ABN and NOMNC
Question and Answer Series
1. What is the Last Covered Day (LCD) that should be entered on the NOMNC for a patient not dually eligible for Part A and Hospice, who elects hospice?
Enter the effective date that the patient will be responsible for payment, i.e., the first non-covered day. There may be times when the 2-day notice is not possible for example, the patient elects to end Part A and decides to elect Hospice benefit.
Technically speaking if the patient elects to end Medicare, the NOMNC is not required.
2. Is NOMNC required for Medicare Part B therapy?
Yes, the NOMNC must be provided to beneficiaries and/ or enrollees receiving Medicare Part B covered services, including but not limited to:
- skilled nursing,
- home health (including psychiatric home health),
- *comprehensive outpatient rehabilitation facility, and
- hospice services.
*The (CORF) is a medical facility that provides outpatient diagnostic, therapeutic, and restorative services for the rehabilitation of injury, disability, or illness.
CORF care is commonly known as outpatient rehabilitation care.
3. Do you still give the NOMNC with the SNF ABN if an SNF resident chooses hospice immediately and the facility is unable to give a 48-hour notice?
In this scenario, the patient is driving the end of the Medicare Part A coverage due to the election of hospice.
The SNF ABN is important to identify the financial liability as the patient comes off Medicare Part A and will be responsible for room and board.
The Hospice GIP benefit is brief and not all facilities can offer this service.
The lack of a 2-day notice is acceptable if the patient is making the determination and was not denied coverage by the facility.
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