, public policymakers and everyone else involved in the system. The Conference has consistently drawn the best national, regional and state speakers talking about the latest and most important aspects of WC – nationally and in Montana. 

Butte is one of the nation’s most historic cities for labor and management relations – not always a positive story, but something we cannot forget. It is one of the homes for the International Workers of the World (the Wobblies) and America’s business baron’s – Rockefeller, Clark, Daly, Carnegie. Chris Fisk will provide a local historical perspective on the 1917 Speculator mine disaster, which lead to many of today’s mining and general safety programs. 

Given the quality of the Conference agenda this year, it’s no surprise that the Conference features seven MSIA members: 

  • Vicki Evans, with MCCF, will update us on Kids Chance MT 
  • Dr. Silivia Sacalis & Dr. Amanda Waltermath with Health-e-Systems talking about Prescribing Empathy and Patient Well-Being in WC Drug Therapy Trends 
  • Rene Mills with Craig Hospital will talk about Assessing Brain Injuries
  • Dr. Laura Kirsch with Clarus IME will talk about Psych and Neuropsych IMEs and their Differences
  • Kerri Poe of Arcadia Settlements and Daniel Tiscareno Romero of Ametros will be joined by Hany Abelsayad to talk about a Hands-On Approach to MSA’s

Other presentations will feature Dr. Ethan Moses, CO WC Division Medical Director, Dr. Al Olszewski a MT Orthopedic surgeon and former political candidate, Dr. Daniel Whiting, Montana’s only dual fellowship trained hip surgeon, Dr. John Schumpert, formerly the state’s WC Medical Director with REOH in Missoula and Dr. Michael Wright talking about shoulders. 

We will also learn about Ethical Choices and Improved Results from Brian Allen and from a physical therapist who went from working in the system, to a workers’ compensation patient, Michelle Despres. Allen has been an MSIA guest speaker and provides a fascinating and thought-provoking presentation. Despres story is a very interesting perspective of our systems from someone who works in it – and became an injured worker in it! 

Finally – MSIA members Medivest, PACBLU and Craig Hospital are hosting the Wednesday evening reception. Registration and additional information are here - - 2024 Governor's Conference on Workers’ Compensation

Welcome New MSIA Member – XcelABLE

The team at XcelABLE, Xcels in delivering top-tier functional capacity and ergonomic evaluations across the United States including in Montana, the last, best place. All of our clinicians are licensed occupational therapists or physical therapists. Embracing cutting-edge technology, and delivering an objective, defensible report, we ensure Xcellent service in facilitating successful reintegration into the workforce for those recovering from injuries or illnesses. To make the process easier for all parties, we have a centralized office for all scheduling for all locations in Montana. Most importantly, when you need this service, you are working directly with the medical care provider and not through a third party to get services scheduled. 

Our team’s commitment Xtends to pioneering preventative measures in occupational health. We are collaborating with Western Michigan University on research initiatives and strive to refine effective and cost-efficient strategies for returning the injured worker to work safely and for preventing injuries in the workplace. We are dedicated to enhancing workplace safety and employee well-being nationwide to Xceed your goals. For more information contact Lisa Fitzpatrick at LFitzpatrick@XcelABLE.com or 858-444-6510.

Business Insurance Recognizes MSIA Member USI Insurance Services

Business Insurance annually recognizes the best of the best in our as part of their United States Insurance Awards. Finalists in 10 categories were selected by BI staff from the more than 140 nominations. The winners were selected by a panel of risk managers who independently assess each of the finalists. They announced their United States Insurance Award winners last month.

This year, MSIA member USI Insurance Services was honored for the Diversity, Equity & Inclusion Initiative of the Year. USI Insurance Services, in 30 short years has grown from one office with 40 employees to being a country-wide brokerage and service provider with over 200 offices and 10,000 employees. Their client base includes all sizes, industries and geographies as well. USI has been recognized as a Best Place to Work in Insurance by Business Insurance, a top employer by Newsweek and Glassdoor. This year, too, they have been recognized for the effectiveness and results from their Diversity, Equity and Inclusion program, “I’m With U.” 

Sad News – Passing of Judith Hosford

Montana is a small town. When one of our own passes, particularly someone who has contributed so much to our community, we notice.

It is with deep regret that we inform you of the passing of Judith Hosford on Sunday August 4 in Billings. Judith was a fixture in Montana’s WC claims community from the early 80’s until her retirement just a few years ago. Judy started her career in Missoula and moved it to Billings where ultimately, she created her own TPA firm and became one of the first 100% woman owned operations in the business. Judith was honored by the Montana WC community in 2019 when she was recognized as the Outstanding Workers’ Compensation Professional of the Year at the Governor’s Conference. She made her career with the phrase, “Treat people with respect and dignity, even when the law or lawyers tell us that there is no coverage. …we don’t make the laws, we just do our best to help people through the process regardless of their circumstances.” 

Judy was a positive constant in an industry filled with change and is missed. At her request, there is no remembrance of life planned.