An important topic needs to be addressed that seems to have been overlooked by some agencies related to the recent update to the Notice of Medicare Non-Coverage, which took effect on January 1, 2025.
We previously shared a Monday Minute discussing the new requirement that Medicare Advantage patients must now receive the same Notice of Medicare Non-Coverage form as traditional Medicare patients. This includes the BFCC-QIO information.
What may have been overlooked by some agencies is that the Notice of Medicare Non-Coverage form was updated in November, with the revised version taking effect on January 1, 2025. The new form carries an expiration date of November 30, 2027. It’s important to review your forms currently in use to notify patients at least two days in advance of their discharge and confirm that the expiration date in the bottom right corner reads November 30, 2027.
In recent months, there have been survey issues involving agencies still using the outdated Notice of Medicare Non-Coverage form. It’s essential to ensure that you are using the updated version, and also confirm that the Detailed Explanation of Non-Coverage has been updated as well with the same expiration date.
It’s important to remember that patients must be notified at least two days before their discharge, whether they are receiving home health or hospice services. This applies to hospice if the patient is discharged live, and the discharge is initiated by the agency and wasn’t a patient revocation.
Make sure your agency staff are aware that this notification must be provided. If a patient files a complaint with the BFCC-QIO to request a reconsideration of their discharge, you will be required to give them the Detailed Explanation of Non-Coverage. Be prepared to supply this explanation if the patient chooses to appeal, clearly outlining the reasons for the discharge.
At Healthcare Provider Solutions, we’re always here to support you with any survey-related needs, including mock surveys, policy reviews, and more. Don’t hesitate to reach out to us if you need assistance.
We also look forward to seeing you at our upcoming workshops this summer. For more information related to our HPS Alliance Hospice Workshop in June, click here. You can find information for our HPS Alliance Home Health Workshop in August by clicking here.
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