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Revised Hospital Discharge Appeal Notices

August 23, 2017
On June 7, 2017, the Centers for Medicare & Medicaid Services (CMS) posted new versions of the Important Message from Medicare (IM) form (CMS-R-193) and the Detailed Notice of Discharge (DND) form (CMS 10066) on the Hospital Discharge Appeal Notices page of the Beneficiary Notices Initiative website (located at http://tiny.cc/HospitalNotices). The associated instructions for use are also available.
The new IM form incorporates the following language related to discrimination – “For more information, call 1-800-MEDICARE (1-800-633-4227), or TTY: 1-877-486-2048. CMS does not discriminate in its programs and activities. To request this publication in an alternate format, please call: 1-800-MEDICARE or email: AltFormatRequest@cms.hhs.gov.” The DND form also has new language related to discrimination. Both forms have new expiration dates. Questions regarding the IM and DND can be e-mailed to BNImailbox@cms.hhs.gov.
CMS is requiring that the new version of these forms must be in use by August 28, 2017.

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