A broad coalition of 75 national, state, and local advocacy organizations joined the Center for Medicare Advocacy (the Center) in submitting comments on a rule to establish appeals for beneficiaries who have been placed in “observation status.” As a … [Read more...] about Advocates Join Center in Comments on Observation Status Appeals
Observation Status
Organizational Sign-On Letter Commenting on Proposed Rule on Observation Status Appeals
The Center for Medicare Advocacy and Justice in Aging invite organizations to sign on to a comment letter responding to CMS’s proposed rule implementing appeal rights for Medicare beneficiaries who are admitted to hospitals as inpatients and … [Read more...] about Organizational Sign-On Letter Commenting on Proposed Rule on Observation Status Appeals
Statement on Proposed Appeal Rules for Hospital Observation Status
As a result of the Center for Medicare Advocacy’s successful litigation, the Centers for Medicare and Medicaid Services (CMS) released a proposed rule on December 21, 2023, to implement appeals processes for hospital patients whose status is changed … [Read more...] about Statement on Proposed Appeal Rules for Hospital Observation Status
Congressman Joe Courtney and Bipartisan Colleagues Reintroduce Observation Status Bill
Congressman Joe Courtney (D, CT) and a bipartisan group of colleagues reintroduce Improving Access to Medicare Coverage Act of 2023, H.R. 5138, a bill to ensure that patients qualify for post-hospital Medicare-covered care in a skilled nursing … [Read more...] about Congressman Joe Courtney and Bipartisan Colleagues Reintroduce Observation Status Bill
Increased Use of Observation Stays Undermined Hospital Readmissions Reduction Program
The Hospital Readmissions Reduction Program (HRRP), enacted as part of the Affordable Care Act, imposes penalties against hospitals that have higher-than-expected rates of readmissions of patients with certain conditions. However, HRRP defined … [Read more...] about Increased Use of Observation Stays Undermined Hospital Readmissions Reduction Program
Reminder: Questions or Comments on Proposed Clarification in Hospital “Observation Status” Case Due November 25
In Alexander v. Becerra, a federal court found that certain beneficiaries must be allowed to appeal to Medicare when their hospitalizations are reclassified from “inpatient” to “outpatient receiving observation services.” The Center for Medicare … [Read more...] about Reminder: Questions or Comments on Proposed Clarification in Hospital “Observation Status” Case Due November 25
Medicare Announces Development of Appeal Process for Certain Hospital “Observation Status” Patients
As the result of a court case, the Medicare.gov website now alerts a nationwide class of Medicare beneficiaries that they “have appeal rights” when a hospital changes their status from inpatient to outpatient observation, and that the appeal process … [Read more...] about Medicare Announces Development of Appeal Process for Certain Hospital “Observation Status” Patients
It’s Time: Repeal the 3-Day Inpatient Hospital Requirement for Medicare Skilled Nursing Facility Coverage
Last year, the Center for Medicare Advocacy suggested that it was time to repeal the three-day inpatient hospital requirement that is necessary for Part A coverage in the traditional Medicare program.[1] The recent Second Circuit decision in … [Read more...] about It’s Time: Repeal the 3-Day Inpatient Hospital Requirement for Medicare Skilled Nursing Facility Coverage
Court Upholds Right to Appeal for Certain Medicare Beneficiaries on “Observation Status”
On January 25, 2022, a federal appeals court decided that Medicare must provide appeal procedures for hospitalized beneficiaries who are reclassified from inpatients to “outpatients” receiving “observation services.” The observation designation can … [Read more...] about Court Upholds Right to Appeal for Certain Medicare Beneficiaries on “Observation Status”
Court Upholds Right to Appeal for Certain Medicare Patients on “Observation Status”
A federal appeals court has decided that Medicare must provide appeal procedures for hospitalized beneficiaries who are reclassified from inpatients to “outpatients” receiving “observation services,” a designation that can have severe ramifications. … [Read more...] about Court Upholds Right to Appeal for Certain Medicare Patients on “Observation Status”