Updated Notice of Denial of Medical Coverage (or Payment) Form CMS-10003

Relevant to: Medicare Advantage Organizations, Cost-Based Contractors, and Health Care Prepayment Plans

The purpose of this memorandum is to announce the availability of the updated OMB-approved standardized Notice of Denial of Medical Coverage (or Payment), also known as the Integrated Denial Notice (IDN). Medicare health plans, including Dual Eligible Special Needs plans (DSNPs), issue the IDN to inform enrollees of their appeal rights, as applicable, for payment or service denials and for discontinuation or reduction of a previously authorized course of treatment.

See the full guidance for more information.