Crosswalk

Crosswalk Document for Changes to CMSR-193 Important Message from Medicare

Summary of Changes to CMS-R-193
Hospitals have used the Important Message from Medicare (IM) to inform original
Medicare, Medicare Advantage, and other Medicare plan beneficiaries who are hospital
inpatients about their hospital rights and discharge rights. In particular, the IM provides
information about when a beneficiary will and will not be liable for charges for a
continued stay in a hospital and offers a detailed description of the Quality Improvement
organization (QIO) review process. The IM was last approved under PRA in 2013 and is
an existing collection, currently in use.
This submission incorporates one minimal, non-substantive change to comply with
Section 504 of the Rehabilitation Act of 1973 (Section 504), which requires Federal
Agencies to be non-discriminatory and provide this publication in an alternative format if
needed. No substantive changes have been made to the existing form. There are no
changes that will affect existing IM users.

The following non-substantive changes have been made to the form:
• The form has been revised to include language informing beneficiaries of CMS’s
nondiscrimination practices and to request this publication in an alternative format
if needed.
There are no changes to the form instructions.
The IM is an existing collection and is in use. It is our expectation that the nonsubstantive changes to the form will have little effect on burden for all users. The Section
504 requirement was in effect with the prior notice, and including standard CMS
language to advise beneficiaries of its nondiscrimination policies and the availability of
alternate forms of this notice is not expected to change burden associated with the IM.