Frequently Asked Questions

General Questions

  • MSPA Registration

    MSACP Registration

  • Each of the learning modules (10 for MSPA; 11 for MSACP) include an instructional video, transcription, presentation materials and a quiz to verify comprehension. Upon completion of all modules, students will then complete a final exam. The MSPA exam is comprised of 100 questions and the MSACP program includes 2 final exams: Exam #1 with 125 questions and Exam #2 with 30 scenario-based questions designed to simulate real-world MSA writing and allocation.

    Students are strongly encouraged (and expected) to thoroughly prepare for the final exams. While the exams are conducted online and allow the use of notes and course materials, the time limit does not permit researching each question individually. To ensure success, students should study in advance, as only 2 attempts will be provided.

    Students must achieve a final exam score of at least 80% AND a cumulative GPA of 80% or higher for all quizzes and final exams to receive your subsequent certification.

  • Both certifications remain valid for a period of 2 years. Thereafter, students must re-certify by obtaining 6 sanctioned continuing education credits and pay the requisite recertification fee.

  • MSPA - $1195 | MSACP - $995

    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.

    Recertification:

    MSPA - $595 | MSACP - $495

  • For inquiries → click here to email us

  • For licensed lawyers and/or nurses, you may be eligible to receive continuing education credits for successfully completing our programs. For licensed lawyers, any request for CLEs must be made by you to your state bar association along with payment by you for any associated fees, 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 along with payment by your for any associated fees, 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 or MSACP Certificate of Completion (whichever applies); documentation requirements may vary.

MSPA

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  • Medicare Secondary Payer (MSP) refers to situations where 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, it means another entity (e.g., a liability, no-fault, or workers’ compensation carrier or self-insured) has primary responsibility for paying for such items and services before Medicare.

  • 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.

  • The Medicare Secondary Payer Accreditation (MSPA) course is comprised of 10 virtual, on-demand learning modules covering Medicare Secondary Payer compliance topics such as Medicare Set-Asides, Conditional Payments, and Section 111 Mandatory Insurer Reporting as applicable to workers’ compensation, general liability, and no-fault payers/plans. MSPA is a professional certification achieved by individuals who successfully complete all learning modules, achieve a score of at least 80% on the 100 question final exam AND a cumulative GPA of 80% or higher on all quizzes and the final exam.

  • 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.

    • Introduction, Background, and Overview: Basics, CMS Submission, Review Thresholds

    • Medicare Set-Asides, Part I: Basics, CMS Submission, Review Thresholds

    • Conditional Payments, Part I: Conditional Payments 101, CPLs, CPNs, & Deadlines, Medicare vs. Advantage Plans

    • Medicare Mandatory Insurer Reporting, Part I: Section 111 Essentials, TPOC & ORM Basics, Query Process

    • Landmark MSP Cases: MSP Legal Framework, Landmark Cases, Federal vs. State Issues

    • Medicare Set-Asides, Part II: Non-Submits, Evidence-Based Medicine, Re-Reviews & LMSAs

    • Conditional Payments, Part II: Treasury Involvement, Demand Letters & Offsets, Litigation Risks

    • Medicare Mandatory Insurer Reporting, Part II: Civil Monetary Penalties, Safe Harbors, Appeals & Compliance

    • Navigating Settlements: Beneficiaries vs. Expectation Claimants, Conditional Payments, Settlement Language

    • Medicare Set-Aside Administration: Self vs. Professional Admin, CMS Guidelines, Compliance Risks

    • MSPA is the most modern and flexible certification available in the MSP compliance space. Students of MSPA may take the course anywhere, anytime on any device at their own pace. This alleviates the potential need to take time away from work, which significantly benefits the student as well as their employer.

    • The curriculum incorporates additional timely update modules (for no additional fee) as changes occur within the MSP compliance industry, and students receive email notifications when the new content is posted.

    • Students of MSPA are able to network and receive updates from MSPA faculty.

    • MSPA students are not required to write a Medicare Set-Aside (MSA) at the end of the course to receive certification. MSPA recognizes 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 Mandatory Insurer Reporting.

    • This program is comprised of comprehensive coursework covering Medicare Set-Asides, Conditional Payments, and Section 111 Mandatory Insurer Reporting.

    • MSPA’s fully on-demand content allows students to proceed at a pace most convenient for them, which also allows students and/or program directors to save time and money otherwise associated with travel expenses, etc.

    • There is an inherent ability to communicate directly with course professors if questions arise.

    • No advanced knowledge of MSP is required, and all of the coursework is approachable which is perfect for all knowledge levels.

    • The curriculum incorporates additional timely update modules (for no additional fee) as changes occur within the MSP compliance industry, and students receive email notifications when the new content is posted.

    • Approved continuing education courses are offered via the online platform and on occasion via partner organizations.

MSACP

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  • An MSA is a financial agreement that allocates a portion of a claimant’s settlement dollars to pay for injury related future medical services. The funds appropriately exhausted before Medicare will pay for treatment related to the claimed injury as a secondary payer.

  • All parties in a workers’ compensation case have significant responsibilities under the Medicare Secondary Payer (MSP) laws to reasonably recognize Medicare’s future interests when resolving claims wherein the claimant needs future care related to the claimed injury.  The Medicare recommended and MSP industry’s preferred method to reasonably recognize Medicare’s interests via use of an MSA. 

  • The MSACP certification requires completion of 11 on-demand online courses on the history, principles, and development of a Workers’ Compensation MSA. The course offers a comprehensive exploration of the history of MSP, detailed insights into constructing an MSA, guidelines for proficiently analyzing medical records and prescription histories, a comparison between traditional and evidence-based methodologies, approaches to minimize medical cost drivers, instructions on submissions to Medicare’s voluntary review program, and best practices for professional administration. Upon completing this course, students will be equipped to develop and write an MSA as well as grasp the intricate details associated with the MSA process and possible submission to Medicare’s voluntary review program for approval. This professional certification is achieved by individuals who successfully complete all learning modules, achieve a score of at least 80% on the 2 final exams AND a cumulative GPA of 80% or higher on all quizzes and the final exam.

  • This program caters to individuals with various levels of experience with MSAs, from beginners to seasoned experts. Individuals who would benefit from taking MSACP include, but are not limited to, nurses, attorneys, lifecare planners, and claims professionals. MSACP makes understanding MSAs approachable, meaning even those without any prior experience will benefit from completing the MSACP course.

    1. Introduction to MSP

    2. MSA Overview

    3. Medical Record Review

    4. Prescription Overview

    5. MSA Deeper Dive

    6. Non-Submits/Evidence-Based MSA’s

    7. Medical Cost Projection and Non-Covered Items

    8. Mitigation Strategies

    9. CMS Submission, Reconsideration and Amended Review

    10. MSA Administration

    11. Sample MSA Allocation

  • Students are not required to complete an MSA to obtain an MSACP certification. The MSACP faculty do an excellent job of breaking down the components of an MSA in detail. You will learn how to complete an MSA from the time of referral all the way up to the time of submission to Medicare’s voluntary review program. We thoroughly go over:

    • Medical records and payment history review

    • Extracting information from the medical records and crafting a medical summary

    • Allocating and pricing future medical care, including prescription medications (evidence-based and traditional allocations)

    • Denied and non-covered treatments

    • Medical mitigation strategies

    • Submissions to Medicare’s voluntary review program

    • Professional administration options

    Additionally, the final exam has specific scenarios and questions tailored to allocating an MSA.  These questions provide the same experience to test a student’s knowledge as completing an MSA.

    • MSACP is the most modern and flexible certification currently available in the MSP space related solely to allocations. Students of MSACP may take the course anywhere, anytime on any device at their own pace. This alleviates the potential need to take time away from work, which significantly benefits the student as well as their employer.

    • MSACP students are not required to write a Medicare Set-Aside (MSA) at the end of the course to receive certification.

    • The curriculum incorporates additional timely update modules (for no additional fee) as changes occur within the MSP compliance industry related to allocations, and students receive email notifications when the new content is posted.

    • Students of MSACP are able to network and receive updates from MSACP faculty.

    • This program is comprised of comprehensive coursework covering Medicare Set-Asides, Conditional Payments, and Section 111 Mandatory Insurer Reporting.

    • MSPA’s fully on-demand content allows students to proceed at a pace most convenient for them, which also allows students and/or program directors to save time and money otherwise associated with travel expenses, etc.

    • There is an inherent ability to communicate directly with course professors if questions arise.

    • No advanced knowledge of MSP is required, and all of the coursework is approachable which is perfect for all knowledge levels.

    • The curriculum incorporates additional timely update modules (for no additional fee) as changes occur within the MSP compliance industry, and students receive email notifications when the new content is posted.

    • Approved continuing education courses are offered via the online platform and on occasion via partner organizations.