CMS Takes Step Toward Rule Making for Future Medicals for Liability Claims and Reporting Penalties – Still Long Road Ahead
Roy Franco
September 10, 2013

Today, the Centers for Medicare & Medicaid Services has submitted for review to the Office of Management & Budget (OMB) two important reviews the Industry has waited for with regard to Medicare Secondary Payer Compliance.  The OMB is being asked to approve a Notice for Proposed Rule Making with regard to how CMS expects its interest with regard to future medical be managed in the liability claim.  Once approved by OMB (time period is unclear) the rule will be unveiled for public comment.  It is not a final rule, and the public commentary period is open for 60 days.  Assuming public comments are significant (and we have no doubt it will be), we could see the agency issues a Further Notice of Proposed Rulemaking that will add time to the process.  A rule in this issue is finalized when a Report & Order is issued.  In line with our previous blogs on this topic, we expect this area of the law to sort itself out sometime during the first quarter of next year given today’s announcement.  To view the present status of the rule making process for future medicals, click here

CMS also moved forward today on rules regarding Mandatory Insurer Reporting Penalties, commonly referred to as MMSEA & Section 111 reporting penalties.  Consistent with the requirements of the MMSEA law of 2007 and the SMART law signed into law this year, CMS is asking OMB to review its Advanced Notice for Proposed Rule Making with regard to safe harbors.  Once approved by OMB (time uncertain), the ANPRM will be published and the public will have 60 days to suggest safe harbors where Section 111 penalties should not issue.  After the 60 day period, CMS will review the information to issue a Notice of Proposed Rule Making, but there are no set time periods by which CMS must act.  To view the present status of the rule making process for Section 111 penalties, click here.