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Focus on the F-tag: SNFABN

Skilled Nursing Facilities (SNFs) must issue a liability notice to Original fee-for-service (FFS) Medicare beneficiaries before the SNF provides an item or service that is usually paid for by Medicare but may not be paid for in this instance because it is not medically reasonable and necessary, or custodial care. In January 2018 CMS released a newly revised Skilled Nursing Facility Advance Beneficiary Notice of Non-coverage (SNFABN) along with newly developed, concise and separate instructions for form completion. The revised SNFABN has the requirements from the Denial Letters and looks like the ABN with 3 different options for Original FFS Medicare beneficiaries to choose from.
 
At that time, CMS discontinued the 5 SNF Denial Letters and the Notice of Exclusion from Medicare Benefits - Skilled Nursing Facility (NEMB-SNF). Since the NEMB-SNF was used as a voluntary notice for care that is never covered by Medicare, CMS encourages providers to issue the revised SNFABN in this voluntary capacity. The revised SNFABN was distributed for use on May 7, 2018. MHCA has attached the form to this week's MHCA E-News for ease of access.
 
For Part A items and services: SNFs must use the newly revised SNFABN as the liability notice. For Part B items and services: SNFs must use the Advance Beneficiary Notice of Non-coverage (ABN), Form CMS-R-131. The ABN and information on this notice can be found here.
 
Staff Contact:
Danielle Watford
Director of Quality Improvement & Regulatory Affairs
dwatford@mehca.org