How to Appeal a Hospital Discharge in Wisconsin

The hospital says your parent is being discharged tomorrow. You can see they're not ready — they can barely stand, their pain isn't controlled, or the home care plan has gaps. You have the legal right to stop this discharge, and the process is faster than most families realize.

Here's exactly how to file an expedited Medicare discharge appeal in Wisconsin.

Step 1: Confirm You Have the Important Message from Medicare

Before filing, verify the hospital gave your parent (or you, as their representative) the Important Message from Medicare (Form CMS-10065). They must deliver it within two days of admission and again before discharge. This document contains the phone number you need for the next step.

If the hospital never provided this notice, they've already violated federal requirements — note the gap in writing.

Step 2: Contact Livanta LLC Before Noon

Wisconsin falls under Region 5 for Medicare's Beneficiary and Family Centered Care Quality Improvement Organization (BFCC-QIO). The designated organization is Livanta LLC.

Call or fax Livanta before noon on the day of the planned discharge. This is the critical deadline — miss it and the appeal still proceeds, but the financial protections change.

When you call, state clearly: "I am requesting an expedited review of a hospital discharge for [patient name] at [hospital name]. I do not believe this discharge is safe."

Livanta will assign a reviewer and notify the hospital.

Step 3: The Hospital Must Deliver a Detailed Notice of Discharge

Once Livanta notifies the hospital that an appeal has been filed, two things happen immediately:

1. The discharge is paused. The hospital cannot proceed with the discharge while the review is pending.
2. The hospital must deliver a Detailed Notice of Discharge (DND) — Form CMS-10066 — by 6:00 PM on the day Livanta issues the appeal notification. This document must explain the specific clinical reasons the hospital believes inpatient care is no longer necessary.

Read the DND carefully. If the clinical reasoning doesn't match your parent's actual condition — for example, it says they can walk independently when they clearly cannot — document the discrepancy for the reviewer.

Step 4: Financial Protection During the Review

This is the part families don't realize: you are not financially responsible for hospital costs while Livanta conducts its review. The hospital absorbs the cost of continued care during the appeal period.

Livanta generally issues its decision within 24 to 48 hours of receiving the patient's medical records from the hospital. If the QIO agrees with your appeal, the hospital must continue providing medically necessary care. If they side with the hospital, you can request a reconsideration — but the financial protection ends once the initial decision is issued.

Appealing a Skilled Nursing Facility Discharge

The appeal process works differently if your parent is in a skilled nursing facility or receiving Medicare home health services and the provider wants to end coverage.

The provider must issue a Notice of Medicare Non-Coverage (NOMNC) at least two calendar days before services are scheduled to end. To appeal, contact Livanta by noon on the day before the planned termination date.

Upon appeal, the provider must deliver a Detailed Explanation of Non-Coverage (DENC), explaining why they believe skilled care is no longer medically necessary. The same financial protections apply during the review period.

What If You Miss the Deadline?

If you miss the noon deadline, you can still request a review from Livanta — it just means the financial liability rules shift. The patient may become responsible for charges starting the day after the planned discharge, even if the review ultimately rules in their favor.

The lesson: act fast. The moment you hear the word "discharge" and disagree, start the appeal process.

State Complaint Channels

If you believe the hospital conducted an unsafe discharge despite your objections, or violated procedural requirements, file a formal complaint with the Wisconsin DHS Division of Quality Assurance at 1-800-642-6552 or online through the DQA portal. For patients 60 and older, the BOALTC Ombudsman at 1-800-815-0015 provides free advocacy.

Get the Full Discharge Playbook

Filing an appeal is one piece of a much larger puzzle — from understanding observation status to navigating Medicaid after Medicare runs out. The Wisconsin Hospital Discharge Guide gives you the complete step-by-step process, including pre-written appeal scripts and a chronological timeline for every decision point.

See more Wisconsin guides →