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July 28, 2021

Advance Beneficiary Notice of Non-coverage (ABN) – Revised Guidelines from CMS

CMS has published MLN Matters Number: MM12242External PDF titled “Section 50 in Chapter 30 of Publication (Pub.) 100-04 Manual Updates” to alert suppliers about changes made to the Advance Beneficiary Notice of Non-coverage (ABN) section in the Medicare Claims Processing Manual, Chapter 30, Section 50External PDF. The revised chapter is part of CR 12242External PDF.

Some of the key revisions of Chapter 30, Section 50 include

  • Some general notice preparation requirements for the ABN
  • Period of effectiveness of the ABN for repetitive or continuous non-covered care
  • How the Financial Liability Protections (FLP) provisions apply to dually eligible individuals (a Qualified Medicare Beneficiary (QMB) Program or Medicaid coverage)

These changes are effective with dates of service on or after October 14, 2021. Refer to MLN Matters Number: MM12242External PDF for more information.

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