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).
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 ... Read More
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 ... Read More
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’ ... Read More
A recent study found that the COVID-19 pandemic is leading Medicare Advantage enrollment to grow more quickly than previously anticipated. Of those Medicare beneficiaries who decided on a Medicare Advantage ... Read More
The Non-Group Health Plan (NGHP) User Guide is the primary source for Section 111 reporting requirements as mandated by Section 111 of the Medicare, Medicaid and SCHIP Extension Act of 2007 (MMSEA). As the ... Read More
Liability Medicare Set-Asides (aka LMSAs): Are they grounded in the Medicare Secondary Payer Act (MSP) as a legal requirement? The P&C industry has heard chatter of the concept of LMSAs since the ... Read More
Just recently, the United States Department of Health & Human Services (HHS) submitted an Amicus Curiae Brief in the Eleventh Circuit in the MSP Recovery Claims, LLC v. Ace American Insurance Company, et ... Read More
The Non-Group Health Plan (NGHP) industry (workers’ compensation, liability, and no-fault insurance) has been curious as to what to anticipate now that the Centers for Medicare & Medicaid Services ... Read More
A recent decision out of Rhode Island demonstrates a common dilemma wherein a Non-Group Health Plan (workers’ compensation, liability, or no-fault insurance carrier or self-insured) Responsible ... Read More