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FFS HHABN

December 6, 2010: REVISED HHABN, FORM CMS-R-296, posted for download. Mandatory use date: April 1, 2011.

The revised Home Health Beneficiary Notice of Noncoverage (HHABN), Form CMS-R-296, is now available, and Home Health Agencies (HHAs) may begin using this notice immediately.

In order for HHAs to have time to transition to using the newly posted notice, mandatory use of the revised HHABN begins on April 1, 2011. All HHABNs with the expiration date of 08/31/09 that are issued on and after April 1, 2011 will be considered invalid.

The OMB-approved HHABN notices and instructions are posted below under "Downloads."  

 

Downloads

HHABN CMS-R-296 English [zip 13kb]

 

HHABN CMS-R-296 Spanish [zip 12kb] 

 

CMS Manual HHABN Instructions [pdf, 574kb]

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Page Last Modified: 11/14/2011 9:03:29 AM
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