Heather Schwartz Sanderson, Esq., President, Sanderson Firm PLLC Since the inception of her career, Heather Schwartz Sanderson, Esq. has been passionately devoted to providing simple and straightforward Medicare Secondary Payer (MSP) legal strategy, compliance solutions, as well as MSP education to the insurance and legal communities. Heather has 12+ years of dedicated experience in MSP compliance, and has often been referred to as one of the foremost experts in the country on MSP. Prior to launching Sanderson Firm PLLC, Heather served as Chief Legal Officer for Franco Signor for 6 years, a leading national MSP services provider, until its ultimate acquisition by ISO CP in 2020. Prior to her tenure as CLO at Franco Signor, Heather previously served as both Corporate Counsel for Optum as well as Staff Counsel for ExamWorks Compliance Solutions. Over the last decade, Heather has served as an MSP expert both in Federal class action litigation as well as in litigated matters at the state level. Heather is an award-winning blogger and national speaker on MSP compliance, and a recipient of a 2018 Business Insurance Break Out Award. Heather serves an Ambassador for the Women to Watch Foundation, a 501(c)(3) entity serving humanitarian initiatives for women. Heather has been an active proponent in Washington D.C. for MSP legislative reform since 2011 and is proud of the industry’s accomplishment of the passage of both SMART Act (2013) and PAID Act (2020).

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Evidence-Based Medicine Results in Optimal Clinical Outcomes: Why Potentially Lowering Your Medicare Set-Aside (MSA) is Just a Secondary Benefit

• 05/24/22

Evidence-based medicine (EBM) is “the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients.”[1] The aim of EBM is ...
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Sanderson Firm Welcomes Leesa Rice as Executive Vice President, Business Development

• 04/04/22

Bradenton, FL (WorkersCompensation.com) - Sanderson Firm PLLC, a Medicare Secondary Payer (MSP) Compliance law firm, is pleased to announce the appointment of Leesa Rice as Executive Vice President, ...
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Why Timely Ongoing Responsibility for Medical (ORM) Termination is so Important in MMSEA Section 111 Reporting

• 11/17/21

If you work with workers’ compensation or no-fault/auto claims involving Medicare beneficiaries, you should be familiar with Ongoing Responsibility for Medical (ORM) as a requirement of MMSEA Section ...
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Important Take-Aways from CMS' PAID Act Webinar

• 06/24/21

Just yesterday on Wednesday, June 23, 2021, the Centers for Medicare & Medicaid Services (CMS) hosted a webinar on the Provide Accurate Information Directly (PAID) Act. Overview of Presentation by ...
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Zero Medicare Set-Aside Allocations: Clearing the Confusion and Strategies for WC Payers

• 05/26/21

How does one successfully settle a workers’ compensation claim with a Medicare beneficiary utilizing a zero Workers’ Compensation Medicare Set-Aside (WCMSA or MSA) allocation, particularly in ...
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Court Addresses Medicare Section 111 Reporting Obligations for Guaranty Funds

• 05/03/21

A recent decision out of the U.S. District Court for the Northern District of Illinois, Eastern Division entitled Ill. Ins. Guar. Fund v. Cochran, 2021 U.S. Dist. LEXIS 78452 (April 23, 2021) illuminates the ...
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CMS Issues Updated NGHP User Guide

• 04/14/21

Two new Medicare Secondary Payer updates (a CMS User Guide update and interesting MSP decision out of Florida) were issued last week which are covered briefly below. Update to CMS NGHP User Guide On April ...
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Take-Aways from Recent NGHP Town Hall on Conditional Payment Recovery, Section 111 Reporting

• 04/05/21

As mentioned in our recent blog, the Centers for Medicare & Medicaid Services (CMS) recently hosted a Town Hall on April 1st.  As a recap, John Albert of CMS introduced the Town Hall and stated that ...
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Attempted Class Action Filing Serves as Reminder of Importance in Diligence to Medicare Conditional Payment Obligations

• 02/25/21

An attempted class action pursuant to the Medicare Secondary Payer (MSP) private cause of action for double damages filed in a North Carolina District Court by a Medicare beneficiary against a workers’ ...
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