Case Management

Q&A: Delivering the second IM on the day of discharge

Case Management Weekly, March 9, 2011

Q: If a situation requires the hospital to provide the follow-up Important Message from Medicare (IM) on the day of discharge, would the delivery still be in compliance with regulations?

A: As long as the hospital does not routinely deliver the follow-up copy on the day of discharge, and there are extenuating circumstances preventing delivery before the day of discharge, such as waiting for lab results, the hospital can validly deliver the follow-up IM on the day of discharge.

When the hospital delivers the IM on the day of discharge, the hospital must allow the beneficiary to remain an inpatient for at least 4 hours following IM delivery, so that he or she has time to consider, and if desired, submit a Quality Improvement Organization review request. The beneficiary is not required to remain in the hospital 4 hours after notice delivery if he or she  is in agreement with the discharge decision.

This week’s tip is adapted from Important Message (IM): Frequently Asked Questions document that CMS provided to the American Case Management Association (ACMA). For more information about this document and to read more questions and answers visit the ACMA website.

Do you have a question about a case management topic? Send it to Associate Editor Ben Amirault at An answer to your question might appear in a future issue of Case Management Weekly.

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