Schedule/Sessions
Dinner and Movie Night
Former DEA special agent Rick Tucker and Bob Baer, Claims Executive, Arrowpoint Capital, will present clips from the award-winning films “Behind the Orange Curtain” and “Oxyana” and moderate a discussion on the epidemic abuse of narcotic pain medication.
Clips from two award-winning documentaries about the prescription drug abuse epidemic interspersed with comments from Rick Tucker will demonstrate the real cost of this national problem.
Keynote
Dr. Andrew Kolodny is the Chief Medical Officer of Phoenix House, a nonprofit addiction treatment organization and he is President of Physicians for Responsible Opioid Prescribing (PROP). Dr. Kolodny was previously the Chair of Psychiatry at Maimonides Medical Center in New York City.
Dr. Kolodny has a long standing interest in Public Health. Prior to his position at Maimonides, he was the Medical Director for Special Projects in the Office of the Executive Deputy Commissioner for the New York City Department of Health and Mental Hygiene. For New York City, he helped develop and implement multiple programs to improve the health of New Yorkers and save lives, including city-wide buprenorphine programs, naloxone overdose prevention programs and emergency room-based screening, brief intervention and referral to treatment (SBIRT) programs for drug and alcohol misuse.
Back to topSession I - Medical Director Panel
- Speakers:
Julie Fortune, Self Employed
Marcos Iglesias, Travelers
Jill Rosenthal, Zenith Insurance Company
Bruce Sherman, Wal-Mart Stores, Inc.
Healthcare is changing rapidly and the future of medicine involves new and innovative technological approaches. The Medical Director of the future is a skilled practitioner, and leader who is financially, politically, and technologically savvy. They have the skills required to navigate complex situations ranging from employee health, workplace safety, the regulatory environment, data management and technology.
This course engages the learner by challenging them to think about how a Medical Director can assist them in their work environment.
After completion, participants will be able to:
Understand the role of a Medical Director
Develop an awareness of how Medical Directors can assist claims and litigation professionals in the understanding and development of medical and pharmaceutical matters or litigated cases.
Broaden their understanding of the current medical and pharmaceutical trends.
Recognize the future of medicine, including technological advancements
Session I - New Prosthetics and Treatment for Amputees
- Speakers:
Chris Doerger, PT, CP, Ossur Americas
Robert Donnelly, Semper Fi Fund
Whitney Harris, Ossur Americas
Gabe Martinez, Semper Fi Fund
David McGill, Ossur Americas
Andrew Rosenthal, Self Employed
Nick Stillwell, Never Say Never Foundation
Christy Stover, Semper Fi Fund
Tina Zink Pernie, North American Risk Services NARS
This course informs the learner about the available new technologies in prosthetics.
After completion, participants will be able to:
Understand how amputees can regain function and return to work.
Identify various available computerized prosthetics in the marketplace.
Understand prosthetic and amputation terminology.
Understand the various timelines for healing depending upon the type of amputation and prosthetic device.
Session 2 - Health Care Reform: Impact on the P&C Insurance Industry
Health care reform is setting the stage for market disruptions that will likely impact claims medical costs and outcomes and fundamentally change the way insurance is bought and sold. We will examine potential disruptions and consider impacts on the P&C industry.
Session 2 - Return to Work/Claim Resolution
- Speakers:
Tara Acton, Lumen Technologies, Inc.
Ronald A. Mazariegos, Ambridge
James M. Poerio, Poerio & Walter, Inc.
Returning an injured worker back to the workforce is crucial in the early stages, ongoing, and during the life of the claim. While many workers experience injuries or health conditions that they believe prevent them from working, many can in fact return to work with a few simple modifications to their work environment, duties or schedule. This course engages the learner by challenging them to think differently about return to work issues in order to achieve a superior claim outcome.
After completion, participants will be able to:
Identify issues which may be preventing the injured worker from returning to work
Identify appropriate legal avenues to explore regarding return to work issues
Learn how to manage legacy claims wherein the claimant has been out of work for an extended period of time
Identify appropriate resolution solutions
Learn how to work with the carrier/employer in getting the injured worker back to work
Session 3 - Discipline and Safety: Lessons from the Inside
- Speakers:
Brian Bellavia, Quintairos, Prieto, Wood & Boyer, P.A.
Donna Larson, Space Coast Health Foundation
Each state has procedures for ensuring that healthcare professionals meet the requirements for safe practice. Typically, the state board of medicine is given the responsibility by the legislature to license, monitor, discipline, and perhaps educate and rehabilitate health care professionals. This presentation will provide an overview of the medical complaint and disciplinary process. Patient safety will also be addressed.
The goal is to provide participants with:
An understanding of the steps involved in the disciplinary process and the role of the liability insurance carrier.
A better understanding of the disciplinary process from the insured physician’s perspective on resolution.
An evaluation of the impact a disciplinary action can have on the liability action.
A better understanding of quality assurance from a risk management perspective.
A discussion of the reporting requirements for disciplinary actions
Trends in patient safety
Session 3 - Juror Decision Making Processes in Medical Malpractice Cases
- Speakers:
Kelly Henderson, Allina Health
Margaret Fonshell Ward, Ward & Herzog
David Zehner, Zehner Trial Consulting
Laura Zehner, Zehner Trial Consulting
This panel will explore the patterns in decision making for jurors in medical malpractice cases. How jurors make decisions about liability, causation, damages, agency and other issues unique to medical malpractice cases will be illustrated with video clips from mock trial deliberations. An attorney, hospital general counsel, insurance claims handler and jury consultant will explain how these repeated patterns in juror decision making influence how medical malpractice claims are handled.
After this panel, participants will:
Understand how a focus group format can be used to evaluate a medical malpractice case
Know what a “patient perspective” is and how it influences juror evaluation of evidence in a medical malpractice case
Realize the difficulties entailed in making agency arguments
Evaluate the factors that can lead to a “runaway jury” on damages
Understand how liability arguments influence damage arguments
Discover the most effective methods for preventing large damage awards
Be able to evaluate the effectiveness of different defenses based on a set of criteria relating to how likely jurors are to process the arguments
Back to topSession 3 - Pain, Pain Go Away: Alternatives to Drug Therapy
Physicians appear to be jumping the gun when it comes to prescribing spinal cord stimulators or pain pumps as a solution to chronic pain. Patients will start a trial of a stimulator (for example) and when that treatment regimen fails the stimulator, is removed and the patient is relegated to a lifetime of oral medications. At what point do we intervene and look for alternative methods to managing these pain issues once traditional methods have been considered? Who will police the ordering physician and intervene on behalf of the patient? Are there steps we can take to introduce new treatment therapies into the regimen before invasive methods are attempted?
This session is designed to engage the audience in discussion of a topic that will likely affect a large segment of our aging population. Upon completion participants will be able to:
· Identify evidence-based criteria for the diagnosis of chronic pain
· Evaluate medical necessity of mechanical interventions for pain management
· Identify additional treatment options available to mechanical interventions
· Determine the use of functional pain management facilities as an alternative treatment program
· Recognize the benefit of the intervention of physiatry specialty in early diagnosis and treatment
Session 4 - Forensic Pharmacy and MSA
- Speakers:
Lori Davis, ISO Claims Partners
Mark Popolizio, ISO Claims Partners
Kevin Puckett, KP Underwriting, LLC
Jessica Smythe, ISO Claims Partners
Prescription drugs continue to be a major cost driver on the WC-MSA front. Rising RX costs and CMS RX allocation approaches are resulting in significantly higher WCMSAs. This presentation focuses on the causes of the current RX challenge and what can be done to reduce WC-MSA RX amounts, including the use of rated ages and structured settlements. The panel will also address how the SMART Act changes MSP compliance and examine the growing Medicare Advantage menace.
After completion, participants will be able to:
Understand CMS’ current approach to WCMSA calculations
Identify potential measures which could help mitigate WCMSA RX costs
Create a checklist of what documents CMS requires related to WCMSA RX calculations and efforts aimed to reduce RX allocation
Better understand the role rated ages play in the WCMSA process
Identify what records and information are needed to obtain rated ages
Understand how the SMART Act changes MSP compliance and what it means to every day claims handling
Identify current issues and challenges related to Medicare Advantage plans
Learn the new “evidence based” standard of review employed by the new CMS Workers’ Compensation Review contractor
Session 4 - Social Media and Medicine
- Speakers:
John Browning, Spencer Fane LLP
Michael Caspino, Busch & Caspino
Elizabeth Ganiere, McDermott
Facebook, Twitter, Pinterest, Tumblr, LinkedIn…the ever-growing list of social media platforms creates both opportunities and challenges for healthcare providers. They can provide tremendous marketing opportunities and build a sense of community among patients. They also can contribute to litigation and cause massive headaches for attorney and claims handlers.
Upon Completion of this course, the participant will be able to:
Better understand the pivotal role of social media in fact investigation/case discovery in all types of claims and litigation.
Appreciate the significant evidence preservation issues that are presented when dealing with electronically stored information (ESI), including social media content.
Know how to make use of evidence obtained from social networking sites and other online resources in jury selection as well as overall case evaluation and strategy.
Understand where the ethical boundaries are drawn with respect to the use (or misuse) of social media and other online resources by claims professionals and defense counsel in litigation
Session 5 - Dazed & Abused: An Overview of Medical Marijuana and its Impact on Claims Management
- Speakers:
Kathryn Bronstein, Ameritox
Rachel Brozina, Lester Norton Law
Scott Yasko, Preferred Medical Network
The rise and legalization of marijuana for medical purposes is a relatively new phenomenon but it is not one that is going away anytime soon. Marijuana or Cannabis is already having a societal affect as it is legal medically in 20 states and DC (with pending legislation in 4 states) as well as legal nearly across the board in both Washington and Colorado. This session is designed to engage the audience in a thought-provoking topic in order to better prepare claims professionals to deal with the implications of such legislation.
Upon completion, the audience will:
Have the ability to identify and understand important case law on medical marijuana as well as its legal standing in key states.
Have gained the knowledge of what is on the horizon as far as medical marijuana and where the legalization is taking claims management.
Understand what medical marijuana is, what it is used for and the different types of administration of the drug.
Have ideas of how to manage a claim where medical marijuana is present.
Understand the unique importance and role that urine drug monitoring plays in the management of a claim where medical marijuana is present.
Session 5 - Malpractice and Never Events
- Speakers:
Mark Gelman, Eraclides Gelman Hall Indek Goodman Waters & Traverso, LLC
Albert Luther, Suite 200 Solutions
Thomas Rockwell, Rockwell & Kaufman, LLC
Healthcare delivery is complex and errors are sometimes made. Healthcare errors are further complicated when they occur during the treatment of a work-related injury. Determining what medical issues are related to the injury and what are related to a malpractice event can be challenging.
Upon completion of this course, participants will:
Understand the interplay of malpractice and workers’ compensation
Placing liens in the case of malpractice
Understand the role of the independent medical examination
Develop strategies for understanding when malpractice has occurred
Understand subrogation rights and statutes of limitations
Session 6 - Chronic Pain Claims: Narcotics are Part of the Problem
- Speakers:
Robert J. Barth, Barth NeuroScience
William Pipkin, Austill, Lewis, Pipkin & Maddox, P.C.
David Randolph, Midwest Occupational Health Management
While intended to help with chronic pain, in many cases narcotics have become part of the problem. Chronic pain and claims related to chronic pain is a complex area that requires an educated professional to evaluate and manage each case. At the conclusion of this course, participants will be able to:
Understand the scientific standards for evaluating claims of injury-relatedness
Understand healthcare standards for evaluating claims of disability
The role of narcotic pain medications as a cause of chronic pain
The lack of credibility for most of the common treatments
Credible treatment
Managing chronic pain claims
Session 6 - Complex Medical Litigation - Hepatitis C, RICO Action and Off-Label Drug Use
- Speakers:
Robert Baer, Arrowpoint Capital
David Humiston, Sedgwick, LLP
Kathleen Klaus, Maddin, Hauser, Roth & Heller, PC
Roxanne Wilson, Reed Smith LLP
New exposures are being created in jurisdictions involving medical networks, plans, physician groups, and the utilization of off label prescription drugs. This course engages the learner by challenging them to think about how creative opponents can develop new causes of action and the steps they can take pro-actively to defend against such litigation.
After completion, participants will be able to:
Define and understand RICO
Understand that RICO litigation can be found in Workers’ Compensation matters and the impact on third party administrators, insurance companies, and independent medical providers
Develop an awareness of how electronic communication can impact a RICO allegation and the discovery costs associated with such litigation
Articulate where RICO litigation has been filed and the status of the matters
Have an awareness of off-label prescription drug promotion and the confusing maze of regulations that can affect the duties of both the manufacture and prescribing physician
Recognize the jurisdictions that have addressed the duties of the manufacture and prescribing physician
Identify the new wave of litigation involving National Health Plans and the conduct of Physicians
Understand that physician networks are not immune from liability where the plan did not have knowledge of inappropriate provider conduct
Articulate the issues surrounding vicarious liability, the duty to audit and inspect plan facilities, and provider credentialing
Session 7 - Imaging Update - The Radiology IME
Medical records that include imaging reporting from Radiologists can be daunting. This course will demonstrate the importance of the Radiological IME Report. Factors including the interpreting physician, image quality, interpretation variability, attributions of causality and application of defined consensus terminology allow a better understanding of claim handling. We will also introduce the use of evidence based medicine and guidelines.
After completion, participants will better understand:
Importance of processing and analyzing information in radiologist records and reports, enabling more educated determination of the significance attributable to the claim.
Depending upon the type and severity of a claim, the timing and type of imaging may or may not be essential.
Explaining and illustrating the utilization of evidence based medicine and guidelines as they relate to radiology.
Session 7 - Obesity - The New Disease
- Speakers:
James Cook, Frye Regional Medical Center
William Pipkin, Austill, Lewis, Pipkin & Maddox, P.C.
R. Douglas Vaughn, Deutsch Kerrigan, LLP
Obesity is a healthcare epidemic and the fastest growing health issue in the United States. It increases costs for medical care, contributes to lost work time and creates potential for discrimination/harassment. Managing any medical claim related to a person who is obese is complicated by the many related health issues.
Upon completion of this course, participants will be able to:
Define obesity and morbid obesity
Know the healthcare issues related to obesity
Understand weight-loss surgical options, risks, consent and outcomes
Understand what protections people who are obese have under the law
Better manage claims involving claimants who are obese
No Learning Objectives Available
