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."
March 2012 - IMPORTANT UPDATE:
ISSUANCE OF REVISED NOMNC and DENC, FORM CMS-10123 and CMS-10124
CMS is issuing a new combined Notice of Medicare Non-Coverage. This notice will replace the CMS 10095 (Medicare Advantage notice) and the CMS 10123 (Original Medicare notice).
This combined notice retains the form number of the current Original Medicare Notice (CMS 10123) and the name of the MA notice (Notice of Medicare Non-Coverage, or NOMNC).
CMS also is issuing a new Detailed Explanation of Non-Coverage, or DENC, with the form number CMS 10124.
The new, combined notices must be in use as soon as possible, but no later than May 1, 2012. To access the new notices, click on the links below, under "Related Links Inside CMS."
- UPDATED - Notice of Medicare Non-Coverage (NOMNC) - English and Spanish [ZIP, 68KB]
- UPDATED - Instructions for Notice of Medicare Non-Coverage [PDF, 52KB]
- UPDATED - Detailed Explanation of Non-Coverage (DENC) - English and Spanish [ZIP, 87KB]
- UPDATED - Instructions for Detailed Explanation of Non-Coverage [PDF, 26KB]
- Notice of Medicare Non-Coverage (NOMNC) - English and Spanish [ZIP, 32KB]
- Instructions for NOMNC [PDF, 53KB]
- Detailed Explanation of Non-Coverage (DENC) - English and Spanish [ZIP, 29KB]
- Instructions for DENC [PDF, 78KB]
- Page last Modified: 08/12/2013 1:23 PM
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