Q&A: Delivery of the follow-up Important Message from Medicare
Q. What guidelines should be followed when delivering the follow-up Important Message from Medicare (IM)?
A. This seemingly straightforward requirement has caused much confusion regarding delivery of the follow-up copy. The confusion rests primarily with the required timing of delivery of the follow-up copy. Delivery must occur no more than two calendar days before discharge. However, the time of discharge often is unknown until it actually occurs. Hospitals have tried to find ways to meet the requirement that the follow-up copy be delivered no more than two calendar days before discharge.
The notification of discharge and appeal rights is a two-step process:
- The IM contains more specific information for beneficiaries or their representatives. Delivery must occur within two days of admission to acute inpatient level of care. Patients must sign the IM upon admission. A copy of the signed IM or a new one must be given to patients no sooner than two days before discharge. A copy of the Important Message may be delivered the day of discharge, but only when unanticipated situations occur. Patients must have time to consider their rights.
- Patients who appeal their discharge, or their representatives, will be instructed to call the BFCC-QIO to begin the appeal process. Upon receipt of notification by the BFCC-QIO, the hospital must prepare and deliver a detailed notice that describes facts relevant to the decision that the patient no longer meets medical necessity for hospital level of care. Financial liability becomes an issue when the patient appeals a discharge and review commences.
For more information, see Discharge Planning Guide: Tools for Compliance, Fourth Edition.
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