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CMS Notice of Proposed Rule on Options for Meeting Future Medical Obligations

In its most recent Regulatory Agenda, the Department of Health and Human Services issued

notice of a proposed rule that would provide Medicare beneficiaries and their representatives with options to select for meeting future medical obligations in workers’ compensation, liability, and no-fault cases. The notice does not indicate which options CMS is considering. However, as we previously reported, CMS has stated that it is considering an expansion of the MSA review process to include MSAs in liability and no-fault cases, and the contract for the current WCMSA review contractor includes an option to review MSAs in liability and no-fault cases. The expansion of the MSA review process could be implemented as soon as Fall 2019.

The text of the proposed rule is set out below and may be found here [].

This proposed rule would ensure that beneficiaries are making the best health care choices possible by providing them and their representatives with the opportunity to select an option for meeting future medical obligations that fits their individual circumstances, while also protecting the Medicare Trust Fund. Currently, Medicare does not provide its beneficiaries with guidance to help them make choices regarding their future medical care expenses when they receive automobile and liability insurance (including self-insurance), no fault insurance, and workers’ compensation settlements, judgments, awards, or payments, and need to satisfy their Medicare Secondary Payer (MSP) obligations.

We will keep you updated on any proposed and final regulations that are issued as well as any developments in the anticipated expansion of the MSA review process.

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