Notification of Limitation on Liability Decision

40.6.5 - Notification of Limitation on Liability Decision (Rev. 133, 04-02-04) SNF-517.8 Detailed instructions and application of limitation on liability is found in The Medicare Claims Processing Manual, Chapter 30, “Limitation on Liability.” The limitation on liability decision is made by the A/B MAC (A) when the medical evidence and admission notice, or the bill is submitted. When coverage is denied, notification will be by telephone, if possible, so written notice can be provided to the patient immediately. When it is determined during the course of a beneficiary’s stay in an SNF that the care is not covered but both the beneficiary and the SNF are entitled to limitation on liability, the Medicare program may make payment for the noncovered services for a grace period of one day (24 hours) after the date of notice to the SNF or to the beneficiary, whichever is earlier. If it is determined that more time is required in order to arrange post-discharge care, up to 1 additional “grace period” day may be paid for. Limitation of liability may apply to Part A and Part B services furnished by the provider.