About Seana Thomas

Seana B. Thomas head shot

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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Recent News

  • New Lee v. Silveira case extends Howell analysis

    New Lee v. Silveira case extends Howell analysis

    New Lee v. Silveira case extends Howell analysis, holding that in order to prevail under C.C.P. Section 998, plaintiff can use only the negotiated rate differential in determining whether he/she did “better” than the statutory offer – not the gross amount the jury may have awarded. Be sure to read our other Howell related posts.

  • MEDICARE NEWS FLASH — Additional Smart Act Provisions Implemented by Medicare – Right of Appeal

    MEDICARE NEWS FLASH — Additional Smart Act Provisions Implemented by Medicare – Right of Appeal

    CMS has just issued final rules implementing additional KEY PROVISIONS of the Strengthening Medicare and Repaying Taxpayers Act of 2012 (SMART Act).  The Act, which was moved through Congress in record time thanks to the efforts of the Medicare Recovery Advocacy Coalition (MARC) and Roy Franco, has five primary provisions, which CMS has been implementing individually.  Perhaps the most important …

  • SIGNIFICANT NEW  DISCOVERY CASE:  Gonsalves v. Li (A140284):

    SIGNIFICANT NEW DISCOVERY CASE: Gonsalves v. Li (A140284):

    Court of Appeal holds that a party’s denials of requests for admissions are inadmissible at trial ,where a party’s conduct in litigation is not in issue. The First District Court of Appeal ruled yesterday that a party’s denial or lack of admission in response to requests for admissions cannot be used for impeachment purposes. The panel overturned a judgment of …

  • UPDATE: CMS Accepts 5 digit SSNs

    UPDATE: CMS Accepts 5 digit SSNs

    In further implementation of the SMART Act, on January 5th, 2015 CMS released the latest version of the MMSEA Section 111 NGHP User Guide. The changes were expected, and are welcomed. The 2 major changes to the user guide are outlined below: 1) CMS will now accept 5 digit SSN’s on submitted records. RREs that submit query and claim input …

  • UPDATES:  Excessive Hospital Billing; Proposed Regulations to Limit Hospital Billing to Medicare Reimbursement Rates

    UPDATES: Excessive Hospital Billing; Proposed Regulations to Limit Hospital Billing to Medicare Reimbursement Rates

    Dear Friends and Colleagues:  The following informative update has been received from a colleague, and I pass it along as it touches on aspects of Medicare and other insurer reimbursement, particularly in the context of charges disputed because they are asserted to be excessive.  Please let me know if you would like to discuss any of these issues further. “Just …

  • ICD-10 Update, August 1, 2014

    ICD-10 Update, August 1, 2014

    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 …

  • MEDICARE UPDATE: NEW BENEFITS FOR PATIENTS WITH END STAGE RENAL DISEASE

    MEDICARE UPDATE: NEW BENEFITS FOR PATIENTS WITH END STAGE RENAL DISEASE

    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

  • 2015 GEMs and Reimbursement Mappings for ICD-10 Now Available

    2015 GEMs and Reimbursement Mappings for ICD-10 Now Available

    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

    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.

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Events

  • 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

    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 …

  • Vons Annual Defense Panel Conference

    Vons Annual Defense Panel Conference

    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 …

  • Supporting Association of Defense Counsel of Northern California and Nevada

    Supporting Association of Defense Counsel of Northern California and Nevada

    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 …

  • Solving the Mystery of Medicare Secondary Payer Reimbursement

    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.

  • MSP Update for Claims Professionals

    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.

  • MSP Update for Claims Professionals

    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.

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