Rise

Rose Arellano Medicare Manager, Claims

Compliance at Markel

Rose Arellano has 12 years' experience with Medicare Secondary Payer (MSP) for Non-Health Group Health Plans (NGHP) and Group Health Plans (GHP) working as a Medicare contractor. She has been working for the past year as an RRE and has a unique perspective and experience from both sides of the table. 

Allison Catalano ERISA Attorney

Cattie & Gonzalez, PLLC

Allison (Allie) Catalano is an accomplished ERISA subrogation attorney. She graduated from St. Mary’s University School of Law in 2015 and has since developed extensive experience navigating the complex intersection of ERISA law, subrogation claims, and personal injury cases. She is dedicated to maximizing recoveries for personal injury claimants. Allie joined Cattie & Gonzalez in June of 2023 and has added her talent for strategically unraveling the intricacies of benefit plans to optimize outcomes for our clients. Her passion is ensuring the best outcomes for the catastrophically injured.

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 $30 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.

Vanessa De Rosa Lipsky, Esq. Partner

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.

Robert J. Finley, Esq. Civil Litigation and Medicare Compliance Counsel  

Hinshaw & Culbertson, LLC

Robert J. Finley is a trial attorney with a wealth of experience in Medicaid third-party liability and Medicare secondary-payer regulatory and administrative matters. He provides elite counsel on recovery and repayment claims to primary payers, and other statutory third parties, under auto, property and casualty, and no-fault policies, as well as workers’ compensation insurance plans. Please read Robert’s full bio at https://www.hinshawlaw.com/professionals-robert-finley.html

Rafael Gonzalez, Esq. President

Medicare & Medicaid Compliance

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 lectures throughout the country on all aspects of Medicare and Medicaid compliance, including Mandatory Insurer Reporting, Conditional Payment Resolution, Medicare Set Asides, MSA Post Settlement Administration, Medicaid Third Party Lien Reimbursement, and Special Needs Trusts.

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.

Recently, WorkCompCentral CEO Kristen Chavez presented Rafael with the Magna Comp Laude Award with Great Honor for his willingness to share his knowledge, experience, and scholastic work with the country’s workers compensation community. Also RISE CEO Ellen Wofford honored Rafael with the RISE Distinguished Service Award for his many years of leadership, scholarship, and professionalism in educating the thousands of professionals who have attended his numerous Medicare and Medicaid programs. And International Association of Industrial Accidents Boards and Commissions President Evelyn McGill awarded Rafael its President’s Award for his leadership and service to the international workers compensation community.

Rafael is active on social media. He is owner and manager of several LinkedIn groups, including Medicare and Medicaid Compliance (8,500 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 2,000 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. He lives in Lithia, Florida with the love of his life, his wife Lisa, and his greatest pride, his two sons, Alex and Andres.

Suzanne Jordan SCHIP Compliance Manager 

Broadspire

• 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

TOTAL YEARS OF INSURANCE INDUSTRY EXPERIENCE: 17 years

YEARS IN CURRENT POSITION: Nine years

EMPLOYMENT:

Broadspire Services (A Crawford Company) Since: 2009

• Professional Designations: ITIL Manager Certified, Help Desk 2000 Manager Certified

• Geographical Experience/States: North America, Canada, India, Philippines

Susan Lin

Industry Specialist

Susan's experience comes from nearly three decades in the P&C industry having held various leadership roles in the Workers Compensation organization including project delivery, quality management, NCCI claim data reporting and Claims EDI.  With the inception of the MMSEA Section 111 Mandatory Insurer Reporting in 2010, she became a Subject Matter Expert and later, transitioned to building strategies and resources to manage reporting and MSP conditonal payment resolution for all lines of business. Susan has spoken at key conferences on the importance of navigating through successful NGHP Section 111 reporting, the impact of the PAID Act and best practices to avoid penalties.

She holds a Bachelor of Science degree in nursing and maintains an active FL RN license.  Susan is a prior member of the National MSP Network and the MARC Executive Committee.  She is also a champion of Diversity and Inclusion having held a Co-Chair role of the Asian & Allies Diversity Network.   

Paul McLaughlin President

APP Technologies

Paul is co-founder and President of APP Tech, a software company based in Norwalk, Conn. APP Tech develops claims and risk management solutions with a focus on self-insured organizations. For over 20 years, APP Tech has pioneered an incident-based approach to claims management that is uniquely suited to self-insurance needs.

The MIR Express platform was originally developed as a module of APP Tech’s claims software but quickly grew into one of the most-used platforms in the market. Going back to the initial announcement of mandatory insurer reporting, Paul remembers flipping through the very first version of the NGHP User Guide and thinking, “Sure, we can do this.” MIR Express now has a track record of successfully processing millions of claims for thousands of RREs.

Paul’s passion is working with people to solve business problems with software. Paul holds two bachelor’s degrees from Lehigh University in computer science and marketing. A husband and father of five, he enjoys reading, working in his yard, and spending time with his family (even if it means relearning high school math so he can help his kids with their homework).

Shannon P. Metcalf Partner

Hedrick Gardner Kinchelow & Garofalo, LLP

Shannon is a partner in the firm’s Charlotte office and represents a variety of carriers and employers, from small businesses to large Fortune 500 companies, in the defense of workers’ compensation claims. Her clients include reputable retail and insurance companies, as well as professional sports teams throughout the country. As a Medicare Set-Aside Certified Consultant (MSCC), her practice also focuses heavily on Medicare Secondary Payer Act compliance. Shannon is an active member of the North Carolina State Bar, North
Carolina Bar Association, North Carolina Association of Defense Attorneys, Mecklenburg County Bar Association, Defense Research
Institute, and the National Medicare Secondary Payer Network.

Shannon is AV peer-rated by Martindale-Hubbell and was selected to North Carolina’s 2010 Rising Stars list in Workers’ Compensation, published nationwide in Super Lawyers Magazines®. She was also listed as one of Business Leader’s 2011 Movers & Shakers. Additionally, Shannon was recognized in the 2014 listing in The Bar Register of Preeminent Women Lawyers.

Shannon provides legal counsel, consulting services, and training in regard to Medicare Compliance matters, including but not limited to,

• Insurer compliance under the Medicare Secondary Payer (MSP)
  Act and as regulated by the Centers for Medicare and Medicaid
  Services (CMS);
• Counsel regarding the need for Medicare Set-Aside Allocations,
  preparation of Medicare Set-Aside Allocations, and submission of
  Medicare Set-Aside Allocations to CMS for approval;
• Consideration of Medicare’s interest in all stages of litigated and
  non-litigated workers’ compensation and liability matters, including
  facilitation of the settlement process, addressing options for resolving
  Medicare claims, resolution of conditional payment lien issues, and
  preparation of settlement documents to adequately address Medicare
  concerns; and
• Mandatory insurer (RRE) reporting compliance under Section 111 of
  the Medicare, Medicaid, and SCHIP Extension Act of 2007 (MMSEA).

Barrye Panepinto Miyagi, JD, CMSP Partner

Taylor, Porter, Brooks & Phillips L.L.P.

Barrye is a Partner at Taylor Porter and the Practice Group Leader for Taylor Porter’s Medicare Secondary Payer (MSP) Compliance Group. She is certified as an MSP Fellow. Barrye assists clients with MSP compliance-related trial and settlement strategy and guides clients on mandatory Section 111 reporting obligations. She has over 25 years of litigation experience defending asbestos and other personal injury cases and is skilled in managing large-scale litigation and settlement dockets. Barrye has authored MSP compliance protocols, drafted and argued MSP Act motions, and served as lead MSP compliance counsel in large, multi-party cases. Barrye and her team resolve MSP issues in single plaintiff and multi-party cases. Barrye also handles MSP global lien resolutions on behalf of her clients. Barrye enjoys working on complex MSP issues and speaking on MSP compliance.

Steven Shaw, Esq. Principal

Shaw Legal Solutions

Steve Shaw is a plaintiff’s attorney and Medicare Secondary Payer consultant from Seattle, Washington. Since 2009, Steve has worked with fellow plaintiff’s attorneys to assist them with Medicare Secondary Payer compliance and other lien issues. 

Steve is a trusted voice in the plaintiff’s bar when it comes to all things Medicare. He is an author and the editor of the subrogation deskbook for the WSAJ (Washington State Association for Justice). He has served on the board of governors for both the WSAJ and the AAJ (American Association for Justice), and also serves as co-chair of the liability committee for the MSPN (National Medicare Secondary Payer Network). 

Steve is a frequent contributor to legal publications and continuing education programs and is a fellow of and an instructor for the Certified Medicare Secondary Payer Professional program. His Medicare consulting practice includes individual, professional, and institutional clients from across the country.

Meghan Tiernan Paralegal

Cattie & Gonzalez, PLLC

Meghan H. Tiernan is a Paralegal at Cattie & Gonzalez, P.L.L.C., where she oversees all lien resolution activities for Medicare, Medicare Advantage, Medicaid, Medicaid Managed Care Organizations, Tricare, Veterans Affairs, Indian Health Services and Private Insurance on behalf of the law firm. Meghan has over 14 years of experience navigating the intricacies of Medicare Secondary Payer and lien resolution, assisting Plaintiff’s counsel, Defense counsel and Insurance Carriers in providing final resolution to these issues on their cases.

Shelley Wisniewski Medicare Lead Consultant

Allstate

Shelley Wisniewski serves as the Account Manager for Medicare Section 111 Reporting as part of Allstate Insurance Company’s Casualty Claims Design team.   Across her 25 years with Allstate, she has held leadership roles in both Risk Management and Claims.  Central to those roles has been delivering exceptional customer service, building internal and external relationships, most notably with CMS and several Medicare Advantage Plans directly, and facilitating Medicare process enhancements for electronic reporting and lien handling.  In her current role, she oversees Section 111 electronic Medicare reporting which includes both process and technology to maintain the highest degree of regulatory compliance. 

In her spare time, Shelley enjoys volunteering as a Junior Achievement teacher for 2^nd, 3^rd and 4^th graders and spending time with family. 

The Allstate Corporation (NYSE: ALL) protects people from life’s uncertainties with a wide array of protection for autos, homes, electronic devices, and identity theft. Products are available through a broad distribution network including Allstate agents, independent agents, major retailers, online, and at the workplace. Allstate is widely known for the slogan “You’re in Good Hands with Allstate.” For more information, visit www.allstate.com.