Rise

Michelle Allan Partner

Gordon Rees Scully Mansukhani

Rosemarie Arellano Director of Recovery Outreach

Performant Corp

Rose Arellano is a business process outsourcing (BPO) manager with 19 years of health care experience, including more than 18 years in operations management. She builds high-performing teams to achieve contractual objectives and financial goals. As a Six Sigma-trained director of health care billing and recovery for Performant Corporation, Ms. Arellano oversees daily office operations for a team of three managers and 55 staff for the Medicare Secondary Program. She uses her strong communication skills to foster collaboration across teams at all organizational levels. Ms. Arellano provides innovative leadership and sound solutions to complex problems to deliver quality results for customers. As a BPO operations manager with CGI Federal Commercial Repayment Center (CRC), Ms. Arellano oversaw $316 million dollars recovered for the Medicare Fund for fiscal years 2014-2016. She specializes in contract management, process improvement, risk management, issue resolution, resource management and development, and relationship management.

Ms. Arellano’s background and expertise includes:

• Increasing operational effectiveness using Lean Six Sigma methodology
• Documenting standard operating procedures and business processes
• Analyzing and refining procedures to meet business needs
• Developing operational metrics and measuring performance
• Working with project start-ups and wind down
• Managing payroll, accounts payable, and accounts receivable
• Overseeing staff training, staff development, and conflict resolution
• Educating staff on state and federal statutes, rules, and regulations
• Implementing innovative programs to increase staff loyalty and reduce turnover

John Cattie Founding Member

Cattie P.L.L.C.

John V. Cattie, Jr. is one of the nation’s most well-respected Medicare Secondary Payer (MSP) legal scholars.  Cattie received his BA from the University of North Carolina and his JD/MBA from Villanova University.

Cattie has personally reviewed or overseen the review of over 12,000 distinct fact patterns for Medicare Set-Aside (MSA) purposes. Federal and state court opinions such as Smith v. Marine Terminals of Arkansas, Tye v. Upper Valley Medical Center, and Doe v. Company X cite his analysis favorably. In each case, his client’s future medical exposure was minimized or extinguished based on how Cattie analyzed the MSA issue. In the Doe case, that difference amounted to a 90% or almost $900,000 reduction in future medical exposure for his client, the injury victim. The Doe Court stated the following in its opinion: “The Court finds that Mr. Cattie’s analysis is more credible [than his opponent’s] in the liability context.” To date, Cattie has been able to save his clients over $27 million in MSA exposure.

Cattie actively participates in many organizations nationwide, including NAMSAP, RIMS, CLM and DRI. For DRI, Cattie recently concluded a four (4) year term as the Chair of DRI’s Medicare Secondary Payer Task Force. During that time, he served as Executive Editor for DRI’s Defense Practitioner’s Guide to Medicare Secondary Payer Issues. He also served as a co-author for the American Bar Association (ABA) treatise “What Are … Medicare and Medicaid Secondary Payer Laws?”

Cattie is the Managing Member of Cattie, P.L.L.C. His law firm is dedicated to minimizing/extinguishing a client’s future medical exposure under the MSP Act. He focuses his law practice on MSA issues, providing legal opinions regarding MSA requirements, a client’s future medical exposure under the MSP Act and proper MSA funding. His firm also handles Medicare conditional payments, writes traditional medically based MSAs, and medical cost projections among other services. For more information, please see www.cattielaw.com.

Lavonya Chapman, RN, Esq. Associate General Counsel, Settlement Solutions

UnitedHealth/Optum Workers Compensation and Auto No-Fault

As Associate General Counsel at Optum Settlement Solutions, Lavonya Chapman is medicolegal consultant on Medicare Secondary Payer (MSP) claim compliance issues, including Mandatory Insurer Reporting, ICD injury code reporting, Conditional Payment Resolution, Medicare Set-Aside Allocations, with or without CMS approval as well as professional administration of medical custodial accounts.

Prior to joining Optum in 2014, Lavonya served as director of MSP compliance for Arthur J. Gallagher & Company for 14 years. She was also the claim director for a new liability and medical malpractice captive in which nearly all the claimants/plaintiffs were Medicare beneficiaries or dual eligible. Additionally, Lavonya has experience in private law practice, litigating medical malpractice, premises and auto liability claims as well as workers compensation cases. She was a field case manager for a national commercial casualty insurer. She taught pharmacology many years at the University of Alabama at Birmingham, and was a utilization review and HIPAA consultant for the Alabama Hospital Association.

Lavonya presents and blogs on all aspects of the Medicare Secondary Payer Act as it pertains to claim compliance involving all claim types. She is a licensed registered nurse, an attorney licensed in both Alabama and Florida, a certified Medicare Secondary Payer Professional, and a member of the National Alliance of Medicare Set-Aside Professionals, (NAMSAP).

Frank Fairchok Vice-President, Medicare Compliance Reporting, Settlement Solutions

UnitedHealth/Optum Workers Compensation and Auto No-Fault

Frank Fairchok is Vice President of Medicare Compliance Reporting and Development for Optum Settlement Solutions. He has nine years of experience in MMSEA Section 111 reporting and Medicare Secondary Payer compliance. In his expanded role, Frank helps formulate strategic direction and drive new product and technology-driven solutions for our clients. Frank previously managed MedicareConnect℠, Optum’s proprietary platform for Non-Group Health Plan reporting requirements mandated by Section 111 of the Medicare, Medicaid and SCHIP Extension Act of 2007.

With almost thirty years of experiencing crossing over the financial, telecommunication and workers’ compensation industries, Frank has a deep background in contract administration, order management, billing, revenue recognition and data management. He has worked for global multinational companies such as AT&T, Orange, and now the UnitedHealth Group family of companies at Optum.

Frank knows the work his team performs for Optum clients in the area of Section 111 reporting plays a critical role in the Medicare Secondary Payer processes. He realizes the data must reflect an accurate picture to not only protect Medicare’s interest in the claim, but also to protect his clients from absorbing costs beyond their legal responsibility. Frank appreciates having a team of people handling the day-to-day operation of MedicareConnect with dedication, tenacity and, very importantly, a deep understanding of this area of Medicare compliance. He is also grateful that his team has been with the MedicareConnect program since the go-live of reporting to Medicare in 2011—or earlier. In a world of call routing and inconsistent customer service, our clients have the comfort of hearing the same voices and knowing they are in great hands when they need to contact us.

Frank has a Bachelor of Applied Science in Technology Management from St. Petersburg College and resides in Tampa, FL.

Robert Finley Partner

Hinshaw & Culbertson LLP

Robert Finley's national civil defense litigation and trial practice focuses on defending businesses and insurers in high value and complex matters involving specialized tort, employment, and healthcare issues.  Robert also has a wealth of experience in Medicaid third party liability and Medicare secondary payer compliance matters, offering elite counsel to primary payers and other interested parties under auto, property/casualty, and no-fault policies, as well as workers' compensation insurance plans.  Robert joined Hinshaw in 2003 and became a partner in 2008.  He is admitted to practice in both Illinois and New York, plus Robert has been admitted pro hac vice in multiple jurisdictions including Connecticut, Massachusetts, New Jersey, Oregon, Pennsylvania, Texas, and Washington D.C.  Prior to pursuing a career in law, Robert worked in the sports radio industry as a producer and reporter covering major spectator events, including the Super Bowl, NBA Finals, Kentucky Derby, U.S. Open Golf Championship, NCAA men's and women's basketball tournaments, and the 1996 Summer Olympics in Atlanta.

Rafael Gonzalez. Esq. President, Settlement Solutions

UnitedHealth/Optum Workers Compensation and Auto No-Fault

Rafael Gonzalez is President of UnitedHealth Group/Optum Workers
Compensation and Auto No-Fault Settlement Solutions, where he is
responsible for all aspects of Medicare and Medicaid compliance issues,
including Mandatory Insurer Reporting, Conditional Payment Resolution,
Medicare Set Asides, MSA Post Settlement Administration, Medicaid Third
Party Lien Reimbursement, Special Needs Trusts, and SNT Administration.
Rafael has over 35 years of experience in the auto, liability, no-fault, and
workers’ compensation insurance industries. He has written extensively on
liability, workers’ compensation, social security, and Medicare/Medicaid
issues. He has also taught these subject matters at several law schools and
medical schools in Florida. He continues to lecture throughout the country on
these topics, as well as the interplay of these with the Affordable Care Act.
Over the last 30 years, Rafael has been recognized by City of Tampa Mayor
Pam Iorio and Hillsborough County Commissioner Ronda Storm for his work
on behalf of the Hispanic community in Tampa and Hillsborough County. He
was awarded the Governors Appreciation Award by Governors Bob Martinez
and Jeb Bush for his work in improving Florida’s workers compensation
system. He was awarded the Governors Leadership Award by Governor
Charlie Crist for his work in improving Florida’s Medicaid system. He was
awarded Florida’s Distinguished Service Award by US Senator Mel Martinez
for his work and advocacy to improve the US Social Security disability
system. He has also been awarded the Presidential National Service Award by
President George W. Bush for his work on improving the Medicare Secondary
Payer system through the addition of the Mandatory Insurer Reporting
process, and by President Back Obama for his work and support of the
Affordable Care Act.
Rafael is active on social media. He is owner and manager of several
LinkedIn groups, including Medicare and Medicaid Compliance (7,500
members), Medicare Mandatory Reporting, Medicare Conditional Payments,
Medicare Set Aside Allocations, Medicare Set Aside Administration (3,500
members), Florida Workers Compensation (2,500 members), Social Security
Benefits (1,500 members), Hispanic Issues and Demographics (500
members), and Affordable Care Act Compliance (250 members). Rafael is
also active on Twitter with 2,000 followers and Facebook with 1,000 friends.
Born in Havana, Cuba, Rafael and his family escaped communism to Madrid,
Spain, and ultimate immigrated to the US. He owes everything he has
achieved to his mother, Miriam Lera. Her love and sacrifice have allowed him
to live in freedom, succeed and prosper. Rafael graduated from Miami Senior
High School, received his Bachelor of Science degree from the University of
Florida and his Jurisprudence Doctorate degree from the Florida State
University. Go Noles!!! FSU!!! He lives in Lithia, Florida with the love of his
life, his wife Lisa, and his greatest pride, his two sons, Alex and Andres.

Heather Hatch Partner

The Chartwell Law Offices, LLP

Heather L. Hatch is the Managing Partner of the Palm Beach Gardens office of Chartwell Law specializing in Insurance Defense with more than 19 years’ experience.  She focuses on workers’ compensation defense, employment related defense, general liability, foreclosure actions on behalf of lenders and Medicare Compliance.  Ms. Hatch is a recognized lecturer of the current issues and “hot topics” of law and ethics in employment and Medicare related claims.  She has admittance with the Florida Bar since 2000 and the Tennessee Bar since 2011.  Ms. Hatch’s education includes University of Florida College of Law, Gainesville, Florida, Juris Doctor: May 2000, cum laude, Wittenberg University, Springfield, Ohio, Bachelor of Arts, cum laude; Georgetown University, Washington, DC, Honors Political Science and Languages.  Ms. Hatch also has affiliation with the United States District Association since 2001, Court for the Northern District of Florida since 2001; United States District Court for the Southern District of Florida since 2001; United States District Court for the Middle District of Florida since 2001, The United States Court of Appeals for the Eleventh Circuit since 2001, Palm Beach County Bar Association, American Bar Association, RIMS Associate Member, Friends of §440, NAMSAP, and FAWL.  She is also fluent in French and literate in German.  

Suzanne Jordan SCHIP Compliance Manager

Broadspire

SCHIP Compliance Manager:

Early involvement since 2009 in the MMSEA Section 111 Mandatory Insurance Reporting “MIR”

Internally manage and track Conditional Payment progress across the country for our organization and clients

8 years of experience in technical and soft skill training

Manage a team of “SCHIP” experts responsible for reporting on behalf of a large client base and a high number of Responsibility Reporting Entities “RRE’s”

Experience working with The Center for Medicaid/Medicare Services “CMS” on matters related to reporting including the development of written recommendations to CMS

Well-versed with the “CMS User Guide” that defines the rules and regulations for MMSEA Section 111 Reporting

Understands and develops internal training to support claim adjusters in SCHIP reporting regulations

Extensive knowledge on issues related to Medicare Beneficiary denials

15 years of experience as an IT Manager within the Insurance Industry including managing large scale infrastructure support, projects and implementation of new technology within Fortune 500 companies

Rachel LaMontagne Partner

Shutts & Bowen

Rachel LaMontagne is a Partner in the Class Action and Mass Litigation Group of Shutts & Bowen, LLP. Rachel maintains a diverse legal career, with a focus on personal injury protection litigation in the class action setting, as well as actions arising under the Medicare Secondary Payer Act.

Rachel serves as lead counsel for various insurance carriers with regard to defense of primary payers’ claims for reimbursement of conditional payments under the MSPA. In addition to defense on the merits, Rachel also defends against class certification of these MSPA matters.

Ms. LaMontagne received her JD from St. Thomas University School of Law in Miami, Florida and has been admitted to practice in Florida since 1996. She is admitted to practice before the Florida Supreme Court, the United States Court of Appeals for the Eleventh Judicial Circuit, the United States Bankruptcy Court for the Southern District of Florida and the United Stated District Courts for the Southern, Middle and Northern Districts of Florida.

Jason Lazarus Chief Executive Officer

Synergy Settlement Services

Mr. Lazarus is the founder and Chief Executive Officer of Synergy Settlement Services.  Synergy offers healthcare lien resolution, Medicare secondary payer compliance services, pooled trust services, settlement asset management services and structured settlements.  He is also the managing partner and founder of the Special Needs Law Firm; a Florida law firm that provides legal services related to public benefit preservation, liens and Medicare Secondary Payer compliance.  Jason received his B.A. from the University of Central Florida and his J.D. with high honors from Florida State University. He received his LLM in Elder Law with Distinction from Stetson University College of Law.  Mr. Lazarus is a Medicare Set Aside Consultant (MSCC) certified by the International Commission on Health Care Certification.  His written work has been cited, as authoritative on Medicare compliance, by the Supreme Court of Florida and the United States Southern District of Florida.  

Vanessa Lipsky Partner/Section Lead Medicare Compliance Department

Eraclides Gelman

Vanessa Lipsky received her Bachelor’s Degree with Honors from the University of Central Florida in 2004, and her law degree from Stetson University College of Law in 2007. During law school, she served as the Florida Regional President of the Hispanic National Bar Association – Law Student Division (2006-2007) and President of Stetson’s Hispanic Bar Association (2006-2007). Upon graduation, Vanessa was recognized with the Thomas E. Penick Jr. Award for Community Service. Following graduation, Stetson invited her to serve a three-year term on its Lawyers Advisory Council (2009-2012). The University of Central Florida’s Burnett Honors College selected her for its 2010 Professional Achievement Award. Vanessa began her career in the workers’ compensation field as a paralegal for prominent attorneys from 2003 to 2007, and is now committed to practicing in the area of workers’ compensation defense. She is especially well versed in calculating social security offsets and PTD supplemental benefits. In 2009, Vanessa completed the University of Florida’s Course in Medicare Set-Aside and was designated by the Commission on Health Care Certification as a Medicare Set-Aside Consultant – Certified.

Heather Schwartz Sanderson Chief Legal Officer

Franco Signor LLC

Over the past 10+ years, Heather has become nationally recognized as one of the foremost and cutting-edge legal experts in Medicare Secondary Payer Compliance. An avid blogger and national speaker, Heather is a regularly published author and national speaker on MSP compliance. Her articles have been featured in publications such Risk & Insurance, Workerscompensation.com, Defense Research Institute (DRI), and Claims and Litigation Management (CLM) Alliance Magazine.  

Currently serving as Franco Signor’s Chief Legal Officer, Heather leads corporate Medicare and Medicaid Secondary Payer compliance initiatives for the organization and remains directly engaged with Franco Signor’s TPA and carrier-based clients. Heather is charged with the drafting and negotiating of corporate contracts, the definition and development of corporate policies and provides continuing counsel on all corporate legal matters. Heather also oversees and directs Franco Signor’s Legal and Human Resources Departments.   

Prior to joining Franco Signor, Heather previously served as lead counsel for Optum (formerly Helios)’s MSP division as well as Corporate Counsel for Gould & Lamb (now known as ExamWorks Clinical Solutions). Heather has a Juris Doctorate degree from St. Thomas University School of Law and an undergraduate degree in Political Science from The University of Central Florida.  

Heather is a recipient of a 2018 Business Insurance Break Out Award. She was also awarded a Best Medicare Set-Aside/Settlements Blog for the years 2016-2019 by WorkersCompensation.com. 

Heather has been active in lobbying for MSP/insurance legislative reform since 2011, both through the Medicare Advocacy Recovery Coalition (MARC) as well as leading Government Affairs efforts for Franco Signor and its clients. Additionally, Heather also serves as an Ambassador for the Women to Watch Foundation, a 501(c)(3) for humanitarian initiatives. 

Monica Williams MSP Compliance Manager, Innovative Claims Strategies, CEO/President

Medicare and Workers Compensation Consultants

Monica Williams has over 25 years of Managed Care and Workers Compensation experience. She is currently the Medicare Compliance Manager for Innovative Claims Strategies (ICS) where she has oversight of the Medicare Set Aside Program which includes CMS Legal Submission and Conditional Payment Resolutions. As Manager she has developed and implemented the Medicare Compliance Department internal workflows. She was formerly the District Manager for Georgia and then the National Catastrophic Program Manager for Intracorp. She is a graduate of Jacksonville State University where she earned a B. S. In Biology/Sociology then a B. S. In Nursing.

Monica is also the President of MWilliams Consulting (MWC) a Southeast Regional Case Management Company which specializes in Catastrophic Field Case Management, Life Care Plans and Complex Case Reviews for the past 10 years. Area coverage of Georgia, Alabama, Northern Mississippi, Carolinas, Southern Tenn and Florida.

She is a member of American Association of Nurse Life Care Planners, Board Member for the National Association of Medicare Set Aside Professional (NAMSAP). She is a member of the Annual Conference Committee, Liability Committee and Co-chair of Membership Committee for NAMSAP. She enjoys teaching nurses the case management process and assist to develop new nurses in the case management area. Monica has hosted webinar trainings to large third-party payer and employer groups on Medicare Secondary Payor Compliance. She is known as a speaker on Case Management across the continuum for all lines of business, Medicare Set Asides and Medicare Secondary Payor Compliance.