Effective March 8, 2017: Medicare Outpatient Observation Notice (MOON) Required

Posted January 25, 2017

Effective March 8, 2017, the Notice of Observation Treatment and Implication for Care Eligibility (NOTICE) Act requires hospitals and Critical Access Hospitals (CAH) to provide the MOON to Medicare beneficiaries, including Blue Cross Medicare Advantage (PPO)^SM, Blue Cross Medicare Advantage (HMO)^SM and Blue Cross Community MMAI (Medicare-Medicaid Plan)^SM members receiving observation services as outpatients for more than 24 hours. The MOON explains the status of the individual as an outpatient as opposed to an inpatient, along with the implications of observation services on cost sharing and coverage for post-hospitalization skilled nursing facility (SNF) services. 

An oral explanation of the MOON must be provided, ideally in conjunction with the delivery of the notice, no later than 36 hours after observation services are initiated or, if sooner, upon release. In addition, a signature must be obtained from the individual, or an individual qualified to act on their behalf, to acknowledge receipt and understanding of the notice. In cases where the individual or person refuses to sign the MOON, the staff member of the hospital or CAH providing the notice must sign the notice to certify that notification was presented. 

The MOON and instructions can be found at cms.gov/bni/  or cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2016-Fact-sheets-items/2016-12-08-3.html.

The information provided here is only intended to be a brief summary of the law that have been enacted and is not intended to be an exhaustive description of the law or a legal opinion of such law. If you have any questions regarding the law mentioned here you should consult with your legal advisor.