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/
Medicare Advantage Plans (MAPs), also known as Medicare Part “C”, are private insurance plans which provide Medicare benefits to beneficiaries. A beneficiary may opt to receive their Part A and B ... Read More
On March 29, 2013, CMS issued its first ever WCMSA Reference Guide. To view and download a copy of the guide, please click here.
At the beginning of this 88 page guide, CMS states that the guide was written ... Read More
Case law as it pertains to Medicare Secondary Payer (MSP) compliance in liability settlements continues to reach different conclusions in different courts. In fact, the only aspect that appears to be ... Read More
A recent case out of a Mississippi District Court, Welch v. American Home Insurance Company, 2013 U.S. District LEXIS 25948 (February 26, 2013), determined the amount of a Medicare Set-Aside (MSA) in a ... Read More
A Federal District Court for the Eastern District of Michigan recently allowed a health care provider to proceed with a claim against a patient's no-fault auto insurance carrier for the full cost of its ... Read More
A Federal District Court in Miami recently refused to determine whether a Medicare Set-Aside (MSA) was required in a personal injury case. In Early v. Carnival Corp., 2013 U.S. Dist. LEXIS 16711 (Feb. 7, ... Read More
The SMART Act reforms certain aspects of the Medicare Secondary Payer Act (MSP) and the Medicare, Medicaid and SCHIP Extension Act of 2007 (MMSEA). While the SMART Act does not directly broach how to protect ... Read More
The SMART Act was signed by President Obama today, on January 10, 2013 after having passed in both branches of Congress. The SMART Act was passed as part of H.R. 1845 and attached onto a Medicare IVIG Access ... Read More
With 2012 over, it appears that those affected by the MSP can look forward to an extremely bright and optimistic 2013. In 2012, CMS and the new WCRC vendor, Congress, and the DHHS were more proactive than ... Read More
Changes in Monday Claims A Case of the Mondays
Sometimes injuries that are not work-related get claimed as workers compensation. Workers may get injured away from their job, but say the injury is related to work to reap better ...