The Medicare Secondary Payer (MSP) industry has been waiting in anticipation for the release of a proposed rule covering future medical obligations. The original Fall 2018 notice, which can be found here, indicated a release in September 2019. It has been presumed that this proposed regulation would codify Liability Medicare Set Asides (LMSA).
However, an updated Spring 2019 notice includes two noticeable changes:
- The second sentence in the descriptive language in the abstract has been eliminated. This removed all references to liability (as well as self-insurance, workers’ compensation and no-fault) insurance and omitted language around “guidance to beneficiaries” as it relates to future medical care. A side-by-side comparison is as follows:
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Fall 2018 Abstract Language |
Spring 2019 Abstract Language |
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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. |
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. |
2. The timeframe for release was changed from September 2019 to October 2019.
What do these changes mean?
It’s difficult to decipher what, if anything, the elimination of the second sentence in the abstract language means. The description is still relatively nebulous and open to speculation. Furthermore, relative to the change in timeframe, a month delay seems negligible. Regardless, this notice and issues surrounding LMSAs will be closely monitored by Ametros and we will provide updates as they are made available. Should you have any questions about this notice, or how it may affect professional administration of a liability claim, please contact referral@ametros.com or call 877.275.7415.
