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Revisions to the ABN Form – Effective 6/21/17

Tuesday, June 6, 2017   (0 Comments)
Posted by: Mandy Rubenstein
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The MHCA Medicare Team wants to ensure members are aware of changes to the Advance Beneficiary Notice of Noncoverage (ABN), Form CMS-R-131, which is issued by home health and hospice providers (as well as other providers and practitioners) to Original Medicare (fee for service) beneficiaries in situations where Medicare payment is expected to be denied. Guidelines for mandatory and voluntary use of the ABN are published in the Medicare Claims Processing Manual, Chapter 30, Section 50.

CMS has made changes in 2 areas of the form:

1. The expiration date at the bottom of the form has been changed to 3/2020

2. The form has been revised to include language informing beneficiaries of their rights to CMS nondiscrimination practices and how to request the ABN in an alternative format if needed.

The effective date for use of this revised ABN form is 6/21/2017. If you have paper copies of this form in your agency, it is recommended that you replace them with an ABN that includes these changes on or before 6-21-17.

Download the ABN in English and Spanish.

More information can be found at:

2550 University Ave. W. | Ste. 350-South
St. Paul, MN 55114-1900

PHONE 866.607.0607 | FAX 651.635.0043