What operational steps should have been taken once the ABN expired on January 31, 2026?
A recent client asked a straightforward but important question:
What operational steps should have been taken once the ABN expired on January 31, 2026?
Their concern was simple: How do we avoid using an invalid form?
That concern is certainly valid. However, expiration does not automatically mean immediate discontinuation. Understanding the Paperwork Reduction Act (PRA) and Office of Management and Budget (OMB) approval process is key to avoiding unnecessary workflow changes or compliance risk.
Understanding the ABN Expiration Date
The Advance Beneficiary Notice (ABN), Form CMS R 131 (exp. 01 31 2026) was the current and only valid form for Fee for Service Medicare beneficiaries through January 31, 2026.
The Centers for Medicare and Medicaid Services made this version mandatory beginning June 30, 2023. Any earlier version used after that date was not valid, even if the printed expiration date appeared acceptable.
If you were issuing an ABN for items or services expected to be denied by Medicare prior to January 31, 2026:
• You were required to use Form CMS R 131 (exp. 01 31 2026)
• Older versions were not permitted
• Draft or proposed versions posted online could not be used
What Happens When an ABN Expires?
ABNs are subject to the Paperwork Reduction Act and must be reviewed and approved by the Office of Management and Budget.
During this process:
• The notice may reach its expiration date before OMB reauthorization is finalized
• If that occurs, providers and plans may continue using the most recently approved version of the notice even after the expiration date
This is a critical distinction.
Expiration does not automatically invalidate the form.
CMS and OMB Reauthorization: What to Expect
Once the OMB control number is reauthorized:
• CMS will notify the industry
• CMS.gov will be updated with the revised form and new expiration date
• Providers and plans will have 60 calendar days from the date of CMS notification to begin using the updated notice
This structured process is designed to:
• Prevent compliance gaps
• Avoid operational disruption
• Ensure uninterrupted ABN issuance
Can You Use Draft or Proposed ABN Forms?
CMS may post draft revisions while renewal requests are under review. However:
• Draft or proposed forms are not official
• They may not be used until formally approved
The updated version must be:
• Posted on the official CMS ABN webpage
• Include a valid OMB control number
• Reflect a new expiration date
Only then is implementation required.
Key Compliance Takeaway
Until CMS issues formal notification of a replacement form, providers may continue using the most recently approved version in accordance with PRA guidance.
Overcorrecting by stopping use of the form or switching to drafts can introduce more compliance risk than continuing with the approved version.
Final Thoughts
ABN expiration dates often create confusion, but the regulatory framework is clear. The PRA and OMB process ensures continuity, not disruption.
Understanding this process allows organizations to:
• Maintain compliance
• Avoid unnecessary workflow changes
• Confidently navigate CMS updates
