Center for Medicare Advocacy

Advancing Access to Medicare and Healthcare

Observation Status

Medicare Publishes Final Rule for Hospital Observation Status Appeals

As a result of the Center for Medicare Advocacy’s class action litigation, the Centers for Medicare and Medicaid Services (CMS) issued a final rule this week to establish appeals for hospital patients whose status is changed from inpatient to … [Read more...] about Medicare Publishes Final Rule for Hospital Observation Status Appeals

Judge Orders Medicare to Speed Up Implementation of Observation Status Appeals

The federal judge who found that Medicare is violating beneficiaries’ constitutional rights by disallowing appeals of their placement on “observation status” in hospitals has imposed deadlines and urged Medicare to “take all possible steps, as a … [Read more...] about Judge Orders Medicare to Speed Up Implementation of Observation Status Appeals

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