CMS Pub. 100-04, ch. 36, § 20.7

Except where an exception applies, a beneficiary has no financial liability to a noncontract

supplier that furnishes an item included in the competitive bidding program for a CBA, unless

the beneficiary has signed an Advance Beneficiary Notice (ABN).

However, if a noncontract supplier in a CBA obtains a signed ABN indicating that the

beneficiary was informed in writing prior to receiving the competitively bid item or service that

there would be no payment by Medicare due to the supplier's non-contract status, the noncontract

supplier may charge the beneficiary for the item or service. In this circumstance, non-contract

suppliers cannot bill Medicare and receive payment for the competitively bid item or service.

An ABN is a written form provided by the supplier and signed by the Medicare beneficiary in

which the beneficiary agrees to pay out of pocket for charges not paid for by Medicare. See

Chapter 30 - Financial Liability Protections of this manual for general instructions relating to

ABN requirements. In addition to the other uses of an ABN as defined in Chapter 30, an ABN

informs a beneficiary before he or she receives specified items or services from a noncontract

supplier that Medicare will probably not pay for the specified items or services for that particular

beneficiary on that particular occasion if furnished by a noncontract supplier.