Health Information Management

Ask the expert: How should we deliver the Important Message from Medicare that went into effect on July 1?

HIM-HIPAA Insider, September 25, 2007

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A: When delivering the initial copy of the Important Message from Medicare using standardized notice CMS-R-193, hospitals must:

  • Deliver it within two calendar days of admission or at preadmission, but not more than seven calendar days before admission.
  • Ensure the beneficiary understands the information. Hospital staff members should be prepared to explain it, answer questions, and assess the beneficiary's comprehension. The beneficiary should sign and date the notice.
  • Give the beneficiary a copy of the notice upon signed delivery and retain a copy to store in the patient's record (either paper or electronic).

If a patient or representative refuses to sign this notice, the hospital should note the refusal and retain a copy of the notice. In this case, the date of refusal is the date of receipt of the notice.

Editor's note: This Q&A was adapted from an article in the September 2007 issue of Briefings on Coding Compliance Strategies. For more information, visit

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