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Beneficiary Notices Initiative (BNI)

Please Note: For Medicare Prescription Drug Coverage Notices -- see below under "Related Links."

Beneficiary Notices Initiative

Both Medicare beneficiaries and providers have certain rights and protections related to financial liability under the Fee-for-Service (FFS) Medicare and the Medicare Advantage (MA) Programs. These financial liability and appeal rights and protections are communicated to beneficiaries through notices given by providers.

Use the navigation tool on the left side of this page to link to the following financial liability notices and their instructions:

  • FFS Advance Beneficiary Notice of Noncoverage (FFS ABN)
  • FFS Home Health Change of Care Notice (FFS HHCCN)
  • FFS Skilled Nursing Facility Advance Beneficiary Notice (FFS SNFABN) and SNF Denial Letters
  • FFS Hospital-Issued Notices of Noncoverage (FFS HINNs)
  • FFS Expedited Determination Notices for Home Health Agencies, Skilled Nursing Facility, Hospice and Comprehensive Outpatient Rehabilitation Facility  (FFS ED Notices)

        Note: Guidance is available for the FFS Expedited Determination Process.  See "Related Links" below, titled "Transmittal 2711 - Expedited Det (Eff Aug 26, 2013)".

  • MA Denial Notices (MA Denial Notices)
  • MA Notice of Discharge and Medicare Appeal Rights (MA NODMAR)
  • MA Expedited Determination Notices (MA ED Notices)
  • Important Message from Medicare (IM) and Detailed Notice of Discharge (DND) (Hospital Discharge Appeal Notices)
  • FFS Notice of Exclusion from Medicare Benefits - Skilled Nursing Facility (FFS NEMB SNF)

August 2016:  The Home Health Change of Care Notice (HHCCN), Form CMS-10289, and form instructions have been approved by the Office of Management and Budget (OMB) for renewal. While there are no changes to the form itself, providers should take note of the newly incorporated expiration date in the form instructions. Additional information, along with the form and corresponding instructions, are available on the “FFS HHCCN” page located in the navigation pane on the left side of this page.

Medicare Outpatient Observation Notice (MOON)

The Medicare Outpatient Observation Notice (MOON) is a standardized notice developed to inform beneficiaries (including Medicare health plan enrollees) that they are an outpatient receiving observation services and are not an inpatient of the hospital or critical access hospital (CAH).  

The MOON is mandated by the Federal Notice of Observation Treatment and Implication for Care Eligibility Act (NOTICE Act), passed on August 6, 2015.  The NOTICE Act requires all hospitals and CAHs to provide written and oral notification under specified guidelines.

CMS held a listening session on December 21, 2015 to solicit the input of the hospital industry, beneficiary advocates, and other stakeholders regarding CMS’s implementation of the MOON. See the link to the written transcript in "Downloads" below.  The link to the audio file of this listening session can be found in "Related Links" below.

CMS Proposals

Updated versions of the MOON, its instructions, and implementing regulations were posted on August 2, 2016, in conjunction with the FY 2017 Medicare hospital inpatient prospective payment systems (IPPS) final rule. 

See "Federal Register - IPPS - NOTICE Act Final Rule" and "CMS-10611" in "Related Links" below to view the proposed NOTICE Act regulation (Section L and 42 CFR 489.20), the updated draft MOON, and accompanying materials. For instructions on how to comment on the MOON and related material, please see "CMS-10611" in "Related Links".