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FFS ED Notices

HHAs, SNFs, Hospices, and CORFs are required to provide a Notice of Medicare Non-Coverage (NOMNC) 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.

Download FFS Expedited Determination Notices and Instructions

August 2014 – IMPORTANT:  UPDATING MEDICARE NOTICES WITH NEW QIO INFORMATION

Original Medicare providers, suppliers, as well as Medicare Advantage Organizations and Prescription Drug Plans should update their Medicare notices with the correct Quality Improvement Organization (QIO) contact information as quickly as possible and no later than September 1, 2014.  Please see www.qioprogram.org for QIO details.

NOTE: GUIDANCE IS AVAILABLE FOR THE FFS EXPEDITED DETERMINATION PROCESS.  THIS GUIDANCE BECAME EFFECTIVE AUGUST 26, 2013.  FOR DETAILS, SEE THE "RELATED LINK" BELOW, TITLED, "TRANSMITTAL 2711 - EXPEDITED DET (EFF AUG 26, 2013)".

To download the FFS Expedited Determination Notices and Instructions, please click on the appropriate link below.