CMS revises ABN--again

Sunday, June 3, 2007

WASHINGTON - A notice published in the Federal Register May 25 requests a second round of public comments on a further revised advanced beneficiary notice (ABN).

CMS revised the ABN again after receiving 43 responses in the first round of public comments. The further revised ABN continues to combine the general and the laboratory forms into a single notice.

Proposed changes to the ABN include:

* Replace the term "items/services" with a customizable blank space so users can insert a description most appropriate to their specific businesses.
* Use more "beneficiary-friendly" plain language.
* Replace the label "supplier/provider" with "notifier" to capture disparate groups like physicians, practitioners and various supplier and provider types.
* Replace "beneficiary name" with "patient name."
* Simplify the paragraph above the items and service box to clarify that Medicare doesn't pay for all services, even if recommended by a healthcare provider.
* Re-order options in the option box so that the first option is the beneficiary's right to receive services and appeal Medicare should services be denied.
* Change the wording in the option box to note that beneficiaries are still responsible for payment if Medicare doesn't pay; provide information on the Medicare Summary Notice as the vehicle for informing beneficiaries of official payment decisions and appeal rights; and add information on Medicare cost-sharing amounts that are not refundable when Medicare pays.
* Replace "other insurance" with "additional information."
* Remove the heading "Privacy Notice" from the disclosure statement.

For a complete list of changes, go to and click on PRA Listing and then CMS-R-131.