Hospitals must issue the Important Message from Medicare (IM) within 2 calendar days of the day of admission. The staff must obtain the signature of the beneficiary or his or her representative to indicate that he or she received and understood the notice.
The IM, or a copy of the IM, must also be provided to each beneficiary within 2 calendar days of the day of a hospital discharge. Thus, in cases where the delivery of the initial IM occurs more than 2 days before discharge, hospitals will deliver a follow-up copy of the signed notice to the beneficiary as soon as possible prior to discharge, but no more than 2 days before. For beneficiaries who request an appeal, the hospital or health plan, if applicable, will deliver a Detailed Notice of Discharge.
If a beneficiary is in observation status or in the emergency department, the IM should be given within 2 calendar days of the actual admission to the inpatient hospital level of care.
Regulations require that the follow-up copy of the IM be delivered as far in advance as possible, but no more than 2 days prior to discharge. When a hospital can anticipate the discharge, it should give the follow-up copy of the notice 1 or even 2 days before discharge. When the hospital cannot anticipate the discharge, it should deliver the follow-up copy as soon as the discharge can be anticipated.
A follow-up copy is not required prior to transfers from one inpatient hospital setting to another inpatient hospital setting, for example, a short-term acute care hospital to a long-term acute care hospital. When a beneficiary is transferred to another inpatient hospital setting, the notice delivery time frames start again. Thus, the receiving hospital must issue an initial IM within 2 calendar days of the day of admission and a follow-up copy no more than 2 days prior to the day of discharge.
A follow-up copy of the signed notice is required prior to discharge to a lower level of care, such as a swing bed or skilled nursing facility.
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