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/
The MSA industry has been abuzz, and Franco Signor has confirmed with the Workers’ Compensation Review Contractor (WCRC), that changes are being made to the requirements for CMS to approve zero ... Read More
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 past three (3) years, the ... Read More
A decision issued out of the Eleventh Circuit Court of Appeals this week, MSP Recovery, LLC v. Allstate, et. al, 2016 U.S. App. LEXIS 15984 (August 30, 2016) has found that Medicare Advantage Plans (MAPs) ... Read More
As a continuing effort to keep the industry updated on the Commercial Repayment Center, below is an update on the CRC’s progress and current issues. For my June blogwire update on the CRC, please click ... Read More
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
Advocacy Based Claims Comes of Age at NWCDC For the many people who have been advocating a shift in our workers’ compensation claims handling philosophy the last few years, this year’s National Workers’ Compensation and Disability ...