Medicare Compliance & Reimbursement

Question: Our practice thought the new advance beneficiary notice (ABN) form was supposed to be implemented in August. We haven’t seen any new updates. Did we miss it?

Ohio Subscriber

Answer: No, you haven’t missed the change. Prior to the COVID-19 pandemic, there were plans by the Office of Management and Budget (OMB) to issue a renewed ABN form at the end of August.

The Centers for Medicare & Medicaid Services (CMS) recently issued an updated notice to expand the deadline for the implementation of ABN Form CMS-R131 until Jan. 1, 2021. However, if you want to start using the renewed ABN Form CMS-R131 before the mandatory implementation date, you can. The new compliance date gives practices struggling with other burdens more time to implement the form if they need it. 

Remember: The ABN is a notice given to Part B beneficiaries by providers to explain that a respective service is unlikely to be reimbursed by Medicare. If Medicare denies the service, the patient will sign the form to agree that they are to be held accountable for the charges. Keep in mind that other commercial payers may also implement their own versions of the ABN.

Review Form CMS-R131 at https://www.cms.gov/Medicare/Medicare-General-Information/BNI/ABN.