CMS recently published an advance notice of proposed rulemaking (ANPRM) seeking comments on proposed rules governing how Medicare beneficiaries may resolve their Medicare Secondary Payer (MSP) obligations when they receive settlements from insurers for future medical care. CMS, Medicare Program; Medicare Secondary Payer and "Future Medicals," 77 Fed. Reg. 35917 (6/15/12). Comments are due by August 14, 2012.

The notice provides guidance on the MSP provisions, which bar Medicare from paying a beneficiary who is reasonably expected to receive payment from a workers compensation, liability insurance, or no-fault insurance plan. When a beneficiary is unable to receive prompt payment, Medicare is permitted to advance conditional payments, with the expectation that Medicare will be repaid if the beneficiary receives a "settlement" — i.e., settlement, judgment, award, or other payment — from a workers compensation, liability insurance, or no-fault insurance plan. Medicare is thereby deemed the secondary payer until the beneficiary exhausts settlement proceeds obtained from his or her primary payer.