Beneficiary Notification

20.3.1.1 - Beneficiary Notification (Rev. 1, 10-01-03) Before admitting a beneficiary, the SNF must notify the beneficiary or responsible family member that sanctions have been imposed, and explain how the sanctions will affect the beneficiary’s benefits. This Notice of Non-Coverage also applies to former residents that had been discharged with no expectation of return and are being readmitted after the imposition of the payment ban. SNFs failing to provide this notification will be held liable for all Part A services covered under SNF PPS. The beneficiary notice must meet the following criteria: a. It must be in writing. b. It must explain the reason sanctions were imposed. c. It must explain the beneficiary’s liability for the cost of SNF services during the period the payment ban is in effect. d. It must explain that Medicare Part A benefits may be available if the beneficiary chooses a different Medicare-participating SNF that is not under sanction.