Notice of Discharge and Medicare Appeal Rights –

7050 - Notice of Discharge and Medicare Appeal Rights – (Rev. 4, 07-18-03) The Medicare+Choice Organization (M+CO) or the hospital (as delegated) issues the NODMAR with the physician's concurrence to the M+C enrollee. The physician's concurrence acknowledges agreement that inpatient hospital care is no longer necessary. A. When the M+CO Issues the NODMAR The M+CO issues the NODMAR to the M+C enrollee once the required concurrence of the physician who is responsible for the enrollee's hospital care has been obtained (See 42 CFR 422.620(b)). B. When Hospital Accepts Delegation If the M+CO allows the hospital to make the non-coverage/discharge determination (delegation), the hospital must obtain concurrence from the contracting physician responsible for the enrollee's hospital care or of another physician as authorized by the M+CO (see 42 CFR 422.620(d)). C. Content of NODMAR The NODMAR must include the following information:  The reason why inpatient hospital care is no longer needed;  The effective date of the enrollee's liability for continued inpatient care; and  The enrollee's appeal rights. D. QIO Responsibility -- You are not required to review or educate the plans regarding the content of the NODMAR. However, if you find an inappropriate NODMAR (e.g., the liability date is missing) during the course of your review, you are expected to report such findings to the CMS RO plan manager through your Project Officer.