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Note from Hugh

Medicare Weekly Update, July 17, 2007

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This week CMS updated a few frequently asked questions on their website related to the new expedited review notice requirement and advance notice requirements for non-covered care in an inpatient setting. Recall that the expedited review notice is required upon admission and upon discharge (in certain circumstances) for patients at an inpatient level of care covered by Medicare.

As you are aware, the new Important Message from Medicare delivers notice of expedited review rights, but not potential liability for the patient. On the May Special Open Door Forum on the new expedited review notices, CMS indicated that the Hospital Issued Notices of Non-Coverage (HINNs), which delivered notice of liability, had been eliminated. At that time they indicated they would issue guidance on what type of notice would be used in the future to notify patient of potential liability but that it would be either a "Inpatient ABN" or some other type of notice.

As of the July 1st effective date of the changes described above, CMS had not issued guidance on which notices should be used to notify patients of their potential liability in an inpatient setting. I wrote to CMS requesting guidance on this issue. This week I received a response from CMS indicating that providers should continue to use the old HINN notices, deleting the language related to QIO review because this is now included in the Important Message from Medicare. I encourage everyone to review the series of FAQs from 6516-6521 for any questions they have on notices to inpatients.

~ Kimberly Anderwood Hoy, Esq.

Editor's Note: Kimberly Anderwood Hoy, director of Medicare and compliance for HCPro, is the author of this week's "Note from Hugh" in Mr. Aaron's absence.

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