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  • CMS Issues Revised Notice of Medicare Non-Coverage (NOMNC) and Detailed Explanation of Non-Coverage (DENC)

CMS Issues Revised Notice of Medicare Non-Coverage (NOMNC) and Detailed Explanation of Non-Coverage (DENC)

The Centers for Medicare & Medicaid Services (CMS) released a long-awaited revised Notice of Medicare Non-Coverage Form last month. The revision requires 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, giving 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 this March, 2012 revision, 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 beneficiaries, but for health care providers.

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.