Thanks to a successful class action lawsuit led by the Center for Medicare Advocacy, if you were hospitalized between January 1, 2009 and February 13, 2025 and reclassified from inpatient to “observation status,” you may have the right to file a retrospective appeal.
- Retrospective appeals must be received by Medicare’s contractor by January 2, 2026.
- Who is eligible: Medicare beneficiaries with original/traditional Medicare who were reclassified from inpatient to observation status between January 1, 2009 and February 13, 2025. Other criteria also apply. See CMA’s FAQ about the observation status court decision.
- What you may recover: Out-of-pocket costs paid to nursing homes, or hospitals, depending on individual circumstances.
- How to appeal: submit your Request for Retrospective Appeal of Medicare Part A Coverage so that it is received by the Eligibility Contractor by January 2, 2026.
Read about a successful retrospective observation status appeal here.
The court case also permanently established prospective appeals, allowing certain patients to appeal their observation status while still in the hospital or after discharge. Read about a beneficiary who won weeks of covered rehabilitation services here.
For more information about both types of appeals, see the Center for Medicare Advocacy’s Observation Status Appeal Resources.
November 6, 2025 – A. Bers