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/

---

CMS Announces Intent to Issue Notice of Proposed Rulemaking on Section 111 Reporting Penalties

• 12/12/18

The Centers for Medicare & Medicaid Services (CMS) has issued yet another abundantly clear signal that Medicare Secondary Payer (MSP) enforcement will be a priority in 2019. Just last week, I issued an ...
Read More

Proposed Rulemaking on LMSAs issued by Office of Management and Budget

• 12/06/18

A proposed rulemaking on “Miscellaneous Medicare Secondary Payer Clarifications and Updates” has been posted on the Office of Management and Budget website. The proposed rulemaking can be found ...
Read More

CMS Maintains Thresholds for Workers’ Compensation, Liability and No-Fault Settlements at $750 for 2019; MSPRP Improvements Webinar to be Hosted by CMS

• 11/20/18

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. For the last two years 2017-2018, CMS ...
Read More

Please Consider Supporting the Women to Watch Foundation to Prevent Up to 90% of Cervical Cancers

• 11/09/18

In December 2017 last year, I attended the Women to Watch conference hosted by CLM/Business Insurance in New York City. During the conference, the newly formed Women to Watch Foundation was introduced to the ...
Read More

CMS Revises MSP Provisions in its Part D Manual: Is the Policy Change a Foreboding of Increased MSP Enforcement in Part D?

• 10/18/18

Recently, CMS updated its Part D Manual to include specific changes to the Manual’s Medicare Secondary Payer (MSP) provisions.  The updated manual can be found here. Page 40 now ...
Read More

MSP Recovery’s Ocean Harbor Class Certification Attempt Backfires: 3rd Circuit Court Declines to Certify Class of Florida Medicare Advantage Plans

• 09/27/18

Recall MSP Recovery LLC, a law firm out of Miami, Florida that has been initiating numerous class action litigation country-wide as assignees on behalf of Medicare Advantage Plans (MAPs) alleging that ...
Read More

Humana Alleges Retailer’s Reliance and Lack of Follow-up to Ensure Medicare Beneficiary Plaintiff Reimburses Medicare Part C for Conditional Payments is Actionable for Double Damages under the MSP

• 08/29/18

Humana is continuing on its mission to establish precedent across the country regarding Medicare Advantage Plans’ (MAPs) ability to pursue a Medicare Secondary Payer (MSP) double damages private cause ...
Read More

Frequently Asked Questions on Ongoing Responsibility for Medical (ORM)

• 07/18/18

In Franco Signor's oversight of numerous MMSEA Section 111 programs nationwide, we frequently answer many questions from clients surrounding Ongoing Responsibility for Medical (ORM). The confusion is ...
Read More

Illinois District Court Gives Green Light to MSP Private Cause of Action Litigation for Medicare Advantage Plan Conditional Payments Despite Exhaustion of No-Fault Policy Limits

• 07/17/18

Recall that MSP Recovery LLC is an entity out of Miami, Florida that has been filing litigation and class actions nationwide on behalf of Medicare Advantage Plans (MAPs) against primary plans for the alleged ...
Read More