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/

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Sixth Circuit Allows Medicare Advantage Plan to Pursue MSP Private Cause of Action for Double Damages against No-Fault Insurance Carrier

• 09/24/15

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 ...
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Updates from CMS’ September 17th Webinar on the New Commercial Repayment Center (CRC)

• 09/18/15

CMS continued its series of webinars on September 17th introducing the CRC to the industry and explaining how it will impact conditional payment recovery processes.  I previously blogged on the last CMS ...
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More Medicare Secondary Payer Private Cause of Action “Action”

• 09/02/15

A new opinion was just released out of the U.S. District Court for the Southern District of Florida, MSPA Claims 1, LLC v. IDS Property Casualty Insurance Company (August 28, 2015). This case involved MSPA ...
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The New Commercial Repayment Center: Important Information from CMS’ Webinar and Update on Conditional Payment Recoveries

• 08/27/15

On Tuesday, August 23rd, CMS held a webinar on the transition for Non-Group Health Plans (NGHP) to the Commercial Repayment Center (CRC). A summary follows on how work will be coordinated between the CRC and ...
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CMS Alert Reminds the Industry Regarding Escalation of Debt to the Treasury Department

• 08/07/15

CMS issued an alert on August 5th which states the following: On May 9, 2014, the President signed into law the Digital Accountability and Transparency Act (DATA Act). One outcome of this legislation will ...
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MSP Medicare Advantage Plan Recovery Rights Case Law Rampant

• 08/03/15

The Medicare Advantage Plan (MAP) system continues to grow; according to the Kaiser Family Foundation, as much as 31% of the Medicare population in the United States is also enrolled in a Medicare Advantage ...
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CMS Alert: New Contractor for NGHP Recoveries and Benefits Coordination in ORM

• 07/01/15

Today, July 1, 2015, CMS issued an alert which states that come October 2015, the Benefits Coordination and Recovery Contractor will be transitioning some of its recovery caseload to a new contractor which ...
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Collateral Source Rule Does Not Apply to Medicare Payments

• 06/24/15

In an opinion out of Delaware, Stayton v. Delaware Health Corporation, et.al, 2015 WL 3654325 (June 12, 2015), Delaware's Supreme Court found that the collateral source rule does not apply to payments ...
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Workers’ Compensation Medicare Set-Aside Reform Introduced in Congress

• 06/08/15

On June 4, 2015, workers' compensation Medicare Set-Aside (WCMSA) legislation was introduced in both the House and Senate. In identical bills, the House, the bill (HR 4269) was introduced by ...
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