An intermediary has explained that all continuing care patients must receive an ABN every 60 days. However, such an approach would represent a significant change in past requirements where HCFA accepted a single notice to a patient with the opportunity for the patient to request a demand bill for any portion of care rendered. We believe that the use of a 60-day periodic notice is unnecessary. A notice every 60 days in no way addresses the timing of potential changes in Medicare coverage eligibility. There is nothing relevant in the use of a 60-day cycle in the Medicare coverage determination process.
Coverage can vary from one visit to the next even on the same day.
Since it is inconceivable that Medicare would require an ABN every visit, the use of a 60-day periodic notice basis serves no useful purpose. If the patients are aware that they have a right to request a demand bill at any point in their care, then ongoing notices represent merely a unnecessary administrative burden an a device for creating potential confusion within beneficiaries. Perhaps the best approach is to modify the form notice to specifically state that it relates to all succeeding care. Patients have expressed confusion regarding their status as a dual eligible patient. They recognize that their Medicaid enrollment should protect them from personal liability.