CMS SOM App. PP, Tag F579

residents and applicants for admission, oral and written information about how to apply

for and use Medicare and Medicaid benefits, and how to receive refunds for previous

payments covered by such benefits.

DEFINITIONS §483.10(g)(13)

“Refunds for previous payments” refers to refunds due as a result of Medicaid and Medicare

payments when eligibility has been determined retroactively.

GUIDANCE §483.10(g)(13)

To fulfill this requirement, facility staff may use written materials issued by the State Medicaid

agency and the Federal government relating to these benefits. Facilities may fulfill their

obligation to orally inform residents or prospective residents about how to apply for Medicaid or

Medicare by assisting them in working with the local Social Security Office or the local unit of

the State Medicaid agency. Simply providing a phone number is not sufficient in assisting

resident or the resident representative. Facilities are not responsible for orally providing detailed

information about Medicare and Medicaid eligibility rules.