On June 15, 2012, CMS published an advance notice of proposed rulemaking (ANPRM) to solicit comments on how to resolve certain Medicare Secondary Payer (MSP) obligations related to “future medicals” – that is, medical care furnished after a settlement (including judgment, award, or other payments) involving automobile and liability insurance, no-fault insurance, and workers’ compensation where Medicare is the secondary payer. The ANPRM sets forth seven standardized options that CMS is considering making available to beneficiaries and their representatives to clarify how they can meet their obligations to protect Medicare’s interest with respect to MSP claims for future medicals. The seven options address the following scenarios: (1) the individual/beneficiary pays for all related future medical care until his/her settlement is exhausted and documents it accordingly; (2) the beneficiary’s case meets a series of conditions pertaining to the amount of liability insurance, the date of the triggering event, the nature of the underlying claim, and the availability of additional settlements, workers’ compensation, or no-fault insurance claims; (3) the individual/beneficiary provides an attestation regarding the date of care completion from his/her treating physician; (4) the individual/beneficiary submits proposed Medicare set-aside arrangement amounts for CMS’s review and obtains approval; (5) the beneficiary participates in one of Medicare’s recovery options; (6) the beneficiary makes an upfront payment; and (7) the beneficiary obtains a compromise or waiver of recovery. CMS notes that the ANPRM does not relate to the mandatory MSP reporting obligations under Section 111 of the Medicare, Medicaid, and SCHIP Extension Act of 2007 (MMSEA). Nevertheless, implementation efforts related to Section 111 of the MMSEA “have sensitized affected parties to other MSP obligations, specifically reimbursement obligations that have been long ignored or overlooked.” Comments on the ANPRM will be accepted until August 14, 2012.