OMB control number
Medicare Change of Status Notice (MCSN) (CMS-10868)
OMB 0938-1467 · HHS/CMS.
OMB 0938-1467
We are proposing to require hospitals to deliver, as soon as possible after certain conditions are met and prior to release from the hospital, a new standardized beneficiary notice, informing eligible beneficiaries of the change in their status, the resulting effect on Medicare coverage of their stay, and their appeal rights if they wish to challenge that change. This new notice will be called the Medicare Change of Status Notice (MCSN). This is as required by the order from the Federal district court for the District of Connecticut in the case Alexander v. Azar, 613 F. Supp. 3d 559 (D. Conn. 2020)), aff’d sub nom., Barrows v. Becerra, 24 F.4th 116 (2d Cir. 2022).
The latest form for Medicare Change of Status Notice (MCSN) (CMS-10868) expires 2027-11-30 and is listed under ICR 202410-0938-018.
Latest Forms, Documents, and Supporting Material
All Historical Document Collections
| Reference | Filing | Received | Concluded | Action |
|---|---|---|---|---|
| 202410-0938-018 | New collection (Request for a new OMB Control Number) | 2024-10-18 | ||
| 202401-0938-012 | New collection (Request for a new OMB Control Number) | 2024-01-26 | Comment filed on proposed rule |