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”
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”
HHS Inspector General Calls on CMS to Address Medicare Observation Status
In an annual report, the Department of Health and Human Services (HHS) Office of Inspector General (OIG) identifies 25 top recommendations that it made in prior years about HHS programs that HHS has not implemented. This year’s report on Top … [Read more...] about HHS Inspector General Calls on CMS to Address Medicare Observation Status
Appeals Court Temporarily Pauses Implementation of Observation Status Decision While Considering Government’s Request for a Stay
In March 2020, a nationwide class of hospitalized Medicare beneficiaries who were reclassified from inpatients to “outpatients,” receiving “observation services,” won the right to appeal their designation, which can have severe ramifications for … [Read more...] about Appeals Court Temporarily Pauses Implementation of Observation Status Decision While Considering Government’s Request for a Stay
Hospital Readmissions Reduction Program Misses Nearly 20% of Hospital Stays in “Observation Status”
Since 2012, the federal Hospital Readmissions Reduction Program (HRRP) has reduced payments to acute care hospitals that readmit patients with certain medical conditions to inpatient status within 30 days of their discharge from the hospital. A … [Read more...] about Hospital Readmissions Reduction Program Misses Nearly 20% of Hospital Stays in “Observation Status”
Senators Introduce Bipartisan Observation Status Bill to Help Vulnerable Medicare Beneficiaries
The Improving Access to Medicare Coverage Act, S. 2048, introduced by a bipartisan group of Senators this week, led by Senators Sherrod Brown (D-OH), Susan Collins (R-ME), Sheldon Whitehouse (D-RI), and Shelley Moore Capito (R-WV). The bill allows … [Read more...] about Senators Introduce Bipartisan Observation Status Bill to Help Vulnerable Medicare Beneficiaries
Observation Status Bill Reintroduced
Congressman Joe Courtney (D-CT) leads a bipartisan group of Members of Congress to introduce legislation to count time spent by a patient in a hospital under outpatient “observation status” towards satisfying the three-day inpatient hospital stay … [Read more...] about Observation Status Bill Reintroduced
It’s Time to Repeal the 3-Day Inpatient Hospital Requirement for Medicare Skilled Nursing Facility Coverage
When Medicare was enacted in 1965, it limited coverage in a skilled nursing facility (SNF) under Part A to beneficiaries who had been inpatients in an acute care hospital for at least three consecutive days before their discharge to a SNF.[1] The … [Read more...] about It’s Time to Repeal the 3-Day Inpatient Hospital Requirement for Medicare Skilled Nursing Facility Coverage
Government Seeks to Stop Implementation of Court Order in Hospital Observation Status Case
Over 10 months ago, in March 2020, a federal district court issued an order in Alexander v. Azar stating that the Centers for Medicare & Medicaid Services (CMS) must permit certain Medicare beneficiaries to appeal the denial of their Part A … [Read more...] about Government Seeks to Stop Implementation of Court Order in Hospital Observation Status Case
“Observation Status” May Disproportionately Burden Medicare Beneficiaries in the Most Vulnerable Neighborhoods
A new study shows that the consequences of “observation status” may disproportionately burden Medicare beneficiaries in neighborhoods with high levels of socioeconomic deprivation.When hospitalized patients are labeled in observation status they … [Read more...] about “Observation Status” May Disproportionately Burden Medicare Beneficiaries in the Most Vulnerable Neighborhoods