CMS Pub. 100-04, ch. 30, § 260.3.3

Providers must deliver the NOMNC to all beneficiaries eligible for the expedited

determination process per §260.2. A NOMNC must be delivered even if the beneficiary

agrees with the termination of services.

Medicare providers are responsible for the delivery of the NOMNC. Providers may

formally delegate the delivery of the notices to a designated agent such as a courier

service; however, all of the requirements of valid notice delivery apply to designated

agents.

The provider must ensure that the beneficiary or representative signs and dates the

NOMNC to demonstrate that the beneficiary or representative received the notice and

understands that the termination decision can be disputed. Use of assistive devices may

be used to obtain a signature.

Electronic issuance of NOMNCs is not prohibited. If a provider elects to issue a NOMNC

that is viewed on an electronic screen before signing, the beneficiary must be given the

option of requesting paper issuance over electronic if that is what is preferred. Regardless

of whether a paper or electronic version is issued and regardless of whether the signature

is digitally captured or manually penned, the beneficiary must be given a paper copy of

the NOMNC, with the required beneficiary-specific information inserted, at the time of

notice delivery.