Do we need to continue therapy after the patient appeals the NOMNC for a Medicare Part A resident that we are “cutting?” We were told we legally HAVE to continue therapy services throughout the appeal because we either need to show that they need ongoing therapy or they don’t, to assist with the appeal decision.
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Please clarify when the SNF needs to issue a NOMNC (Notice of Medicare Non-Coverage) form for Medicare Part B residents.
Answer: Below you will find 3 references that support the answer.
“Our facility is focused on how to manage therapy services, the NOMNC and ABN with appeals. Does therapy continue to treat when appealing? Is an ABN issued along with the NOMNC? So many managed care are cutting and family and therapy believe services should be continued. In that case we do continue but would an ABN be issued for Med A?”
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“What about in the scenario where the managed plan initiates the NOMNC but we disagree with it. And the patient goes up to the 3rd level appeal. We should continue to see them if we disagree with the insurance? “
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