Crosswalk

Version for 60-day
comment period

Your hospital changed
your status from
inpatient to outpatient
receiving observation
services.

Version for consumer Version for consumer
testing - round 2
testing - round 1

added: Because of this
change, Medicare won’t
cover your skilled
nursing facility (SNF)
stay after you leave the
hospital.

Round 1 language
retained but moved
down to original
placement

added: The box marked Round 1 edit retained
below show what
applies to you (and
checkboxes added)

Reason for Change

commenter suggestion from
4204-p to move this info up
front and tested this way for
Round 1,but this placement
caused great confusion for
beneficiaires, so moved back
down in the document for
Round 2 testing
commenter suggestion from
proposed rule CMS-4204-P

Final Version

Round 2 version retained -edit tested
well as it was understood by
beneficiaries

Round 2 version retained -edit tested
well as it was understood by
beneficiaries

added: • Even if you
Round 1 edit retained
already left the hospital,
you still have appeal
rights.
added: • If you decide
to stay in the hospital
during the appeals
process and the QIO
agrees with the original
decision to change your
status, you’ll be
responsible to pay for
any services you get
during the appeal
process.

commenter suggestion from
proposed rule CMS-4204-P

added: Get help
You can also get for
free, personalized help
from your local State
Health Insurance
Assistance Program
(SHIP). Visit
SHIPhelp.org or call
877-839-2675 to find
the SHIP near you.

CMS staff suggestion for use
Round 2 version retained -edit tested
with Round 1 testing However, well as it was understood by
reconsidered as need to direct beneficiaries
beneficiaries to resources most
relevant to them in this timesensitive situation with
imminent potential financial
ramifications. More appropriate
assitance information added to
the the Round 2 version.

added: You don’t have Round 1 edit retained
Medicare Part B, so the
hospital may charge
you the full cost of your
outpatient hospital

commenter suggestion from
proposed rule CMS-4204-P

Round 2 version retained -edit tested
well as it was understood by
beneficiaries

for readability and to comport
with other agency formatting

Round 2 version retained beneficiaries remarked that notice
was easy to read and understand

overall reformatting of
document

Round 2 version retained -edit tested
well as it was understood by
beneficiaries

commenter suggestion from
proposed rule CMS-4204-P