Hospital Discharge Appeals and the Important Message from Medicare
On November 27, 2006, the Centers for Medicare & Medicaid Services (CMS) published a final rule, CMS-4105-F: Notification of Hospital Discharge Appeal Rights. Beginning July 2, 2007, hospitals must deliver a revised version of the Important Message from Medicare to inform Medicare beneficiaries who are hospital inpatients about their hospital discharge appeal rights. Notice is required both for Original Medicare beneficiaries and for those enrolled in Medicare health plans. Beneficiaries who choose to appeal a discharge decision will receive a more detailed notice that will be issued by the hospital.
Hospitals must issue an Important Message from Medicare notice within two calendar days of admission and obtain the signature of the patient or representative to indicate understanding. A copy should be provided to the patient/representative, and a copy of the IM should be kept by the facility. The initial copy of the IM may be delivered at the time of a preadmission or registration visit, but not more than 7 calendar days prior to the actual admission.
Hospitals will also deliver a follow-up IM as far in advance of discharge as possible, but not more than two calendar days before discharge. If the initial IM was received and signed as part of preadmission registration, and this occurred more than 2 calendar days prior to discharge, a follow up copy of the notice is required.
Expedited discharge appeals will be conducted by the KFMC Review Team as part of our responsibilities as the Medicare QIO for Kansas. Appeals will require that a copy of the Important Message from Medicare, Detailed Notice of Discharge, and the beneficiary's medical record be provided to KFMC no later than noon that day after we notify the hospital of the appeal request. KFMC's decision will be issued within one calendar day after receiving all pertinent information.
The phone number that should be listed on the Important Message from Medicare for the Kansas Foundation for Medical Care is 1-800-432-0407 and the TTY # is 1-800-766-3777.
Below you will find links to the Important Message from Medicare, the Detailed Notice of Discharge, regulations, and resources related to the discharge appeal process.
Important Information
- Discharge Appeals Process
- Educational Webex for Providers Regarding Hospital Discharge Appeals
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CMS Information & Resources
The latest information, documents and resources for Hospital Discharge Appeal Notices can be found on the CMS website. 