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As of July 1, 2005, Home Health Agencies (HHAs), Skilled Nursing Facilities (SNFs), Comprehensive Outpatient Rehabilitation Facilities (CORFs) and Hospices with beneficiaries in Fee-For-Service Medicare are required to notify beneficiaries of their right to a new expedited review process when these providers anticipate that Medicare coverage of their services will end. HHA, SNF, Hospice, CORF, and swing beds (under instruction) are required to provide a Generic Notice to beneficiaries to alert them that Medicare covered item(s) and/or service(s) are ending and give beneficiaries the opportunity to request an expedited determination from a QIO. A Detailed Notice is given when the QIO review is requested in order to provide more explanation on why coverage is ending. Effective October 1, 2005, HHA, SNF, Hospice, CORF, and swing beds must use approved versions of the Expedited Determination notices. To download the FFS Expedited Determination Notices and Instructions, please click on the appropriate link below.
Page Last Modified: 03/24/2006 10:31:00 AM
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