The Office of Management and Budget has renewed the Notice of Medicare Non-Coverage (NOMNC) and the Detailed Explanation of Non-Coverage (DENC) with updates which are applicable only to Medicare Advantage enrollees.
Providers must use the current notices until Dec. 31, 2024, and are required to use the new NOMNC and DENC beginning Jan. 1, 2025.
Home health and hospice providers, along with others, are required to provide a NOMNC to beneficiaries when their Medicare covered services are ending. The NOMNC informs beneficiaries on how to request an expedited determination from their Beneficiary and Family Centered Care Quality Improvement Organization.
The NOMNC has been modified to reflect regulations providing enrollees additional fast-track appeal rights when they untimely request an appeal or still wish to appeal after they end services on or before the planned termination date.
A DENC is given only if a beneficiary requests an expedited determination. The DENC explains the specific reasons for the end of covered services. DENC instructions have been updated to include a new element for health plans to complete.