Resources

Client Alerts, News Articles, Blog Posts, & Multimedia

Everything you need to know about BMD and the industry.

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.


Permanent Injunction of “Heartbeat” Abortion Ban in Ohio

Hamilton County Common Pleas Judge Christian Jenkins has ruled Ohio’s six-week abortion ban unconstitutional, citing the state’s new reproductive rights amendment. This ruling emphasizes that Ohio law must fully reflect the will of voters, offering clarity for medical providers and safeguarding women's health care rights.

Trump vs. Harris: What Could Their Presidencies Mean for Employment Law?

In the latest 2 episodes of Employment Law After Hours, BMD Partner Bryan Meeks dives deep into the potential employment law changes we could see under two very different 2024 election outcomes with Kamala Harris or Donald Trump.

Charitable Planning: A Menu of Options

Find out ways you can take advantage of charitable planning to minimize the amount of estate taxes due. Here are some of the popular charitable planning techniques, their uses, and some general advice regarding their formation.

Nationwide Ban on Non-Compete Agreements: Requirements and Texas Court Decision Explained

Watch this Employment Law After Hours video to find out about the Federal Trade Commission’s (FTC) groundbreaking Final Rule that bans non-compete agreements nationwide. This video also explores the recent decision by the Northern District of Texas to enjoin and delay the implementation and enforcement of the Final Rule banning non-compete agreements nationwide.

Parental Approval Mandate for Diagnosing Gender-Related Conditions in Minors under Ohio House Bill 68

Ohio House Bill 68, effective August 6, 2024, introduces strict guidelines for mental health professionals diagnosing and treating minors with gender-related conditions. The law mandates parental or guardian consent before any diagnosis or treatment can proceed. Additionally, professionals must first screen for other comorbidities and assess for any history of abuse. Failure to adhere to these requirements can result in disciplinary action for unprofessional conduct.