Heather Schwartz Sanderson

Heather Schwartz Sanderson, Esq., MSCC, CHPE, CLMP, CMSP Heather is Chief Legal Officer for Franco Signor LLC, the nation's compliance authority for Medicare Secondary Payer (MSP) matters. She has lectured on MSP compliance to the workers’ compensation and liability insurance communities at conferences, associations, and individual offices nationwide. She is a regularly published author on court decisions and legislative reforms involving Medicare Set-Asides, conditional payments, and Mandatory Insurer Reporting issues. Understanding that compliance with the Medicare Secondary Payer Act can be at times complex and frustrating for those that handle claims with Medicare beneficiaries, Heather’s goal is to speak and write with the primary goal being simple and understandable solutions to compliance. Heather can be reached at Heather.Sanderson@francosignor.com Franco Signor's Blog can be found at: http://www.francosignor.com/msp-blog/

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A Busy Week for Medicare Secondary Payer: LMSA/NFMSAs Provider Notice Rescinded; New Contract Award for Commercial Repayment Center

• 10/06/17

Liability Medicare Set-Asides (LMSAs) and No-Fault Medicare Set-Asides (NFMSAs) Update - The Centers for Medicare and Medicaid Services (CMS) has been taking incremental steps recently to implement a review ...
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Workers’ Compensation Review Contractor (WCRC) Missing the Mark in Enforcement of CMS Directives Regarding Zero Allocations

• 09/26/17

Back in November of 2016, I blogged regarding the Workers’ Compensaton Review Contractor (WCRC) introducing more stringent requirements for CMS approval of a zero Workers’ Compensation Medicare ...
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Plaintiff Attorneys Targeted by Medicare Advantage Plans Lawsuits Seeking Double Damages Under MSP Private Cause of Action Theory

• 09/14/17

Over the past several years, we have witnessed Medicare Advantage Plans (MAPs) flex their muscles in establishing their rights to recover double damages through a Medicare Secondary Payer (MSP) private cause ...
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New Contractor to Inherit Workers’ Compensation Review Contractor (WCRC)

• 09/07/17

The WCRC, the entity which reviews Workers’ Compensation Medicare Set-Asides (WCMSAs) for the Centers for Medicare & Medicaid Services (CMS) has issued the award to Capitol Bridge LLC, a government ...
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CMS Issues Updated WCMSA Reference Guide Version 2.6: Multiple Important Updates to the WCMSA Submission Process

• 08/02/17

The Centers for Medicare & Medicaid Services (CMS) issued an updated Workers’ Compensation Medicare Set-Aside (WCMSA) Reference Guide on July 31st, although the Reference Guide is dated July 10, ...
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Updates in Funding of Future Medical in Workers’ Compensation: Arizona Now Allows for Full and Final Settlements; Opana ER Removed from Market

• 07/24/17

There are two recent updates which may impact workers’ compensation payers looking to finalize and foreclose future medical expenses and which additionally may impact claims that involve a Medicare ...
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It Feels Like Christmas in July: CMS Expands MSA Re-Review Process; Updates WCMSAP User Guide

• 07/11/17

The Centers for Medicare & Medicaid Services (CMS) has followed through on their previously announced intent to expand their Medicare Set-Aside (MSA) Re-Review process. For my prior blogwire article on ...
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CIGA Update: California District Court Rules CMS’ Interpretation of the MSP for Conditional Payments is Unlawful

• 05/05/17

The California Insurance Guaranty Association (CIGA) is California’s largest workers’ compensation provider as the insurer of last resort for employers who would otherwise not be able to afford ...
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United States Intervenes in Two Whistleblower Lawsuits Against United Health Group for Improper Medicare Payments; Trump Administration Tackling Medicare Fraud, Waste and Abuse

• 05/04/17

During an interview on this past Sunday, President Trump indicated that he does not plan to touch the concept of Medicare; however, he and his administration would be tough on Medicare fraud, waste, and ...
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