SNF Notice Cheat Sheet
health provider must give an advance, completed copy of the
Notice of Medicare Non-Coverage (NOMNC) to enrollees receiving skilled nursing, home health (including
psychiatric home health), or comprehensive outpatient rehabilitation facility services, no later than two days before the termination of services.
This notice fulfills the requirement at 42 CFR 422.624(b) (1) and (2)In situations where the termination decision is not delegated to a provider, the plan must provide the service termination
date to the provider not later than two days before
the termination of services for timely delivery to occur.
NOMNC Guidance Issued to MyCare Ohio Plans
April 10, 2015.
When should providers issue the Notice of Medicare Non
Under Section 2.10.5 of the Ohio 3
-way contract, and in accordance with Chapter 9, Section 8
of the MyCare Ohio member handbook,
beneficiaries receiving services from home health
agencies (HHAs), comprehensive outpatient rehabilitation facilities (CORFs), and skilled nursing
facilities (SNFs) must receive a
Notice of Medicare Non
Coverage (NOMNC) at least two
calendar days before a
covered service is scheduled
Providers are responsible
for delivering this notice.
More detail about the NOMNC is available at
-The NOMNC gives a beneficiary
access to a fast-
track Medicare appeals process designed to
prevent inappropriate termination of services
or discharge from a facility
. The process and
notices were implemented as part of a 2003 litigation settlement and are not waived as part of
the MyCare Ohio demonstration.
Note also that Medicare rules require issuing the NOMNC only when Medicare-covered services are terminating.
Reductions in services are not subject to the NOMNC rules.
In the context of the MyCare Ohio demonstration, there are
circumstances where the NOMNC should be tailored or not be issued. For example:
If the “Medicare-covered” portion of a benefit ends
, but the “Medicaid-covered” portion of the benefit provides unchanged coverage for the beneficiary, the NOMNC
should not be issued.
If the end of the “Medicare-covered” portion of the benefit results in a reduction in services for the beneficiary
, the plan/provider should issue the NOMNC and specify in
the “Additional Information” field in the NOMNC
how the beneficiary’s services are changing and that a discharge or service termination is not occurring.
If the “Medicare-covered” portion of the benefit is endin
g, and the service is not being
continued under the Medicaid benefit
the NOMNC should be issued.
If a member is receiving skilled services beyond the usual 100 day benefit period for Medicare (for example they are receiving skilled services under the plan for 105 days), do not issue the NOMNC if the services terminate on day 105. Under Medicare rules, the NOMNC is not issued when a Medicare service is exhausted.
Part A ABN
Part B ABN
NEMB Form- Notice of Exclusion From Medicare Benefits