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Hospital Discharge Appeal Notices

Both Medicare beneficiaries and providers have certain rights and protections related to financial liability under the Fee-for-Service (FFS) Medicare and the Medicare Advantage (MA) Programs. These financial liability and appeal rights and protections are communicated to beneficiaries through notices given by providers.

On November 27, 2006, the Centers for Medicare & Medicaid Services (CMS) published a final rule, CMS-4105-F: Notification of Hospital Discharge Appeal Rights. Beginning July 1, 2007, hospitals must deliver a revised version of the Important Message from Medicare (IM) to inform all Medicare beneficiaries, including Medicare Advantage enrollees, Medicare as a Secondary Payor (MSP) and dual-eligible beneficiaries, who are hospital inpatients about their hospital discharge appeal rights.

CMS has provided guidelines regarding the delivery of the initial follow-up IM along with communication specifications regarding the size of the notice. Beneficiaries who choose to appeal a discharge decision will receive a more detailed notice outlining the rationale and applicable Medicare Coverage guidelines for such a decision.
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