Plans should begin using the updated IDN no later than May 2, 2023
CMS updated an Office of Management and Budget-approved standardized Notice of Denial of Medical Coverage (or Payment), also known as the Integrated Denial Notice (IDN). Medicare health plans, including Dual-Eligible Special Needs plans (DSNPs), issue the IDN to inform enrollees of appeal rights for payment or service denials, and for discontinuation or reduction of a previously authorized course of treatment.
- Plans should begin using the updated IDN no later than 60 days from 3/3/23, which is 5/2/2023
- No substantive changes were made to the notice or form instructions
- The only change to this notice is the inclusion of updated nondiscriminatory language required on CMS forms and notices
Instructions for Medicare Health Plans
The IDN and instructions are posted on the CMS Beneficiary Notices Initiative (BNI) webpage.
For questions regarding the IDN or Medicare health plan appeals, submit to the Part C Appeals and Grievances resource portal.
Instructions for Medicare-Medicaid Plans
Medicare Medicaid Plans (MMPs) within the Financial Alignment Initiative will continue to use demonstration-specific versions of the IDN.
- The updated demonstration-specific IDNs will be released to MMPs via a separate HPMS memorandum
- Demonstration-specific IDNs will be posted here
- For questions regarding Medicaid benefit appeals, DSNPs should contact the State Medicaid Agency with which they contract