Home Health Change of Care Notice (HHCCN) (CMS-10280)

OMB 0938-1196

OMB 0938-1196

Home health agencies (HHAs) are required to provide written notice to original Medicare beneficiaries under various circumstances involving the initiation, reduction, or termination of services consistent with Home Health Agencies Conditions of Participation (COPs) as set forth in section 1891 of the Social Security Act (the Act) and subsequent to the decision of the US Court of Appeals (2nd Circuit) in Lutwin v. Thompson. The notice used to fulfill these requirements is the HHCCN.

The latest form for Home Health Change of Care Notice (HHCCN) (CMS-10280) expires 2022-04-30 and can be found here.


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