The facts are in: The ever-increasing use of observation status deprives many Medicare beneficiaries of care and coverage in skilled nursing facilities (SNFs). In 2018, research by Avalere Health confirmed that the use of SNFs by … [Read more...] about Observation Status Deprives Medicare Beneficiaries of their Skilled Nursing Facility Benefit. Period.
Observation Status
Observation Status: Physicians Challenge the Inspector General
A group of physicians has challenged a recent audit report from the Inspector General for the Department of Health & Human Services[1] that concluded that between 2013 and 2015 Medicare incorrectly paid $84.2 million for skilled nursing facility … [Read more...] about Observation Status: Physicians Challenge the Inspector General
Court Denies All Government Motions in Class Action Seeking Appeal Right for Medicare Beneficiaries on “Observation Status”
FOR IMMEDIATE RELEASE March 28, 2019 Contact: Matthew Shepard: 202-293-5760, MShepard@MedicareAdvocacy.org In a decision issued on March 27, 2019, a federal judge denied multiple attempts by the federal government to halt a lawsuit by Medicare … [Read more...] about Court Denies All Government Motions in Class Action Seeking Appeal Right for Medicare Beneficiaries on “Observation Status”
Members of Congress Reintroduce Legislation to Fix Outpatient Observation Status
Medicare requires a three-day inpatient hospital stay in order to qualify for care at a skilled nursing facility. Sadly, and all too often however, beneficiaries are classified as hospital outpatients on observation status. While outpatients on … [Read more...] about Members of Congress Reintroduce Legislation to Fix Outpatient Observation Status
Improve and Expand Medicare: End the Use of Outpatient Observation Status – A Billing Issue that Restricts Needed Care
Recently, the Center for Medicare Advocacy laid out our Medicare Platform for the New Congress. One of the core considerations to improve Medicare for all beneficiaries, now and in the future, is the need to end ongoing barriers to care. One of the … [Read more...] about Improve and Expand Medicare: End the Use of Outpatient Observation Status – A Billing Issue that Restricts Needed Care
Improve Medicare: Correct Medicare Hospital Observation Status
Recently, the Center for Medicare Advocacy laid out our Medicare Platform for the New Congress. One of the core considerations to improve Medicare for all beneficiaries, now and in the future, is the need to reduce ongoing barriers to coverage … [Read more...] about Improve Medicare: Correct Medicare Hospital Observation Status
Study: Three-Day Hospital Requirement for Post-Hospital Care In a Skilled Nursing Facility Increases Medicare Costs
In order to qualify for Medicare Part A coverage of a post-hospital stay in a skilled nursing facility, the traditional Medicare program requires that the beneficiary first be hospitalized as an inpatient for three consecutive days, not counting the … [Read more...] about Study: Three-Day Hospital Requirement for Post-Hospital Care In a Skilled Nursing Facility Increases Medicare Costs
Does Observation Status Undercut Claims that Hospital Readmissions Have Been Reduced? MedPAC Says No, Research Says Yes.
As required by the Affordable Care Act, the Medicare Hospital Readmissions Reduction Program (HRRP) reduces Medicare payment rates, by up to 3%, to hospitals that readmit patients with certain specified conditions within 30 days.[1] The … [Read more...] about Does Observation Status Undercut Claims that Hospital Readmissions Have Been Reduced? MedPAC Says No, Research Says Yes.
NPR Observation Status Story: How Medicare’s Conflicting Hospitalization Rules Cost Me Thousands Of Dollars
On April 20, 2018, Alison Kodjak of NPR published the story of trying to navigate her own Mother’s “Outpatient” Observation Status and follow-up care. After four nights in the hospital, all coded as observation, Alison’s … [Read more...] about NPR Observation Status Story: How Medicare’s Conflicting Hospitalization Rules Cost Me Thousands Of Dollars
Hospitalists Continue to Oppose Observation Status and Call for Significant Change
Patients in “outpatient” observation status often receive care in acute care hospitals that is indistinguishable from the care patients receive when they are formally admitted to hospitals as inpatients.[1] Nevertheless, the … [Read more...] about Hospitalists Continue to Oppose Observation Status and Call for Significant Change