Delores L. Galias, RN, RHIT

STATEMENT OF CONFIDENTIALITY:
The information contained in this electronic message and any attachments to this message are intended for the exclusive use of the addressee(s) and may contain confidential or privileged information. If you are not the intended recipient, please notify D. Galias, RN, RHIT immediately at [EMAIL PROTECTED] and destroy all copies of this message and any attachments.  Thank you for your cooperation

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Internet-Only Manual: Pub. 100-4, Medicare Claims Processing Manual,
Chapter 30, Financial Liability Protections, was published online and
effective on October 1, 2003. It is available at
http://www.cms.hhs.gov/manuals/104_claims/clm104c30.pdf. This chapter
includes Section 70, "Form CMS-10055 Skilled Nursing Facility Advance
Beneficiary Notice (SNFABN)."  The SNFABN is intended to replace the
five previous SNF notices of noncoverage (NONCs) that were published in
Pub. 12, Skilled Nursing Facility Manual, at section 358.

Implementation: The new model SNFABN form was available for use as of
October 1, 2003. This form is available online at CMS's Beneficiary
Notices Initiative webpage at: http://www.cms.hhs.gov/medicare/bni/
Although we strongly encourage use of the new form, it is not yet
mandatory and we recognize that SNFs may need several months to switch
over to the use of the new form. Until the form has been finalized
through the Paperwork Reduction Act (PRA) public comment and clearance
process and becomes a mandatory use form, intermediaries will not
require use of the new ABN for liability transfer purposes. Interested
parties will have an opportunity to participate in a public meeting on
the SNFABN at CMS on March 16, 2004 and to submit comments during the
PRA process comment periods. The details of this public meeting will be
published in an upcoming Federal Register notice, expected during the
final week of February 2004. We anticipate that the SNFABN will become a
mandatory form around October 1, 2004. We will provide written
clarification via the CMS' SNF list-serve and through the fiscal
intermediaries when the new SNFABN becomes a mandatory, standardized
form.

Practical Effect:  While the SNFABN is still a model form for the time
being, SNFs that wish to afford beneficiaries the best notice possible,
and to best ensure that they are not made liable on the basis of
ineffective notice, are advised to use the model SNFABN (in conjunction
with the advance beneficiary notice policies enunciated in Chapter 30,
especially in Sections 40.3 & 70). The model SNFABN has precisely the
same weight now that the NONCs in Exhibits 1-5 of Pub. 12 Sec. 358 had
previously: SNFABNs are the agency's current best advice as to proper
notice. We believe the new form should greatly simplify SNF notice
procedures by eliminating the inherent confusion associated with the use
of the five different notices, depending on the situation. The earlier
NONCs are no longer included in agency instructions, and their use
should be phased out as soon as possible.

The Beneficiary Notices Initiative (BNI): The use of beneficiary
notices is one of CMS's best opportunities to achieve successful
outreach to program beneficiaries. CMS directly touches the lives of
millions of beneficiaries every day by its program notices to
beneficiaries. The purpose of the BNI is to wed consumer rights and
protections with effective beneficiary communication, so that
beneficiaries are given the opportunity to timely exercise their rights
and protections in a well-informed manner. The new SNFABN is the latest
product of these efforts.

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