Expedited Determinations for Provider Service Terminations

August 2, 2013
Rick Gawenda

On July 1, 2013, the Centers for Medicare and Medicaid Services (CMS) issued a revised MLN Matters publication on expedited determinations for provider service terminations. This MLN Matters® Article is intended for Home Health Agencies (HHAs), Comprehensive Outpatient Rehabilitation Facilities (CORFs), Hospices, and Skilled Nursing Facilities (SNFs) providing services to Medicare beneficiaries. This has implications for therapy services reimbursed under both Part A and Part B benefits. Topics discussed include: Health Care Settings in Which the Expedited Determination Process is Available to Beneficiaries, Care Settings in which Notice of Medicare Non-Coverage (NOMNC) Delivery Does Not Apply, NOMNC Preparation and Delivery, Amending the NOMNC Date, Beneficiary Responsibilities, Provider Responsibilities, and Effect of Quality Improvement Organization Determination on Continuation of Care.

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