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/
As I have noted in numerous recent blogs, Medicare Secondary Payer (MSP) Private Cause of Action litigation has been on the rise and has grown to be incredibly rampant in the past several years. Innate to ... Read More
On April 2, 2018, the Centers for Medicare & Medicaid Services (CMS) issued a final rule that updates Medicare Advantage Plan (MAP) and Medicare Part D policy changes which provides the plans “with ... Read More
The U.S. District Court for the Southern District of Texas has issued an opinion in ongoing litigation by Aetna and Humana, both Medicare Advantage Plans (MAPs), against a Plaintiff law firm that represented ... Read More
Recall that in September 2016, the Eleventh Circuit Court of Appeals ruled that Humana Medicare Advantage may sue a primary plan for failure to reimburse conditional payments under the Medicare Secondary ... Read More
Yesterday, January 18th, the Centers for Medicare & Medicaid Services (CMS) conducted a webinar for Non-Group Health Plans (NGHPs) to discuss the transition of the new Commercial Repayment Center (CRC) ... Read More
As required by section 202 of The SMART Act, CMS is required to annually review its costs relating to recovering conditional payments as compared to recovery amounts. Last year in 2016, CMS announced that ... Read More
The United States District Court for the District of New Mexico has issued an interesting decision involving the uncertainty for the need of a Liability Medicare Set-Aside (LMSA) in a medical malpractice ... Read More
Liability Medicare Set-Asides (LMSAs) and No-Fault MSAs (NFMSAs) Update:
I recently issued a blog that CMS withdrew/rescinded a MedLearn article to medical providers which directed medical providers to bill ... Read More
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 ... Read More
4-1-1 on Comp: Upcoding and Workers' Compensation Upcoding is the practice of a medical provider billing a medical event on a more expensive code than the service that the provider actually gave to the patient. Upcoding can occur in four different ...