1. Healthcare

2015 Regional Meeting
January 29, 2015
Confirmed Speakers
Rey Alvarez
Rey (Reinaldo) Alvarez is the Managing Attorney for the Workers’ Compensation and Medicare Compliance Division of
Luks, Santaniello. He also serves as the WC Committee Chair for the Florida Defense Lawyers Association (FDLA).
Martindale­Hubbell and his peers have also rated him AV® Preeminent™. Rey has substantial WC experience defending
employers, insurance carriers, tpa's, government entities and self­insureds throughout Florida. He also has more than a
decade of experience in preparing Medicare Cost Projections, Medicare Set­Asides and Conditional Lien negotiations
with CMS. Rey handles all firm wide conditional lien negotiations. Prior to working at Luks, Santaniello, Rey managed a
Medicare Reporting and Set­Aside Department with his last firm.
Rey authored and published a book on the new Medicare Reporting and MSA requirements. More recently, he co­
authored with Dan Santaniello, a Medicare White Paper that was presented at the 15th Annual Florida Liability Claims
Conference and was published in the FDLA issue of 'Trial Advocate Quarterly' (Volume 30, Number 4, Fall
2011). Rey also wrote an article on “Reducing the Cost of Funding a Medicare Set­Aside” that was published in the
Florida Bar Workers' Compensation Section 'News & 440 Report' (Summer 2011). A.M. Best released an Insurance Law
Podcast (2012) featuring Dan Santaniello and Rey Alvarez discussing Medicare Compliance issues.
Rey spoke in January 2014 at the NAMSAP Regional Conference on WC MSA trends and impact, reporting and
conditional liens. He was a featured speaker at a Medicare Lien boot camp sponsored by the National Business Institute
in November 2013. Rey was a speaker at the American Academy of Disability Evaluating Physicians on WC Impairment
Ratings and Impairment Benefits. He also spoke in an AM Best Insurance Law pod cast on the SMART Act.
Rey also possesses substantial knowledge of the Social Security Disability law and has represented all types of Social
Security Disability matters. He also writes a blog on current Workers' Compensation case law and important decisions. It
can be viewed at http://floridaworkerscomp.blogspot. Rey works out of the Miami office and directs the assigned teams
in Jacksonville, Tampa, Orlando, and Tallahassee.
Monika Boswein, INS, AIS, AIC, CMSA
Monika Boswein is a Claims Consultant for ACUITY, a Mutual Insurance Company and has been with the company since
1991. Monika is responsible for Project Management, Coverage Analysis, Training, Auditing, and Medicare Compliance.
She was previously employed as a Senior Inside Claim Representative for ACUITY. Monika has an Associate in General
Insurance, Associate in Claims and is a Certified Special Master Arbitrator.
Brian M. Chance, MBA, CPCU, AIC
Brian Chance holds his Bachelors of Science in Management from Rutgers University, and his masters of Business
Administration from Drexel University.
Brian has been with ECBM, Inc. & The Graham Company from 1991 to 1995 Graham., and ECBM since 1995. Brian has
been a Commercial Insurance Broker for 20+ years, with concentration in claims management and oversight. Brian
currently oversees the handling of all of the workers compensation and liability claims for several different clients. These
clients annually report over 12,000 claims worth over $60,000,000 each year all over the country and to different degrees
retain liability for the payment of the first several hundred thousand dollars of each claim. Over the course of my career
I’ve been responsible to oversee the handling of at least 25,000 workers compensation and liability cases all over the
country.
On a daily basis Brian am responsible for establishing claim handling procedures and guidelines, reserve and settlement
authority, auditing claim files, advising adjusters and defense counsel on strategy, deciding which strategy to employ,
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recommending investigations, selection of service providers including TPA’s, investigators and medical case management
and repricing companies. All of the above are done to assist the client with lowering the cost of their claims and ensuring
compliance with generally accepted claim handling procedures.
For the 3 years prior to Graham and ECBM, Brian was a Claims representative for CIGNA and ESIS in their Marlton, NJ
office.
William A. Delaney, MSCC
William A. Delaney is a partner at Nyhan Bambrick Kinzie & Lowry focusing on Workers’ Compensation and Employer
Liability and Medicare Secondary Payer Compliance and Medicare Set-Asides. Prior to joining Nyhan Bambrick Kinzie &
Lowry, Mr. Delaney held positions as assistant defender for the Office of the State Appellate Defender, Second District in
Elgin, Illinois; Law Clerk to Justice Marvin D. Dunn, Illinois Appellate Court, Second District, Geneva, Illinois; Associate at
Linder, Speers & Reuland, P.C.; and the Senior Staff Attorney at Hartford Insurance Company, concentrating on defense of
Workers’ Compensation claims and defense of personal injury cases. Mr. Delaney received his Bachelors of Administration
in History from the University of Notre Dame and J.D. Cum Laude from New England Law. Mr. Delaney holds memberships
in the Workers’ Compensation Lawyers Association and NAMSAP.
Rasa E. Fumagalli
Rasa Fumagalli holds a law degree from IIT’s Chicago Kent College of Law with an undergraduate business degree from the
University of Illinois. Prior to joining Protocols, she spent over twenty years specializing in workers’ compensation defense
work in the Chicago area. She has worked for private firms as well as in-house counsel for several insurance companies.
Rasa oversees quality control in Protocols’ product line and is an active member of the Evidence Based Medicine
Committee of the NAMSAP trade group. She is admitted to practice law in the State of Illinois and holds a Medicare SetAside Consultant Certification.
Roy A Franco
Over the past two decades, Roy A Franco has emerged as one of the principal architects of policies and practices that
define the world of Medicare Secondary Payer (MSP) compliance. From his experience as Director of Risk Management for
Safeway, Inc. from 1993-2010, he realized the need for greater clarity and efficiency in matters related to Medicare
compliance. Pursuant to that realization, he became a serious student of Medicare policy and its impact on risk
management and revenue. This, in turn, prompted him to work for reform of Medicare regulatory policy.
The Medicare Advocacy Recovery Coalition (MARC) became the chosen vehicle for that reform effort. Founded in 2008 by
Franco and other persons interested in Medicare policy, its membership comprises most sectors of the MSP-regulated
community, including plaintiffs, defense attorneys, brokers, trade associations, and third part administrators. The
coalition’s primary mission is to advocate for MSP on behalf of Medicare beneficiaries and companies. Its major
achievement to date is the Strengthening Medicare and Repaying Taxpayers (SMART) law of 2013.
Drawing on his experience with Safeway and MARC, in 2011 Roy Franco and Jeff Signor founded Franco Signor LLC, which
specializes in Medicare compliance. In his capacity as Chief Legal Officer, Roy Franco continues to lead national efforts to
streamline the world of Medicare Secondary Payer compliance. He is the Co-Author of Medicare Secondary Compliance,
which may be found on the Juris Publishing website.
Allison Haley
Allison Haley is an attorney with the firm O'Meara, Leer, Wagner & Kohl, P.A. She concentrates her civil litigation practice
in the areas of Medicare Secondary Payer compliance, general liability litigation, and worker's compensation. She speaks
nationally on the issue of Medicare Secondary Payer compliance in litigation. She focuses on creating and implementing
Medicare Secondary Payer compliance protocols for national corporate insurance clients. She is a Medicare Set-Aside
Consultant Certified by the International Committee on Health Care Certification.
Daniel W. Hayes
Daniel W. Hayes is a partner with Teague Campbell Dennis & Gorham, LLP’s Asheville, North Carolina office, where his
main area of practice is workers’ compensation. He has been designated a Medicare Set-Aside Consultant Certified
(MSCC) by the International Commission on Health Care Certification. Mr. Hayes presents regularly to national and local
organizations on the topic of Medicare Secondary Payer issues and in 2014 launched the website
www.medicaresettlementsolutions.com to further educate attorneys, mediators, and insurance professionals on the role
of considering and protecting Medicare’s interests in workers’ compensation and liability settlements. Mr. Hayes is
currently licensed in South Carolina and North Carolina. He has been included in Best Lawyers in America for workers’
compensation law from 2010 to the present and was chosen by his peers to be listed as a Rising Star in the South Carolina
Edition of Super Lawyers. He is peer-review rated AV-Preeminent by Martindale-Hubbell. Mr. Hayes earned his B.S.
degree from the University of South Carolina Honors College and his J.D. degree from the University of South Carolina
School of Law.
Anita Hunt
Anita is a graduate of North Carolina Central University and received her legal training at NCCU School of Law. Shortly
after graduation she founded The Hunt Law Firm, PLLC (HLF) in 1998. The Firm started as a general practice representing
clients in both civil and criminal matters. Currently, Anita and her husband Ralph, work and practice together at The Hunt
Law Firm.
Anita has participated in and completed several National Institute for Trial Advocacy (NITA) programs and courses
including Trial Advocacy Skills and Deposition courses. A longstanding member of the North Carolina Advocates For
Justice (formally known as the North Carolina Academy of Trial Lawyers), she has over a sixteen years of courtroom
experience and is licensed to practice in both North Carolina State and Federal Courts.
As an attorney at HLF, Anita’s primary concentration has been in the area of Personal Injury, Workers’ Compensation and
Contract and Settlement negotiations. Having lectured on numerous issues relating to personal injury practices, Anita
considers her niche to be the use of experts, medical or otherwise, to increase or maximize the value of an injury case.
She has also served as General Counsel for various businesses and organizations.
Tracey L. Jones
Tracey L. Jones is a partner with Teague Campbell Dennis & Gorham, LLP’s Raleigh, North Carolina office. She focuses her
practice exclusively in the field of workers’ compensation and has extensive experience defending both insurance
companies and employers throughout North Carolina. She further specializes in defending asbestosis and other
occupational disease claims. In addition to her trial practice before the North Carolina Industrial Commission, she has a
significant appellate practice, having defended numerous workers’ compensation claims before the North Carolina Court
of Appeals and North Carolina Supreme Court. Ms. Jones is a member of the North Carolina Association of Defense
Attorneys, North Carolina State Bar, North Carolina Bar Association, and Wake County Bar Association. She has also been
a member of the North Carolina Bar Association’s Workers’ Compensation Section Council. She has participated in
numerous seminars discussing the North Carolina Workers’ Compensation Act and presented on numerous topics at
seminars and continuing education programs for adjusters. Ms. Jones is a certified Superior Court and workers’
compensation mediator who enjoys educating and representing insurance companies and employers in workers’
compensation claims. She was designated a Medicare Set-Aside Consultant Certified (MSCC) by the International
Commission on Health Care Certification. In 2010, she was designated a Rising Star in the North Carolina edition of Super
Lawyers, and in 2013, 2014 and 2015 she was listed with Best Lawyers in America for Workers’ Compensation-Employers.
Ms. Jones earned the highest (AV-Rated) ranking awarded by Martindale-Hubbell. She received her B.A. degree from the
University of North Carolina at Chapel Hill and her J.D. degree from Wake Forest University.
Marci Moorehead, RN, CRRN, CLCP, CRP, CMAS, MSCC
Marci Moorehead, RN, CRRN, CLCP, CRP, CMAS, MSCC is a legal nurse consultant with 25 years of nursing experience. She
is co-owner of Professional Resource Network, LLC with her husband who is a Certified Professional Coder offering
services including medical record reviews, medical bill review/audit, second opinion medical coding, life care planning, and
Medicare Set-Aside allocations. She has extensive experience in multiple areas of medical legal consulting including
medical records review, life care planning, Medicare Set-Aside allocations, medical cost projections, medical bill
audit/review, expert witness testimony preparation, as well as expert testimony for workers compensation, life care
planning, and medical bill review/audit. Ms. Moorehead holds national board certifications in life care planning (CLCP
since 1998), rehabilitation nursing (CRRN since 1998), medical audit consulting (CMAS since 2010) and Medicare Set-Aside
allocation consulting (MSCC since 2005). She also holds a state certification as a rehabilitation provider (CRP since 1998).
She has reviewed/audited over $50,000,000.00 in medical bills including workers compensation, private health care
insurance, Medicare claims, personal liability, and auto liability. She is a member of the American Association of
Rehabilitation Nursing (ARN), the Virginia Association of Rehabilitation Nursing (VARN), National Alliance of Medicare SetAside Professionals (NAMSAP), and the American Association of Medical Audit Specialists (AAMAS). Ms. Moorehead has
worked as a consultant for most of that time with clinical experience in neonatal care, adult critical care, geriatric nursing,
and rehabilitation nursing. In addition to her clinical experience she has worked as an educator in geriatric nursing
teaching IV certification, CPR, nurse aide certification, and in-service training. Ms. Moorhead has been involved in geriatric
research coordinating and monitoring multiple studies including phase III and phase IV wound care and drug studies for
Marion Laboratories, Coloplast, and Ciba Geigy. She first began working with workers compensation in 1993. First
working as a field case manager then providing legal nurse consulting services such as life care planning, legal nurse
review, medical cost projections, medical bill review, and Medicare Set-Aside preparation. She attended Medipro
seminars for life care planning (120 hour post graduate studies) and Medicare Set-Aside preparation (32 hour program).
Ms. Moorehead has worked with the Veterans Administration preparing independent living assessments for disabled
veterans and serving as a consultant to the vocational case managers. Ms. Moorehead has spoken at the Department of
Veterans Affairs Annual Training for Vocational Case Managers, the American Association of Legal Nurse Consultants,
Central Virginia Chapter Meetings, the American Association of Consulting Pharmacists, and the American Health Care
Association. She serves as an expert witness in workers’ compensation hearings and the civil court system for Virginia as a
life care planner, medical cost expert, medical audit specialist, and medical case manager.
Mark Poplizio, Esquire
Mark Popolizio, Esquire is the CP of MSP Compliance and Policy at ISO Claims Partners. Mark is a nationally recognized
authority in Medicare Secondary Payer (MSP) compliance. Mark practiced insurance defense litigation for ten years
concentrating in the areas of workers’ compensation and general liability. During this time, he developed a national
Medicare practice that included Medicare Set-Asides (MSA) and general MSP compliance. While in private practice, Mark
represented numerous carriers, third party administrators and self-insureds. Since 2006, Mark has dedicated his practice
exclusively to MSP compliance working with carriers, self-insureds, TPAs and other claims professionals in addressing MSP
compliance issues.
Mark is a regularly featured presenter on MSP issues at national seminars and other industry events. He provides
presentations and educational training on a wide array of MSP topics, including Medicare Program Basics, MSAs, Medicare
Conditional Payments, Medicare Part D (prescription drugs), and Section 111 of the Medicare, Medicaid & SCHIP Extension
Act. Mark has authored numerous articles addressing several topics related to MSP matters, including a chapter in the
California Bar CLE publication, Special Needs Trusts: Planning, Drafting and Administration.
Mark also served as Vice President of the National Alliance of Medicare Set-Aside Professionals (NAMSAP) from 20062008. Mark remains active with NAMSAP concentrating on education and legislative matters. He was also a featured
instructor on Medicare and Life Care Planning issues with the former University of Florida/Medipro LLC program.
Mark grew up in Wallingford, Connecticut. He graduated Summa Cum Laude from Quinnipiac University in Hamden,
Connecticut with Bachelor of Science degrees in Legal Studies and Sociology. Mark relocated to South Florida in 1992 to
attend law school at Nova Southeastern University School of Law in Ft. Lauderdale, Florida. While at law school, Mark
served as a Judicial Clerk to the late Honorable John D. Wessel (15th Judicial Circuit, Palm Beach County, Florida) and was a
research assistant for Professor Leslie Larkin Cooney. Mark graduated from Nova in 1995 and is licensed to practice law in
Florida and Connecticut. He resides in Miami, Florida.
Doug Shaw
Doug Shaw is the President of Medivest Benefit Advisors, Inc. and Medivest Allocation Services, Inc. (collectively know as
Medivest). He has written and lectured frequently across the country about issues related to Medicare Set-Asides. Doug
has served as President, CFO and controller for companies ranging from a large Fortune 500 company to an
entrepreneurial growth company. He began his career in the international accounting firm of Price Waterhouse Coopers.
He received his BS in Accounting from Florida State University and Masters in Accountancy (emphasis in tax) from Virginia
Tech. He is a Certified Public Accountant, Certified Management Accountant and Certified Medicare Secondary Payer
Professional. Medivest is a national leader in the professional administration of custodial accounts used in settlement of
liability and workers' compensation cases and in providing Medicare Set-Aside (MSA) allocations that accurately project
the claimant's future medical needs. Doug resides in Orlando Florida.
Thomas Spratt
As Senior Vice President – Technical Operations, Tom is responsible for the Protocols Claims Management Consulting
Group. He oversees assessment of clients’ Medicare compliance programs, training of staff and client settlement
strategies for costly or complex cases involving both Workers’ Compensation and Liability. Tom, as AVP and
Manager, was responsible for the Home Office Workers’ Compensation Claims Examining Unit for Liberty Mutual for 15
years. His expertise spans all state and federal statutory jurisdictions.
Tom has a long record of active involvement in the insurance industry, serving on committees for the Workers’
Compensation Research Institute, the Property Casualty Insurers Association of America , the Strategic Services on
Unemployment and Workers’ Compensation and the National Structured Settlement Trade Association. He is also on the
faculty as a facilitator for the Certified Medicare Secondary Payer designation program (CMSP). Educated at St. Anselm
College in Manchester, N.H., Tom holds a bachelor degree in Economics and Business
Michael E. Westcott
Michael is an associate at Ringler Associates. Michael has expertise in the use of structured settlements in the resolution
of claims involving Medicare Set Asides, Workers Compensation, Long Shore and Harbor Worker Claims, Common Carrier
and Trucking Claims, Complex Medical Claims, Religious Organization claims and Specialty Risk claims.
Michael’s business experience includes 24 years of structured settlement experience having worked for several national
firms. While working for AON Brokerage at their world headquarters in Chicago, Michael served as National Vice President
– Technical Markets prior to joining SFA. Prior to that he served as Sales Manager for JMW Settlements of Washington,
D.C. and was an officer with MWC Settlements of Wisconsin.
Michael received his B.A. from the University of Wisconsin. In addition Michael holds insurance licenses in multiple states.
He is a member of the National Structured Settlement Trade Association and serves as Co-Chair of the Government
Benefits Committee, The Long Shore and Harbor Workers Claims Association, the Trucking Industry Defense Association
and is a Charter Member of the National Alliance of Medicare Set Aside Professionals.