Corporate Compliance

Note from Hugh

Medicare Weekly Update, July 29, 2008

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Interestingly, CMS has not issued a single transmittal in the last ten days. That’s fairly unusual. It could be that a lot of CMS staffers or on vacation, or they might be tied up working on other things. At any rate, I suspect that we will see a lot of transmittals issued this week.

I do have some news from CMS to report relating to the new ABN form. As discussed in the March 11, 2008 issue of the Medicare Weekly Update, CMS had previously announced that hospitals must begin using the new form no later than September 1, 2008. The instructions that CMS issued with the form are relatively terse and do not address many of the details relating to the ABN that are currently set forth in Chapter 30 of the Medicare Claims Processing Manual. However, CMS has not updated Chapter 30 to reflect the numerous changes made in the new ABN form. As discussed in the May 27, 2008 issue of the Medicare Weekly Update, this leaves hospitals in a difficult position. They have to begin planning for implementation of the new ABN form even though the current CMS manual instructions are based on the old form.

My colleague Kimberly Hoy contacted CMS last week to ask whether CMS planned to issue revised manual instructions for the new ABN form prior to September 1.   Here is the response Kimberly received from Charlayne D. Van, J.D. at CMS:

“Yes, we do plan to publish revised manual instructions soon. Until such time, the current manual instructions should be used for issues not addressed in the revised form instructions.”

We will, of course, let everyone know as soon as the new manual instructions are issued. In the meantime, hospitals will have to contact their local FI or MAC for guidance in resolving inconsistencies between the current CMS manual instructions and the new ABN form.




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