HCFA ISSUES REVISIONS TO
SKILLED NURSING FACILITY MANUAL

Implementing Section 4311(b) of the Balanced Budget Act of 1997, a new revision to the Skilled Nursing Facility
Manual requires facilities to provide a beneficiary with an itemized statement of any Medicare item or service
provided to that beneficiary. The beneficiary, or duly authorized representative, must submit the request in writing
and the facility must supply the itemized statement within 30 days.

The Health Care Financing Administration (HCFA) includes suggested content of the itemized statement:
"beneficiary name, date(s) of service, description of item or service furnished, number of units furnished, provider
charges, and an internal reference or tracking number." For claims already adjudicated by Medicare, HCFA suggests
that additional information be included: "amounts paid by Medicare, beneficiary responsibility for co-insurance, and
Medicare claim number."

A "knowing failure" to furnish the statement subjects a facility to a civil money penalty of up to $100 for each failure.

Beneficiaries may find the information useful in confirming services provided and costs. Congress enacted the provision
as part of its efforts to strengthen program integrity.

The manual revision, Transmittal 365 (Jun. 2000), is available at http://www.hcfa.gov/pubforms/transmit/R365SNF.pd