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/
Anderson v. Burwell, 2016 U.S. Dist. LEXIS 26633 (March 3, 2016), arises out of the United States District Court for the Eastern District of Michigan, Southern Division. It raises many interesting ... Read More
The False Claims Act's (FCA) purpose is to deter fraud upon the U.S. government, and whistleblowers are incentivized to bring such actions due to the potential to recover triple damages against the ... Read More
On February 22nd, CMS issued a Request for Proposal (RFP) which invites bids for the contractor that reviews WCMSA submissions- also known as the Workers' Compensation Review Contractor (WCRC). The ... Read More
In Franco Signor's review of numerous reporting programs we have found that there is confusion within the industry regarding the proper indicators in which an RRE can terminate Ongoing Responsibility for ... Read More
We now have the third version of the WCMSA Reference Guide; however, the Reference Guide remains entirely the same with the exception of one addition. The one change is the addition of the following to ... Read More
Recently, I wrote a blogwire article that CMS had planned to go-live with its pre-settlement final demand functionality on January 1, 2016, but instead CMS has moved it up to December 21st. In its ... Read More
Yesterday, CMS issued an alert which states:
As part of the Strengthening Medicare and Repaying Taxpayers Act of 2012 (the SMART Act), the MSPRP will be modified to include Final CP process functionality by ... Read More
Today, the Supreme Court of Florida issued an opinion regarding Medicare payments and the collateral source rule in John Joerg, Jr., etc. et. al v. State Farm Mutual Insurance Co. (October 15, ... Read More
In an opinion out of the United States District Court for the Eastern District of Tennessee, Cariten Health Plan, Inc. v. Mid-Century Insurance Company, 2015 U.S. Dist. LEXIS 126887 (September 1, 2015 ... Read More
TN Work Comp Now Requires Electronic Claims Nashville, TN (WorkersCompensation.com) - Effective as of August 2018: New revisions have been made to the Claims Handling Standards, that will impact both adjustors and healthcare providers. One of the ...