Scope of the HHCCN

60.2 - Scope of the HHCCN (Rev. 2781, Issued: 09-06-13, Effective: 12-09-13, Implementation: 12-09-13) A. Statutory Authorization for HHCCN The requirement to give an HHCCN is based on the HHA COPs in §1891 of the Act. The COPs are further implemented through Title 42 of the Code of Federal Regulations (CFR), Part 484. §1891(a)(1)(E) stipulates that beneficiaries have: “The right to be fully informed orally and in writing (in advance of coming under the care of the [home health] agency) of – all items and services furnished by (or under arrangement with) the agency for which payment may be made under this title, the coverage available for such items and services under this title, title XIX or any other Federal program of which the agency is reasonably aware, any charges for items and services not covered under this title and any charges the individual may have to pay with respect to items and services furnished by (or under arrangement with) the agency, and any changes in the charges or items and services described in clause (i), (ii) or (iii).” HHAs are required to use the HHCCN to notify the beneficiary of reductions and terminations in health care in accordance with Medicare COPs. B. HHAs and Other CMS Notices HHAs will now use the Advanced Beneficiary Notice (ABN), Form CMS-R-131 for liability notification instead of the HHABN Option Box 1. The ABN and form instructions can be downloaded from the CMS website at: http://www.cms.gov/Medicare/Medicare-General-Information/BNI/ABN.html HHAs must continue to issue an expedited determination notice called the Notice of Medicare Provider Non-Coverage, (NOMNC), CMS-10123, if applicable, when all covered services are being terminated. Please see the “FFS ED Notices” link at: http://www.cms.gov/Medicare/Medicare-General-Information/BNI/FFSEDNotices.html for information on the delivery of expedited determination notices. C. HHCCN Issuers and Recipients HHAs are the only type of Medicare provider that issues the HHCCN to notify the beneficiary of care changes involving reductions or terminations of items and/or services. The recipients of the HHCCN are beneficiaries enrolled in Original Medicare only. HHCCNs are not used in Medicare managed care. When a beneficiary transitions to Medicare managed care from Original Medicare during a home health episode, HHCCN issuance is required only if there is a specific need to provide notification of changes in care as the transfer occurs. Subcontractors may deliver HHCCNs under the direction of a primary HHA; however, notification responsibility, including effective delivery, always rests with the primary HHA. HHAs are always responsible for providing HHCCNs associated with the care that they provide. In the form instructions and instructions in this section, the term “beneficiary” is used to mean the beneficiary or the beneficiary's representative, as applicable. For more information on representatives, see §40.3.5 and §40.3.4.3 of this chapter. HHAs should contact their CMS Regional Office if they have questions on the HHCCN or related instructions. Beneficiaries who need assistance may be directed to call 1-800- MEDICARE.