FROM: Theodore O. Will, FACHE /s/ Chief Executive Officer
DATE: March 28, 2012
RE: CHANGES TO CENTERS FOR MEDICARE AND MEDICAID SERVICES’ (CMS) NON- HOSPITAL NOTICES OF NONCOVERAGE
IPRO CONTACT: Andrea Goldstein, Vice President, Medicare/Federal Health Care Assessment, 516-209-5364
The Centers for Medicare and Medicaid Services (CMS) has recently issued a new, combined, Notice of Medicare Non-Coverage. This Notice replaces the CMS 10123 (Original Medicare Notice) and the CMS 10095 (Medicare Advantage (MA) Notice). The combined notice retains the form number of the current Original Medicare Notice (CMS 10123) and the name of the MA Notice (Notice of Medicare Non-Coverage, or NOMNC). This new notice, available in both English and Spanish, can be found on the CMS Beneficiary Notices Initiative (BNI) website at https://www.cms.gov/BNI/ by clicking on the link to “FFS ED Notices” or “MA ED Notices”.
IPRO has received many inquiries regarding the use of this new form. Many of these questions concern which IPRO toll-free number should be utilized. At this time, you may insert either the BIPA FFS number 1-800-833-0356 or the Grijalva MA Fast Track appeal number 1-888-696-9561 on the new notice, as illustrated in the example included with this Memorandum. IPRO will continue to answer all calls received on either telephone number through November 30, 2012
However, with this CMS adoption of one form, IPRO is also now planning the transition to the use of one toll-free telephone number. Therefore, as of December 1, 2012, only the toll-free 1-800-833-0356 number will be utilized for receipt of expedited Non-Hospital appeals. Accordingly, this should be the IPRO toll-free number included on the NOMNC as well.
Please feel free to contact Frances Gordon at 516-209-5304, should you have any questions in regard to this Memorandum.