The Centers for Medicare & Medicaid Services (CMS) recently released a revised Skilled Nursing Facility Advance Beneficiary Notice (SNFABN).
The SNFABN is a liability notice SNFs are required to issue to original fee-for-service Medicare beneficiaries before an item or service covered by Medicare ends or when it’s been determined Medicare will no longer pay for an item or service. SNFs are required to issue the SNFABN in conjunction with the Notice of Medicare Non-Coverage when a Medicare Part A stay ends and the beneficiary is remaining in the facility. The SNFABN informs the beneficiary of his or her liability for payment after Medicare coverage ends.
The CMS will discontinue the use of the five SNF Denial Letters and the Notice of Exclusions from Medicare Benefits - Skilled Nursing Facility (NEMB-SNF). The NEMB-SNF is a voluntary notice used to notify beneficiaries of care that Medicare never covers. The CMS encourages providers to use the SNFABN in its place. The SNFABN will continue to have the three option boxes for beneficiaries similar to the old version including the demand bill request.
Use of the SNFABN Form CMS-10055 (2018) will be mandatory effective May 7, 2018. SNFs may continue to use the old version of the SNFABN, the denial letters and NEMB-SNF until that time.
SNFs are reminded the SNFABN is for Medicare Part A items and services, and the CMS-R-131 continues to be used for Medicare Part B items and services.
Contact Suzy or your trusted BKD advisor with questions.