The Office of the Inspector General (OIG) of the Department of Health and Human Services (HHS) released a statement on October 30, 2015 that advises hospitals that it will not administratively sanction them if they discount or waive charges for an … [Read more...] about Office of Inspector General Authorizes Hospitals to Discount or Waive Certain Drug Charges for Patients Classified as “Outpatients”
Observation Status
Revisions to “Two-Midnight Rule” Do Not Help Hospitalized Medicare Patients in Observation Status
In 2013, the Centers for Medicare & Medicaid Services (CMS) promulgated the Two-Midnight Rule, which, for the first time in the Medicare program’s 50-year history, determined patient status in a hospital by reference to time.[1] … [Read more...] about Revisions to “Two-Midnight Rule” Do Not Help Hospitalized Medicare Patients in Observation Status
Solution to Medicare Part B Cost Increases? Look at “Outpatient” Observation Status
If Congress and the Administration truly seek ways to limit Medicare premiums and deductibles, they ought to look at CMS's hospital Observation Status policy.A major cause of the Part B increase is likely the parallel increase in … [Read more...] about Solution to Medicare Part B Cost Increases? Look at “Outpatient” Observation Status
Observation Status Again!
Hospitals often classify hospitalized Medicare patients as outpatients, even though their hospital care may be indistinguishable from the care they would receive if they were formally admitted as inpatients. This issue – called … [Read more...] about Observation Status Again!
Observation Status: The NOTICE Act Will Soon Be Law
An increasing number of patients in hospitals are not formally admitted as inpatients, but as “outpatients” on “observation status.” Although they receive whatever medical and nursing care, diagnostic tests, medications, … [Read more...] about Observation Status: The NOTICE Act Will Soon Be Law
Proposed Revisions to “Two-Midnight” Rule Provide Little, If Any, Relief for Medicare Beneficiaries Stuck in the Hospital in Observation Status
In the annual update to Medicare reimbursement of acute care hospitals for outpatient care (July 8, 2015)[1] the Centers for Medicare & Medicaid Services (CMS) includes proposed revisions to the “Two-Midnight Rule” and its … [Read more...] about Proposed Revisions to “Two-Midnight” Rule Provide Little, If Any, Relief for Medicare Beneficiaries Stuck in the Hospital in Observation Status
Observation Status: Virginia Requires Hospitals to Notify Patients of their Observation Status
Effective July 1, 2015, Virginia has become the fifth state to enact legislation requiring hospitals to inform patients when they are in Observation or other outpatient status, and the consequences of not being admitted as inpatients. Senate … [Read more...] about Observation Status: Virginia Requires Hospitals to Notify Patients of their Observation Status
Saga of an Inpatient Hospital Appeal: Notice and Use of Lifetime Reserve Days and Comments on Observation Status
This CMA Alert highlights a recent individual ALJ decision that sets out an important but often unrecognized beneficiary right to a written notice when he or she is about to use hospital “Lifetime Reserve Days.” A hospital’s … [Read more...] about Saga of an Inpatient Hospital Appeal: Notice and Use of Lifetime Reserve Days and Comments on Observation Status
Observation Status Update
Observation Status – hospital patients’ classification as outpatients, which makes them ineligible for Medicare Part A coverage of their subsequent stay in a skilled nursing facility (SNF) when they do not have “inpatient” … [Read more...] about Observation Status Update
Observation Status and the Medicare Payment Advisory Commission
At its January 16, 2015 public meeting, the Medicare Payment Advisory Commission (MedPAC), the government agency that advises Congress on Medicare payment policy, addressed observation status as part of its discussion of hospital short stay policy … [Read more...] about Observation Status and the Medicare Payment Advisory Commission