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 2-1 final decision out of the Eleventh Circuit Court of Appeals, Humana Medical Plan, Inc. v. Western Heritage Insurance Company, Humana prevailed in recovering double damages under the Medicare ... Read More
A recent opinion out of the Eastern District of New York, Sexton v. Medicare, 2016 U.S. Dist. LEXIS 89815 (July 11, 2016), found that a Plaintiff cannot refute or defeat Medicare’s ability to recover ... Read More
CMS issued an Alert yesterday which states:
The Centers for Medicare and Medicaid Services (CMS) is considering expanding its voluntary Medicare Set-Aside Arrangements (MSA) amount review process to include ... Read More
Three months ago, I issued a blogwire article (click here to view) regarding the CRC beginning to issue Conditional Payment Notices (CPNs) and Demands on no-fault and workers' compensation claims where ... Read More
The Centers for Medicare and Medicaid Services (CMS) released a technical alert dated May 23, 2016 related to Non-Group Health Plan (NGHP) MMSEA Section 111 reporting. This alert communicates that there are ... Read More
Medicare Advantage Plans have set their sights on a new target for the MSP Private Cause of Action: Plaintiff attorneys representing Medicare beneficiaries. We have previously only seen these causes of ... Read More
In an opinion out of the U.S. District Court for the Middle District of Pennsylvania, Mikiewicz v. Hamorski and Erie Insurance Exchange, 2016 U.S. Dist. LEXIS 58859 (May 3, 2016), the Defendant Erie ... Read More
Modified RFP for WCRC: I previously blogged that CMS had invited bids for an RFP for the contractor that reviews WCMSA submissions, the WCRC. For my prior blogwire article, please click here. Just a few ... Read More
In a decision out of the Court of Appeal of California, Karpinski v. Smitty's Bar, Inc., 2016 Cal. App. LEXIS 277 (April 12, 2016), the Court affirmed the trial court's decision to enforce a ... Read More
Hard Liquor, Hard Bodies, Hard Times It is not often you hear about a workplace theft that piques your interest. It is rarer when charges related to that theft also include illegal distribution of anabolic steroids. And when the theft is ...