Limitation on Liability Notices to Beneficiaries From

120.4 - Limitation on Liability Notices to Beneficiaries From Contractors (Rev. 1186, Issued: 02-23-07; Effective: 01-01-06; Implementation: 05-23-07) The contractor adds MSN Limitation of Liability Message 50.36.2 to the MSN sent to the beneficiary (who is presumed not to have knowledge of nonpayment by Medicare) at the time of the initial determination. To message 50.36.2, it also adds the following language: Do not apply if your (doctor/supplier) told you in writing, before furnishing the service, that Medicare would not pay. The contractor adds MSN Limitation of Liability Message 50.36.1 to the MSN sent to the beneficiary (who is held to have had knowledge of nonpayment by Medicare) at the time of the initial determination. The contractor adds, from the Remittance Advice Remarks Codes, the Justification for Services Remark M25 to the RA sent to the physician/supplier (who is presumed to have knowledge of nonpayment by Medicare) at the time of the initial determination. The contractor adds, from the Remittance Advice Remarks Codes, the Justification for Services Remark M38 to the RA sent to the physician/supplier who is held to be not liable because the beneficiary is held liable at the time of the initial determination. In addition to the above, as appropriate, the contractor notifies both the beneficiary and the physician/supplier at the time of the initial determination of their appeal rights (this is contained on the back of the MSN and the RA).