IMPORTANT NOTICE
(provided by Joie Glenn, Executive Director of the New Mexico Association of Home and Hospice Care)

CMS Issues Revised Notice of Medicare Non-Coverage (NOMNC)

and Detailed Explanation of Non-Coverage (DENC)

It is a requirement that Medicare beneficiaries who are receiving services from a skilled nursing facility (SNF), home health agency (HHA), hospice, or comprehensive outpatient rehabilitation facility (CORF) be given a notice to inform them that their Medicare covered services are ending, which gives them the opportunity to request an immediate, independent review of the proposed discontinuation of the covered services. When a review is requested, an additional notice is given to provide a more detailed explanation as to why the coverage is ending.

Prior to March 2012, different notices were given depending on whether the beneficiary had original Medicare or was enrolled in a Medicare health plan. This was confusing, not only for the beneficiaries, but for the health care providers. In March 2012, CMS announced that they were issuing a revised, combined NOMNC and DENC.

Providers are required to begin issuing the new combined notices as soon as possible, but no later than May 1, 2012.

Providers can access the notices on the CMS website at http://www.cms.gov/Medicare/Medicare-General-Information/BNI/FFSEDNotices.html or http://www.cms.gov/Medicare/Medicare-General-Information/BNI/MAEDNotices.html.

Steve