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CMS Medicare Outpatient Observation Notice (MOON) Form

CMS Medicare Outpatient Observation Notice (MOON) Form

JULIANNE KIPPLE, HEALTHCARE shareholder

 

On December 8th, CMS released the Medicare Outpatient Observation Notice (MOON) form. The intent of the form is to educate Medicare beneficiaries on their status as an outpatient versus inpatient, the related impact to their out-of-pocket expenses as an outpatient, and the potential impact of their observation status on out-of-pocket expenses if they are released to a skilled nursing facility (SNF).

Beginning on March 8, 2017 hospitals, including Critical Access Hospitals (CAHs) must provide the MOON form to Medicare beneficiaries receiving outpatient observation services for more than 24 hours and within 36 hours of the patient receiving outpatient observation services or sooner if released. The form must be signed by the beneficiary or representative. There must be an oral explanation to the beneficiary along with the form. Failure to provide the MOON is a violation of the hospital’s Medicare provider agreement, which could result in the termination of that agreement.

The MOON forms can be found here: https://www.cms.gov/Regulations-and-Guidance/Legislation/PaperworkReductionActof1995/PRA-Listing-Items/CMS-10611.html

ABOUT THE AUTHOR

julianne kipple

402.827.2075

jkipple@lutz.us

LINKEDIN

JULIANNE KIPPLE + HEALTHCARE SHAREHOLDER

Julianne Kipple is a Healthcare Shareholder at Lutz with over 12 years of professional experience in the healthcare industry. Her expertise is in accounting and consulting services for healthcare facilities, including outsourced CFO services, Medicare and Medicaid reimbursement, and Medicaid Disproportionate Share Surveys (DSH).

AREAS OF FOCUS
AFFILIATIONS AND CREDENTIALS
  • Healthcare Financial Management Association, Member
  • American Institute of Certified Public Accountants, Member
  • Nebraska Society of Certified Public Accountants, Member
  • Certified Revenue Cycle Representative
  • Certified Public Accountant
  • Certified Healthcare Financial Professional
EDUCATIONAL BACKGROUND
  • BSBA in Accounting, with high distinction, Creighton University, Omaha, NE
  • MBA, Creighton University, Omaha, NE

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