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As of July 1, 2005, Home Health Agencies (HHAs), Skilled Nursing Facilities (SNFs), Comprehensive Outpatient Rehabilitation Facilities (CORFs) and Hospices with beneficiaries in Fee-For-Service Medicare are required to notify beneficiaries of their right to a new expedited review process when these providers anticipate that Medicare coverage of their services will end. HHA, SNF, Hospice, CORF, and swing beds (under instruction) are required to provide a Generic Notice to beneficiaries to alert them that Medicare covered item(s) and/or service(s) are ending and give beneficiaries the opportunity to request an expedited determination from a QIO. A Detailed Notice is given when the QIO review is requested in order to provide more explanation on why coverage is ending. Effective October 1, 2005, HHA, SNF, Hospice, CORF, and swing beds must use approved versions of the Expedited Determination notices. August 20, 2008– Download current CMS Forms 10123 and 10124 The renewed, OMB-approved Notice of Medicare Provider Noncoverage (CMS-10123) and Detailed Explanation of Noncoverage (CMS-10124) are now available for download and immediate use. The expiration date for the renewed forms is 07/31/20011. CMS will allow a 60-day transition period for use of the new forms. Mandatory use of the renewed forms will begin on November 1, 2008. To download the FFS Expedited Determination Notices and Instructions, please click on the appropriate link below.
Page Last Modified: 08/28/2008 3:48:44 PM
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