30.06.20 | Noreen Hiltsley

SKILLED NURSING FACILITY ADVANCE BENEFICIARY NOTICE OF NON-COVERAGE

SKILLED NURSING FACILITY ADVANCE BENEFICIARYNOTICE OF NON-COVERAGE 
To our valued customers:

The ABN, Form CMS-R-131 notice is subject to comment and re-approval every 3 years. The ABN, Form CMS-R-131 has been approved by the Office of Management and Budget (OMB) for renewal. The new renewal form has an expiration date of 06/30/2023 and will be mandatory on 8/31/2020.

There are no changes in the form itself, or its purpose, however, it now allows for dual eligibility (Medicare and Medicaid) for beneficiaries. This is outlined in the new instructions. The ABN form and instructions may be found at:https://www.cms.gov/Medicare/Medicare-General-Information/BNI/ABN

Please make sure you have systems in place to transition to its use.

As a reminder:
Key elements of the proposed rule include:

Continue to use the ABN FORM CMS-R-131 for items and services that may be denied by Medicare under Medicare Part B to inform beneficiaries of their potential liability.

Events triggering issuance of an ABN remain the same: 
initiation of services a SNF believes Medicare will not reimburse,
reduction of services that a SNF believes Medicare will no longer reimburse, and
termination of services a SNF believes Medicare will nor reimburse.

SNFs should follow the new instructions when completing the SNF ABN Form CMS-R-131

Further information regarding the ABN can be found beginning in Section 50 in the Medicare Claims Processing Manual, 100-4, Chapter 30 (PDF)
Preferred Therapy Solutions continues to provide its partners with vital information that may impact rehabilitation management, reimbursement policies, and clinical programs, supported with compliance and regulatory requirements that are necessary for a thorough understanding on practices and procedures. If you have any questions, please contact Barb Blatt, Appeals Management Coordinator at: bblatt@preftherapy.com.