Crosswalk - DND

Crosswalk Document for Changes to
Detailed Notice of Discharge
Summary of Changes to CMS-10066 (OMB 0938-1019)
When a Medicare beneficiary requests a Quality Improvement Organization (QIO)
review of his/her inpatient hospital discharge, hospitals and Medicare plans have used the
Detailed Notice of Discharge (DND) to provide the beneficiary with a detailed
explanation regarding the reason for discharge. The DND is an existing collection and is
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 DND users.
This package incorporates no substantive or non-substantive changes to the form
instructions. We request an extension of use for the existing form and instructions which
expire on July 31, 2016.