Friday, August 19, 2016

Comment Period Open on the Revised Medicare Outpatient Observation Notice

Dana Halvorson

The Notice of Observation Treatment and Implication for Care Eligibility (NOTICE) Act requires hospitals to notify Medicare beneficiaries of their outpatient status within 36 hours. Outpatient status affects a patient’s ability to receive Medicare coverage for post-acute care in a skilled nursing center. AHCA/NCAL supports the NOTICE Act law.

On August 2, 2016, the final rule from the Centers for Medicare and Medicaid Services (CMS) on the implementation of the NOTICE Act was released. A brief summary of the NOTICE Act section of the CMS final rule put together by Hancock, Daniel, Johnson & Nagle, P.C., is available here. The NOTICE Act had technically required that Medicare eligible patients receive a notice of their outpatient observation status starting on August 6, 2016. However, the CMS final rule notes that the Medicare Outpatient Observation Notice (MOON) has not yet been approved for use and is thus delaying official implementation of the law until Fall 2016.

According to an August 16, 2016, CMS email notice, beginning August 2, 2016, the public has 30 days to comment on the revised MOON under the Paperwork Reduction Act (PRA). The information collection request will be submitted to the Office of Management and Budget (OMB) for review and approval. The information collection requirements are not effective until approved under a valid OMB control number.

CMS expects final PRA approval of the MOON around the time the implementing regulations are effective. It also expects hospitals and CAHs to begin using the MOON no later than 90 calendar days from the date of final approval of the MOON by OMB. The draft MOON subject to the 30 day comment period, along with instructions on how to submit comments, can be found here. The comment period ends September 1, 2016. According to the CMS email, the Agency will provide additional information related to MOON implementation on its Beneficiary Notices Initiative webpage when the MOON is approved and in a Health Plan Management System memorandum to Medicare Advantage plans.

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