USCIS expect to change RFE & NOID

From http://www.immigration-law.com/, it is said that the USCIS will change the current RFE and NOID policy. One issue is that the USCIS will deny any application when required initial evidence is missing. Now while my 485 is pending without submission required medical examination, and one bad thing is I already used EAD (485 based). So are there any ways I can switch to H1 or other means if 485 is denied I can stay here and file re-open? thanks