Source of Beneficiary Notification

70.6.1 - Source of Beneficiary Notification (Rev.: 4198; Issued: 01-11-19; Effective: 04-30-18; Implementation: 04-30-18) Written Notification must be given by one of the following sources: A. The SNF that is furnishing non-covered extended care items or services. Examples: • On or before the day of admission, the SNF furnishes to the beneficiary a SNF ABN notifying the beneficiary that the extended care item(s) or service(s) is non- covered; or • During the inpatient stay, the SNF timely furnishes to the beneficiary a SNF ABN notifying the beneficiary that the covered extended care item(s) or service(s) will no longer be covered. B. The UR entity of the SNF that is furnishing non-covered extended care items or services. Example: • The UR entity timely furnishes to the beneficiary a SNF ABN notifying the beneficiary that the extended care item(s) or service(s) is no longer covered. C. The QIO or Medicare contractor. Example: • The QIO, where a beneficiary is in a swing bed, timely furnishes to the beneficiary, a SNF ABN notifying the beneficiary that the extended care item(s) or service(s) is not covered or the item(s) or service(s) is no longer covered. NOTE: This occurs after the beneficiary receives a HINN 1 (Preadmission/Admission HINN) and after the QIO’s decision of the non- coverage. • The Medicare contractor sends the beneficiary her or his first notification of non- coverage (e.g., the MSN). 70.7 – 70.13 New sections to be added