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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)

Medicare Outpatient Observation Notice (MOON)- Listening Session December 21, 2015

On August 6, 2015, Congress enacted the Notice of Observation Treatment and Implication for Care Eligibility Act (NOTICE Act).  Under this law, all hospitals and critical access hospitals (CAHs) are required to provide written notification and an oral explanation of such notification to individuals receiving observation services as outpatients for more than 24 hours.

The Medicare Outpatient Observation Notice (MOON) was 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 CAH.  The statute prescribes that the notice must include the reasons the individual is an outpatient receiving observation services, and the implications of receiving outpatient services, such as cost sharing, and post-hospitalization eligibility for Medicare coverage of skilled nursing facility (SNF) services.

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 NOTICE Act. 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.