On March 24, 2020, a federal court issued a decision in a nationwide class action, Alexander v. Azar, finding that certain Medicare beneficiaries who are admitted as hospital “inpatients” but then switched to “observation status” have the right … [Read more...] about Frequently Asked Questions about the “Observation Status” Court Decision
Observation Status
CMS Temporarily Waives Medicare Access Barriers for Skilled Nursing Facility Care
On March 13, 2020, President Trump proclaimed the COVID-19 pandemic a national emergency. As a result, the U.S. Department of Health and Human Services (HHS) now has the authority under Section 1135 of the Social Security Act to waive or modify … [Read more...] about CMS Temporarily Waives Medicare Access Barriers for Skilled Nursing Facility Care
Federal Court Orders Appeal Rights on “Observation Status” Issue for Certain Medicare Hospital Patients
For Immediate Release March 24, 2020Contact: Matthew Shepard: 202-293-5760, MShepard@MedicareAdvocacy.orgIn a decision issued today, Judge Michael P. Shea of the U.S. District Court in Hartford, Connecticut found that certain Medicare … [Read more...] about Federal Court Orders Appeal Rights on “Observation Status” Issue for Certain Medicare Hospital Patients
Accountable Care Organizations and Observation Status
One of the ongoing problems that Medicare beneficiaries face is so-called “outpatient” hospital observation status. When a hospital classifies a patient as an outpatient, rather than as an inpatient, the result is that the patient is ineligible for … [Read more...] about Accountable Care Organizations and Observation Status
Administrator Verma’s Tweet Sparks Support for Addressing Observation Status
On August 4, CMS Administrator Seema Verma tweeted that beneficiaries wanting Medicare to pay for their stay at a skilled nursing facility (SNF) should make sure they are first admitted to the hospital for at least three days.[1] Writing, “Govt … [Read more...] about Administrator Verma’s Tweet Sparks Support for Addressing Observation Status
Alexander v. Azar Trial Update – Seeking an Appeal of Outpatient Observation Status
Since 2011 the Center for Medicare Advocacy has been pursuing a nationwide class action lawsuit seeking an appeal for Medicare beneficiaries who are classified as hospital outpatients in observation status. (Alexander v. Azar, 3:11-cv-1703, U.S. … [Read more...] about Alexander v. Azar Trial Update – Seeking an Appeal of Outpatient Observation Status
CMS Administrator Acknowledges that Prior Inpatient Hospital Rules Do Not Make Sense
Medicare requires beneficiaries to have a three-day inpatient hospital stay in order to qualify for skilled nursing facility (SNF) care. Unfortunately, too many beneficiaries continue to be classified as hospital outpatients on observation status, … [Read more...] about CMS Administrator Acknowledges that Prior Inpatient Hospital Rules Do Not Make Sense
More Doors to Medicare Home Health Closing, More Harm for Observation Status Patients
Many Medicare hospital patients classified as observation status “outpatients” currently forego necessary skilled nursing facility (SNF) care and head home to continue care through Medicare’s home health care benefit. This is because they lack a … [Read more...] about More Doors to Medicare Home Health Closing, More Harm for Observation Status Patients
Observation Status and Surprise Medical Bills
The Center for Medicare Advocacy frequently hears from Medicare beneficiaries and their families about patients who receive treatment, tests, and services for multiple days while they are in a hospital bed but who are called “outpatients.” If these … [Read more...] about Observation Status and Surprise Medical Bills
Congressional Hearing on Surprise Medical Bills; Center for Medicare Advocacy Submits Statement on Observation Status
“Protecting Patients from Surprise Medical Bills” – a hearing held on May 21 by the House Ways and Means’ Subcommittee on Health – considered the bills for health care services that patients get after they received care from health care providers who … [Read more...] about Congressional Hearing on Surprise Medical Bills; Center for Medicare Advocacy Submits Statement on Observation Status