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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.


Cleveland Joins the Pay Transparency Movement: What Employers Need to Know

Beginning October 27, 2025, all Cleveland employers with 15 or more employees will be prohibited from asking applicants about their pay history and will be required to include reasonable pay ranges in all job postings where the position will be performed, solicited, considered, or processed in Cleveland. The ordinance is intended to help close the gender wage gap and promote greater pay equity across the city.

New $100,000 Fee on H-1B Petitions – Legal Immigration

President Trump issued an Executive Order (EO) imposing a $100,000 payment to accompany any new H-1B visa petitions submitted after 12:01 a.m. eastern time on September 21, 2025 and will remain in place for 12 months (unless extended).

Implications of Supreme Court Stay for Business Operations in Noem v. Vasquez Perdomo

On September 8, 2025, the U.S. Supreme Court temporarily reinstated immigration officers’ authority to conduct brief stops based on factors such as location, work type, language, or appearance. This stay in Noem v. Vasquez Perdomo allows enforcement actions to resume in California pending appeal. Employers in industries like construction, agriculture, landscaping, and day labor should prepare for increased worksite disruptions and review compliance protocols.

Ohio House Bill 429: Potential Relief for Providers Facing Same-Day Reimbursement Restrictions

Ohio House Bill 429 aims to prevent third-party payers from reducing provider reimbursement for multiple procedures performed on the same day. The bill could improve payment practices for a range of specialties, including surgery and gastroenterology.

FTC Continues to Target Noncompetes

The FTC is intensifying its focus on noncompete agreements in healthcare, urging employers to review contracts for compliance. While Ohio still generally enforces noncompetes, pending legislation could limit their use.