Observation status is not working as a way of classifying hospital patients and should be eliminated, members of the Medicare Payment Advisory Commission proposed at a Nov. 6 meeting.
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A growing number of patients covered by Medicare, have spent days in the hospital, only to be surprised with large out-of-pocket costs and an inability to access long-term care because they were totally unaware the hospital never actually admitted them as a patient. Legislation signed by President Obama this summer was designed to limit the use of “observation stays.”
via Entitled to Know.
As if being in a hospital wasn’t tough enough, patients on Medicare (those 65 and older) are now facing potentially huge out-of-pocket costs if they are placed on “observation status” instead of being formally admitted. And when such a patient then goes from the hospital to a nursing home, the bill from that stay, too, can be catastrophic. A new disclosure law that took effect Saturday will provide a much-needed heads-up.
via Next Avenue.
Related Reading:
For years, patients and advocates have been warning of the increasing use of the patient classification status known as “observation stays.”
via Entitled to Know.
Many people never learn about Observation Status – until it’s too late. An explainer from @CMAorg.
Related Reading:
- Why All Hospital Stays Aren’t Created Equal in Medicare.
- For years, patients and advocates have been warning of the increasing use of the patient classification status known as “observation stays.”
A growing number of patients covered by Medicare, have spent days in
the hospital, only to be surprised with large out-of-pocket costs and an
inability to access long-term care because they were totally unaware
the hospital never actually admitted them as a patient.
Many people never learn about Observation Status – until it’s too late. An explainer from @CMAorg.
Related Reading:
- Why All Hospital Stays Aren’t Created Equal in Medicare.
- For years, patients and advocates have been warning of the increasing use of the patient classification status known as “observation stays.”
A growing number of patients covered by Medicare, have spent days in
the hospital, only to be surprised with large out-of-pocket costs and an
inability to access long-term care because they were totally unaware
the hospital never actually admitted them as a patient.
Today, U.S. Sens. Sherrod Brown (D-OH), Susan Collins (R-ME), Bill Nelson (D-FL), and Shelley Moore Capito (R-W.Va.) introduced legislation to end a Medicare policy that causes seniors to be charged unknowingly with high, unfair costs after receiving needed post-acute medical care. Currently, a Medicare beneficiary must have an “inpatient” hospital stay of at least three days in order for Medicare to pay for post-hospitalization skilled nursing care. Patients that receive hospital care on “observation status” are left to pay for skilled nursing care, even if their hospitalization lasts longer than three days.
The Improving Access to Medicare Coverage Act is endorsed by the National Committee.
Under Medicare, coverage for inpatient and outpatient care is determined under very different payment rules. In some cases, a hospital admission classified as inpatient can result in lower bills for beneficiaries.
via Washington Post.
Related Reading:
- Hearing on “Challenging the Status Quo: Solutions to the Hospital Observation Stay Crisis”.
- Currently, Medicare beneficiaries are being denied access to Medicare’s skilled nursing facility (SNF) benefit because acute care hospitals are increasingly classifying their patients as “outpatients” receiving observation services, rather than admitting them as inpatients.
The sticker-shock can happen when people go to the hospital but health care providers are not sure what’s wrong. If the patient is not sick enough to be formally admitted, but still not healthy enough to go home, they can stay in the hospital for “observation care,” which Medicare considers an outpatient service. That can mean higher out-of-pocket expenses for the patient.
via Kaiser Health News.
Related Reading:
The observation stay issue is a critical one for hospitals and for Medicare’s Part A trust fund as well as for beneficiaries. It appears that the increase in observation stays can be attributed in large part to hospitals’ concerns about being challenged by Medicare’s Recovery Auditors.
via NCPSSM.
Seniors went to Capitol Hill earlier this month to tell Congress why their current #SocialSecurity benefits are inadequate. Boost Social Security Now! https://www.ncpssm.org/campaigns/boost-social-security-now/ @RepJohnLarson