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MA ED Notices

Medicare health plan enrollees receive a Notice of Medicare Non-Coverage (NOMNC) prior to termination of Medicare-covered skilled nursing facility (SNF), home health (HH), and comprehensive outpatient rehabilitation facility (CORF) services.  The NOMNC informs individuals of their right to an immediate, independent review of the proposed discontinuation of covered services. 

Plans are required to provide a Detailed Explanation of Non-Coverage (DENC) when an independent review is requested.  The DENC provides additional explanation concerning the reasons Medicare coverage is ending.

To download these notices, and corresponding instructions, please click on the links below under "Downloads."

Plans currently are required to use the versions of the Medicare notices and instructions posted below, under  "Downloads."

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

Providers, suppliers, 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  http://www.qioprogram.org/  for QIO details.

To access these notices, click on the links below, under "Related Links Inside CMS."