WASHINGTON--A notice published in the May 25 Federal Register announced the start of a second public comment period on additional revisions to the Advanced Beneficiary Notice.

CMS said the new ABN package reflects changes made after the first round of public comments about its February proposal to combine two versions of the form--a general and a laboratory-specific--into a single notice. ABNs are used to warn beneficiaries before a procedure or service that Medicare likely would not cover it, giving them the opportunity to forgo the service or to assume the financial responsibility themselves.

CMS said in the notice that it expected compliance with ABN requirements would involve more than 4.7 million hours and more than 1.2 million respondents annually, with a total of more than 40 million responses.

The proposed changes to the ABN include:

--Replacing the term "items/services" with a customizable blank so that users can insert a description most appropriate to their specific businesses.

--Streamlining text as much as possible to include more "beneficiary-friendly plain language."

--Replacing the label "supplier/provider" with the more generic "notifier," since this term captures disparate groups such as physicians, practitioners and various provider and supplier types.

--Changing the label "beneficiary name" back to "patient name" in response to comments that the simpler language in the current ABN be maintained. (CMS said it had proposed the change to "beneficiary" to make it clear that the notice is only required from Medicare, which the agency said was a repeated point of inquiries.)

--Shortening the paragraph above the items and service box to clarify that Medicare does not pay for all services, even if recommended by a health care provider.

--Re-ordering the options box so that the first option is the one that makes beneficiaries aware of their right to receive services and appeal to Medicare should they be denied.

--Wording would note that beneficiaries are still responsible for payment if Medicare does not pay; provide information on the Medicare Summary Notice as the vehicle informing beneficiaries of official payment decisions and appeal rights; be adjusted so that non-participating providers are less likely to have beneficiaries seeking refunds from them inappropriately; and add information on Medicare cost-sharing amounts that are not refundable when Medicare pays.

--Replacing the label "other insurance" with "additional information." CMS said many commenters opposed the mandatory inclusion of information about other insurance, since there is no requirement that they bill such insurers.

--Adding 1-800-MEDICARE contact information.

--Removing the heading "Privacy Notice" from the disclosure statement.

During the comment period, CMS said providers should continue using the existing ABNs until a final combined notice is approved.

To view the entire list of proposed ABN changes, go to http://www.cms.hhs.gov/PaperworkReductionActof1995, click on PRA listing and scroll down to CMS-R-131.

Comments must be received by 5 p.m. on Sunday, June 24, 2007.

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