Notice of Medicare Non-Coverage (NOMNC): what it means and what to do

Says a covered SNF, home health, hospice, or CORF service is ending on a specific date.

A Notice of Medicare Non-Coverage tells you that a covered skilled nursing, home health, hospice, or outpatient rehab (CORF) service is ending on a specific date — and that you have a fast, free right to ask an independent reviewer (the QIO) to check whether that's the right call before it takes effect.

Request the fast appeal by the date and time on the form — no later than noon of the day before your services end.rule42 CFR 405.1202

This is one of the fastest rights in all of Medicare appeals — a phone call, not a letter, is what actually starts the review, and it has to happen before services end, not after.

The QIO still reviews a late request, but you lose the financial protection an on-time request carries.

The NOMNC covers four different service types — skilled nursing/rehab, home health, hospice, and outpatient rehab through a CORF — but the notice, the deadline, and the QIO process are the same form and the same clock regardless of which one applies to your family.

Delivery timing matters too: the notice is required to reach you at least two days before the service actually ends, not sprung on the family the same day it takes effect. If that didn't happen, it's worth mentioning to the QIO when you call, even though it doesn't extend your own filing deadline.

Call the QIO the same day. Say you want to file a fast appeal (expedited determination) of a coverage-ending decision. Give the QIO the date services are set to end, from the NOMNC. Ask them to request the detailed explanation from the facility on your behalf.

Note the deadline. Request the fast appeal by the date and time on the form — no later than noon of the day before your services end.

Ask for the detailed explanation. The facility must send the QIO a Detailed Explanation of Non-Coverage (DENC) stating its reasons — you don't have to request this yourself; asking the QIO to request it is enough.

Know what happens next. The QIO decides within 72 hours of having what it needs. The facility must send a detailed explanation of why coverage is ending.

The whole point of this right is an independent second opinion — the QIO is a separate organization under contract with CMS, not the facility that made the original coverage-ending decision, so the review carries real weight rather than just re-asking the same people who already said no.