Getting a fast appeal from non-hospital settings

You may have the right to a fast appeal if you think your services are ending too soon from one of these facilities:

• A Medicare-covered skilled nursing facility (SNF)
• A Medicare-covered home health agency (HHA)
• A Medicare-covered comprehensive outpatient rehabilitation facility (CORF)
• A Medicare-covered hospice facility

While you’re getting SNF, HHA, CORF, or hospice services, you should get a notice called “Notice of Medicare Non-Coverage” at least 2 days before covered services end. If you don’t get this notice, ask for it. This notice explains:

• The date your covered services will end
• That you may have to pay for services you get after the coverage end date given on your notice
• Information on your right to get a detailed notice about why your covered services are ending
• Your right to a fast appeal and information on how to contact the Beneficiary and Family Centered Care Quality Improvement Organization (BFCC-QIO) in your state to request a fast appeal.

Ask the BFCC-QIO for a fast appeal no later than noon of the first day after the day before the termination date listed on your “Notice of Medicare Non-Coverage.” Follow the instructions on the notice.

If you miss the deadline for requesting a fast appeal from the BFCC-QIO, you can request a fast reconsideration from your plan. But, services will only be covered if there’s a decision issued in your favor.