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CMS’s expected release of its “future medicals” proposals now scheduled for August 2020

An updated notice from the Office of Information and Regulatory Affairs (OIRA) indicates that CMS’s long-anticipated release of its “future medicals” notice of proposed rulemaking (NPRM) is now scheduled for August 2020. As many will recall, CMS’s previously announced two expected release dates in 2019 before then pushing back the projected date to February 2020.   

It is widely anticipated that the forthcoming NPRM proposals will concentrate on future medical obligations concerning liability claims (i.e., LMSAs). However, the OIRA’s latest notice also references no-fault and workers’ compensation. Thus, we will need to wait to see CMS’s actual NPRM proposals to examine the exact proposals relative to the various insurance lines referenced.

Liability Medicare Set Asides – Bracing For The Storm

In this regard, the new OIRA notice states as follows: 

This proposed rule would clarify existing Medicare Secondary Payer (MSP) obligations associated with future medical items services related to liability insurance (including self-insurance), no-fault insurance, and worker’s compensation settlements, judgments, awards, or other payments. Specifically, this rule would clarify that an individual or Medicare beneficiary must satisfy Medicare’s interest with respect to future medical items and services related to such settlements, judgments, awards, or other payments. This proposed rule would also remove obsolete regulations.

ISO Claims Partners is closely monitoring this development and will provide further updates as warranted. In the interim, for a more in-depth discussion regarding this issue, please see our recent article Liability Medicare Set-Asides – Bracing for the storm.  

Please do not hesitate to contact the author if you have any questions.


Mark Popolizio

Mark Popolizio, J.D., is vice president of MSP compliance at ISO Claims Partners, a Verisk business. You can contact Mark at mpopolizio@verisk.com.


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