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HHS Releases MOON Form

Hospitals Must Provide Form to Observation Patients

The U.S. Department of Health and Human Services (HHS) recently released the two-page Medicare Outpatient Observation Notice (MOON) form. The form must be given to certain observation patients under the Notice of Observation Treatment and Implication for Care Eligibility (NOTICE) Act.

Beginning Aug. 6, patients placed in an outpatient observation bed for more than 24 hours will receive the MOON form. The form explains what outpatient observation services entail, cost sharing and post-hospitalization eligibility for skilled nursing facilities, and prescription and copay costs associated with Medicare plans. It also includes information on what to do if a patient refuses to sign the form.

Facilities also must provide an oral explanation with the form, all before discharge and no later than 36 hours after observation begins.

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