Medicare health plan enrollees receive a Notice of Medicare Non-Coverage (NOMNC) prior to termination of Medicare-covered skilled nursing facility (SNF), home health (HH), and comprehensive outpatient rehabilitation facility (CORF) services.  The NOMNC informs individuals of their right to an immediate, independent review of the proposed discontinuation of services. 

Plans are required to provide a Detailed Explanation of Non-Coverage (DENC) when an independent review is requested.  The DENC provides additional explanation concerning the reasons Medicare coverage is ending.

CMS regulations ensure that, when an enrollee challenges a plan termination decision, an independent review decision is made before the enrollee incurs liability.  

To download these notices and instructions, please click on the appropriate link below.

Downloads
Notice of Medicare Non-Coverage (NOMNC) – English and Spanish [zip, 96KB] 

Instructions for NOMNC [pdf, 26KB] 

Detailed Explanation of Non-Coverage (DENC) – English and Spanish [zip, 93KB]  

Instructions for DENC [pdf, 15KB] 

 

Source:http://www.cms.hhs.gov/BNI/09_MAEDNotices.asp#TopOfPage

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