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/
In a case out of the Civil Appeals Court in Oklahoma, Ramos v. Becco Contractors, Inc., 2013 Okla. Civ. App. LEXIS 105 (December 13, 2013), a claimant who misrepresented his immigration status and ... Read More
On December 27, 2013, CMS issued a Notice of Proposed Rulemaking (NPRM) relating to circumstances where “applicable plans” (liability insurance, no-fault insurance, and workers' compensation ... Read More
A Medicare Set-Aside (MSA) is intended to pay for future medical items which would otherwise be covered by Medicare. The intent behind establishing an MSA is to prevent the cost shifting of these future ... Read More
CMS has released an updated User Guide for NGHPs. Although the User Guide is dated October 7, 2013, it was not released to the public until October 18, 2013. Access to the updated User Guide can be found ... Read More
Some of us in the industry may remember an interesting case back from May of 2011 where a class of Medicare beneficiaries successfully obtained an injunction against CMS for certain conditional payment ... Read More
I am frequently asked what the Medicare Secondary Payer (MSP) obligations are when a settlement occurs and the claimant/plaintiff alleges that he/she does not have a social security number (SSN) and/or is ... Read More
HHS/CMS is planning to issue a Proposed Notice of Rulemaking (NPRM) sometime in September 2013 regarding Medicare Secondary Payer requirements and Future Medicals. The NPRM is the next step after the ... Read More
I previously provided an update regarding Medicare Advantage Plans (MAPs) and their recovery rights under the MSP on April 24, 2013. Please click here to read my previous article which delves into detail of ... Read More
At last, one of the components of the SMART Act is set to take effect on July 10, 2013. The SMART Act, also known as H.R. 1845, provides that: six months after enactment (signed by President Obama on January ... Read More
Court Denies Peyman Heidary Indictment Appeal Sacramento, CA - Former chiropractor Peyman Heidary allegedly owned and oversaw a network of medical clinics to generate fraudulent billings to workers’ compensation and insurance carriers. As a ...