HHS/CMS is planning to issue a Proposed Notice of Rulemaking (NPRM) sometime in September 2013 regarding Medicare Secondary Payer requirements and Future Medicals. The NPRM is the next step after the Advanced Notice of Proposed Rulemaking (ANPRM) phase. An ANPRM on this topic was issued in June of 2012 with the public comment period closing in August of 2012. For more information and background about the ANPRM, access our prior blog here.
After the NPRM is issued, CMS will collect public comments for 60 days, and then it will move onto the final rulemaking stage. Within the initial ANPRM, CMS made the industry aware that it was considering various options pertaining to protecting Medicare’s interests with regard to future medicals in both workers’ compensation and liability cases.
One of these options provided in the ANPRM, which would directly impact liability settlements, is the option of providing a full formal MSA and CMS approval process for liability insurance, similar to what is currently in place for workers’ compensation. Another option would be to exempt liability settlements from having to consider Medicare’s interests with regard to future medicals if the liability settlement is under a certain monetary threshold.
The outcome of this NPRM will certainly be impactful, particularly to the liability industry, where currently CMS has issued little guidance. It is possible that the NPRM may not come out in September as scheduled; however, it is abundantly clear that rules will be forthcoming very soon.
PMSI will continue to follow this issue and keep our subscribers informed. A link to the NPRM on the regulatory calendar can be found here.