CMS Withdraws its “Future Medicals” Notice of Proposed Rulemaking

By Sidney Wong October 14, 2014

Last week the Centers for Medicare and Medicaid Services (CMS) withdrew its Notice of Proposed Rulemaking (“NPRM”) for “future medicals” proposals for liability and workers’ compensation claims. A link to this notice, which the Office of Management and Budget now lists as withdrawn, can be found here.

By way of background, in June 2012 CMS released an Advance Notice of Proposed Rulemaking (ANPRM) proposing to codify formal legal regulations, including possible liability Medicare set-asides, for liability and workers’ compensation claims.  At that time, ISO Claims Partners publicly commented, critically examining CMS’ proposals and the assumptions upon which CMS based its ANPRM. To review what CMS proposed as part of its ANPRM proposals, see ISO CP’s prior analysis here.

Since releasing the ANPRM, the industry has been waiting for CMS’ next move in this process. In August 2013, the agency announced plans to release an NPRM.  Little fanfare accompanied that announcement and no details were publicly provided. CMS has now withdrawn the NPRM.

We anticipate that CMS will – at some point – revisit the issue of post-settlement compliance measures.  Exactly when CMS will return to this issue is unknown. This issue has been a matter of controversy and debate, with very divergent opinions in the industry as to what form the possible regulations could take and who will be ultimately responsible for adhering to them. Until that time, the best approach remains to develop a well-reasoned MSP compliance program taking into account all relevant factors and considerations.


Sidney Wong

Sidney Wong is the assistant vice president of policy at ISO Claims Partners, where he provides the highest level of client services—with a focus on meeting the needs of clients through ISO’s products and services. He is also responsible for assisting clients with effectively navigating Medicare compliance issues.