CMS is releasing a newly revised SNF ABN (SNF Advance Beneficiary Notice of Non-coverage), along with new, concise, easy to follow, and detailed instructions to complete the form. CMS will be discontinuing the 5 SNF denial letters and the Notice of Exclusion from Medicare Benefits. (NEMB-SNF). The requirement for Notice has not changed, nor have the guidelines- only the form.
SNFs must issue a liability notice to FFS Medicare beneficiaries, prior to providing an item or service that is usually paid for by Medicare, but may not be paid for because the service is not medically reasonable and necessary, or it is custodial care. The ABN form is to help the beneficiary decide whether or not he/she wants the care that may not be paid for by Medicare, in which case they would be financially responsible.
For Medicare Part B, SNFs should continue to use the ABN Form CMS R-131.
The revised SNFABN will be mandatory for use on May 7, 2018, however, it is recommended that the revised SNFABN be used as soon as possible. The revised form and instructions are under downloads at the following link:
If you have any questions please contact Barbara Blatt, Appeals Management Coordinator at firstname.lastname@example.org.