Background on the HHCCN

60.1 - Background on the HHCCN (Rev. 2781, Issued: 09-06-13, Effective: 12-09-13, Implementation: 12-09-13) HHAs have issued HHABNs related to the absence or cessation of Medicare coverage when a beneficiary had liability protection under §1879 of the Social Security Act (the Act) since 2002. The HHABN gained additional notification capabilities in 2006 following the U.S. Court of Appeals (2nd Circuit) decision in Lutwin v. Thompson, 361 F.3d 146; 2004 U.S. App. LEXIS 3774. Following Lutwin, the HHABN was modified so that it could also be used by HHAs to notify beneficiaries receiving home health services of any care changes in accordance with the HHA conditions of participation (COPs) in §1891 of the Act. To account for this expanded use, the HHABN was revised to contain three interchangeable Option Boxes within the body of the notice designated as Option Box 1, Option Box 2, and Option Box 3. Option Box 1 language was applicable to situations involving potential beneficiary liability for HHA services as directed by §1879 of the Act. Option Box 2 or Option Box 3 was inserted into the HHABN form to notify beneficiaries of changes in a home health plan of care that are subject to the requirements of § 1891 of the Act. In order to streamline, reduce, and simplify notices issued to Medicare beneficiaries, the HHABN is being discontinued. HHABN, Option Box 1, which is the liability portion of the notice, is replaced by the existing Advance Beneficiary Notice of Noncoverage (ABN), CMS-R-131. The change of care notification portions of the HHABN, Option Box 2 and Option Box 3, is replaced by the newly approved HHCCN.