URGENT: New Regulation Requiring Notice of Medicare Non-Coverage to Include BFCC-QIO Information

A new regulation has been released regarding Medicare Advantage plans. If you are providing home health services to a patient enrolled in a Medicare Advantage plan, you are now required to issue the Notice of Medicare Non-Coverage. This notice must include information about the BFCC-QIO, allowing patients the opportunity to appeal decisions related to their discharge.

This notice ensures patients receive the necessary information to contact their Medicare Advantage plan and appeal decisions regarding their care.

Starting January 1, 2025, any Notice of Medicare Non-Coverage issued by home health or hospice to a patient enrolled in Medicare Advantage must include the same BFCC-QIO information provided to traditional Medicare home health patients. This ensures that Medicare Advantage patients will have the right to request an immediate review of termination or discharge decisions through the BFCC-QIO.

This change stems from a regulation issued in June 2024. The updated Notice of Medicare Non-Coverage, set to take effect on January 1, 2025, includes an expiration date at the bottom indicating November 2027.

The new forms will take effect in January, and surveyors are expected to verify that agencies are using them correctly and are in compliance with providing the required information to Medicare Advantage patients.