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Revised Hospital Discharge Appeal Notices

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 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:" 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
CMS is requiring that the new version of these forms must be in use by August 28, 2017.