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CMS Requires Providers to Use an Updated Advance Beneficiary Notice (ABN) Form by May 12, 2026

Client Alert

The Centers for Medicare & Medicaid Services (CMS) has issued an UPDATED version of the Advance Beneficiary Notice of Noncoverage (ABN), Form CMS‑R‑131, which providers and suppliers must begin using no later than May 12, 2026.  A copy of the form can be found here

An ABN is a written notice provided to traditional Medicare beneficiaries to inform them that the items services that they are receiving will likely be denied by Medicare as non-covered.  This must be provided by the provider to the Medicare beneficiary in advance of the items or services so that the beneficiary can decide whether to proceed with the items or services, which will most likely require the beneficiary to pay out of pocket.

What Has Changed?

The revised ABN does not substantially alter Medicare coverage policy or when an ABN must be issued. All previous rules and guidance remain in effect.  Instead, CMS has focused on improving the clarity and usability of the form, including:

  • Simplified, plain‑language instructions to better communicate potential financial liability to patients;
  • Streamlined formatting and improved layout for readability; and
  • Revised beneficiary option language to make decision-making clearer.

The updated form is approved for use through March 31, 2029.

Critical Compliance Deadline

CMS has permitted a limited transition period; however, all providers must discontinue use of prior versions of the ABN after May 12, 2026.

Failure to use the current ABN form on or after this date may render the notice invalid, which can prevent providers from charging the patient if Medicare denies the claim and the provider attempts to collect payment from the patient.   

Key Reminders for Providers:

  • The ABN must be issued prior to furnishing items or services when coverage is expected to be denied.
  • It applies to traditional Medicare (fee‑for‑service) beneficiaries, not Medicare Advantage plans.
  • Providers must ensure the form is properly completed, signed, and retained to support billing compliance.
  • Ensure all forms are updated (including paper and electronic versions). 
  • Ensure all staff members are properly trained. 

For questions regarding the updated ABN requirements or assistance with compliance and implementation, please contact Vice President and Akron Managing Partner Amanda Waesch at alwaesch@bmdllc.com or Paralegal Tracy Miller at trmiller@bmdllc.com.


Understanding Reasonable Fear vs. Credible Fear Interviews: A Critical Guide for Immigrants Facing Removal

In his latest article, Immigration Attorney and former Immigration Judge Rob Ratliff offers a clear breakdown of Reasonable Fear vs. Credible Fear Interviews—key procedures for noncitizens seeking protection from persecution or torture. Citing Judge Brian Murphy’s recent ruling on unlawful deportations to South Sudan, Ratliff connects these critical legal standards to current judicial developments. Read the full article at www.removal-defense.com.

House Republicans Propose Cuts to Medicaid to Finance Savings

House Republicans have introduced legislative language that proposes substantial cuts to the Medicaid entitlement program, aiming to achieve significant budget savings through policy changes. The proposed measures include stricter eligibility verification, work requirements for certain adults, and federal funding cuts to states providing coverage to undocumented residents. The Congressional Budget Office (CBO) estimates that the proposed healthcare provisions would reduce spending by $715 billion and could result in 8.6 million fewer people having health insurance by 2034.

Protecting Your Image in the Age of AI-Generated “Deepfakes”

The rapid evolution of artificial intelligence (AI) has transformed how we create and consume digital content, but it also poses significant risks. Among the most troubling developments in AI is the proliferation of AI-generated fraudulent content, often called “deepfakes”.

Tariffs, Market Downturn, and Employment Considerations for Employers

As tariffs continue to impact various industries, employers must prepare for the ripple effects these economic pressures can have on workforce management. The economic impact can dramatically impact companies’ bottom lines, and companies look to improve finances and save for the future and many will choose to reduce employee count/wages.

Corporate Transparency Act Overhauled: U.S. Entities No Longer Required to Report

The Department of Treasury has issued an interim final rule significantly altering the Corporate Transparency Act (CTA). As of March 21, 2025, all U.S.-created entities and their beneficial owners are exempt from reporting requirements. Only non-U.S. entities registered to do business in the U.S. must still report, but they are not required to disclose U.S. citizen owners. Business owners should stay informed on these changes and consult legal counsel for compliance guidance.