Important Message from Medicare (IM): what it means and what to do

Given at hospital admission and again near discharge; explains the right to appeal a discharge.

The Important Message from Medicare is given at admission and again near discharge — it's what tells you a hospital discharge decision can be appealed, and how fast that right moves.

Request review no later than the day of discharge, before you leave the hospital.

Requesting review doesn't require you to have a plan for what happens next — it just pauses the discharge while an independent reviewer checks whether your parent is really ready to leave.

If your parent is still inpatient, you can still request review — the QIO decides within 2 days, without the same billing protection. After discharge, you have 30 days, or any time for good cause.

You get this notice twice — once at or near admission, and again close to the actual discharge date, with the specific planned discharge date filled in. It's the second, dated copy that starts your same-day filing clock, not the first, general one given at admission.

Asking for the QIO review doesn't require proving where your parent will go next or what care will be arranged — that's a separate, later question. The review itself is only about whether discharge right now is medically appropriate.

Both copies of this notice have to be signed and dated by the patient or their representative acknowledging receipt — if the second, near-discharge copy was never actually presented for signature, that's itself worth mentioning when you call the QIO.

Call the QIO before you leave. Say you want to file a fast appeal (expedited determination) of a hospital discharge decision. Give the QIO the planned discharge date from the Important Message. Ask them to request the detailed notice from the hospital on your behalf.

Note the deadline. Request review no later than the day of discharge, before you leave the hospital.

Ask for the detailed notice. The hospital must send the QIO a Detailed Notice of Discharge stating its reasons — asking the QIO to request it is enough.

Know what happens next. The QIO decides within 1 calendar day of having what it needs. The hospital must send a detailed notice explaining the discharge decision.