About Seana Thomas
Attorney Seana Thomas is a recognized authority on Medicare Secondary Payer law (MSP) and procedure, and has been a civil litigator in California for over 25 years. Since 2008, Ms. Thomas has been involved in the analysis and understanding of issues relating to the existing Medicare Secondary Payer reimbursement system, current and anticipated revisions in MSP law and procedure in the liability context, and the effect they have on the rights and obligations of “primary payers” (RREs), beneficiaries and their counsel in liability claims or lawsuits asserted by a Medicare beneficiary.
In the summer of 2008 she was co-author, with Roy Franco, J.D. and David Rosenbaum, Esq., of a detailed analysis of the Medicare statutory reimbursement system and issues it presents for RREs and beneficiaries in the liability context in response to a Request for Comment regarding proposed changes to the MSP. This 100-plus page analysis was entered into the United States Congressional Record. Since then, MSP law and procedure has been a significant focus of Ms. Thomas’s practice. Ms. Thomas continues an active civil litigation practice through trial and appeal for defense entities and plaintiffs. Ms. Thomas was awarded an AV-Preeminent rating by Martindale-Hubbell following extensive peer review. References are available upon request.
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On August 1, 2014, the Centers for Medicare and Medicaid Services (CMS) provided additional information regarding the upcoming change to the ICD-10 coding system which we regularly use in preparing documents, such as notices to COB&R and Releases, for our clients. If you have wondered why the change is being made, the current ICD-9 coding system has about one-tenth the […]
A proposed rule updates payment policies & rates under for patients with End-Stage Renal Disease (ESRD) for services furnished on or after January 1, 2015
The 2015 General Equivalence Mappings (GEMs) and Reimbursement Mappings are now available on the 2015 ICD-10-CM and GEMs web page and 2015 ICD-10-PCS and GEMs web page. These mappings can be used to convert policies from ICD-9-CM to ICD-10 codes. The GEMs provide both forward (ICD-9-CM to ICD-10) and backward (ICD-10 to ICD-9-CM) mappings. For detailed information on these mappings, see […]
Appellate Court Affirms Trial Court Exclusion of Expert Testimony for Failure to Timely Disclose Expert Witness Information
Defense counsel made a motion in limine to preclude plaintiff from offering expert witness testimony based on the contention that plaintiff’s failure to disclose expert information was unreasonable. The trial court agreed, and that decision was upheld on appeal. The Third District reasoned that while C.C.P. §2034.300 did not mandate exclusion of plaintiff’s expert testimony because the defendant did not timely comply with the disclosure date, there is nothing in C.C.P. §2034.300 that would preclude the court from exercising its discretion to exclude the testimony based on the plaintiff’s “egregious violation” of the exchange requirements.
ICD-10 Compliance, recently set to start on October 1, 2014, has now been PUSHED BAC, by the Protecting Access to Medicare Act of 2014 (PAMA) (Pub. L. No. 113-93), to October 1, 2015. The Act provides that the Secretary may not adopt ICD-10 prior to October 1, 2015. Accordingly, the U.S. Department of Health and Human Services expects to release […]
CMS Issues Proposed Hospital Inpatient Payment Regulation Proposed rule would strengthen tie between payment and quality improvement On April 30, CMS issued a proposed rule that would update FY 2015 Medicare payment policies and rates for inpatient stays at general acute care and long-term care hospitals (LTCHs). This rule builds on the Obama administration’s efforts through the Affordable Care Act to […]
On April 1, 2014, President Obama signed into law the Protecting Access to Medicare Act of 2014. This new law prevents a scheduled payment reduction for physicians and other practitioners who treat Medicare patients from taking effect on April 1, 2014.
Video from a seminar entitled Proving the Value of Present and Future Medical Bills under Howell, Corenbaum and Dodd v. Cruz and How to Establish “Negotiated Rate Differentials” in Medicare, Kaiser and other Lien Cases presented by the Association of Defense Counsel of Northern California and Nevada.
Change in Reporting Threshold for Certain Liability Settlements, Judgments Awards, or Other Payments
As required by section 202 of the Strengthening Medicare and Repaying Tax Payers Act of 2012 (SMART Act), the Centers for Medicare & Medicaid Services (CMS) has reviewed the costs related to collecting data and determining the amount of Medicare’s recovery claim and has calculated a revised single threshold for physical trauma-based liability insurance settlements. (Note: This threshold does not apply to settlements for alleged ingestion, implantation or exposure cases.)
Proving the Value of Present and Future Medical Bills Under Howell and Corenbaum: How to establish “Negotiated Rate Differentials” in Medicare, Kaiser and Other Lien Cases
Seana Thomas will be lead panelist at an important seminar for all litigators in California, combining her two areas of practice emphasis: litigation and Medicare Secondary Payer Reimbursement. The Seminar, sponsored by the Association of Defense Counsel of Northern California and Nevada will be held in San Francisco, CA, on Friday February 21, 2014. We’ll post updates as they become […]
Seana will be speaking at the Vons Annual Defense Panel Conference this year in Arcadia, California. Her discussion will focus on Medicare Secondary Payer reimbursement updates. The event will take place on November 8th, 2013 Seana Thomas is frequently sought for public speaking engagements and expert witness testimony. If you would like to have Seana at your next event, please […]
In support of the Association of Defense Counsel of Northern California and Nevada’s 20th Annual Golf Tournament at Silverado Resort in Napa, CA, happening on September 27, 2013 About the Association of Defense Counsel of Northern California and Nevada The Association of Defense Counsel is the only organization in Northern California and the state of Nevada devoted exclusively to representing the […]
Seana Thomas will discuss “Solving the Mystery of Medicare Secondary Payer Reimbursement” on March 28, 2013 at an MCLE-approved presentation sponsored by the Santa Barbara Legal Secretaries Association. The meeting will be held at the Santa Barbara College of Law, 20 E.Victoria Street, Santa Barbara, California. RSVP by March 20, 2013 to SBLPA, P.O.Box 2013, Santa Barbara, CA 93102.
Seana Thomas will be presenting a Medicare Secondary Payer procedural update, emphasizing recent and upcoming changes in MSP law, to claims professionals in Pleasanton, California on March 19, 2013.
Seana Thomas and Krystie Vance will be presenting a Medicare Secondary Payer Reimbursement Update to claims professional in Phoenix, Arizona on February 19-20, 2013.