Help Offered to Comply with Notice of Medicare Non-Coverage Delivery

Posted on June 20, 2018

Healthcare providers are required by law to use a Notice of Medicare Non-Coverage (NOMNC) form to notify Medicare and/or Medicare Advantage enrollees that the skilled services they are receiving will be ending. The NOMNC informs the beneficiary of their right to appeal the decision to end skilled services if they feel more care is necessary. The form must be provided no later than two calendar days prior to the termination of services provided by skilled nursing or home health (including psychiatric home health) facilities, hospice services and comprehensive outpatient rehabilitation facilities.

To appeal the decision, the beneficiary must contact KEPRO, the Beneficiary and Family Centered Care Quality Improvement Organization, either in writing or by telephone.

KEPRO has found that skilled nursing facilities experience the highest volume of reviews. To help these providers experience a smoother NOMNC review process, KEPRO has developed a new publication to clarify issues that commonly cause confusion.

Additional information is available on the KEPRO/QIO website, including frequently asked questions for the NOMNC and the Important Message from Medicare about Your Rights document, which is provided to Medicare patients to explain how to make an appeal. Questions may be directed to Andrea Plaskett at KEPRO.

Tags: home health, skilled nursing facilities, medicare non-coverage delivery, KEPRO

Posted in: Member News

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