Topic: Observation Status

Under ‘Observation,’ Some Hospital Patients Face Big Bills

Patients can be hospitalized for days, can undergo exams and tests, can receive drugs — without ever officially being admitted to the hospital. Instead, they’re “under observation,” which means they’re outpatients, not inpatients. That can bring financial hardships — including lack of coverage for subsequent nursing home care.

CMA Alert – Critical Issue Roundup: MA Overpayment; HH Payment; Observation; More

CMA Alert - Former CMS Administrator Comments on Medicare Advantage Overpayments; Proposed Home Health Rules – Payments Drive Delivery of Care, Harming Beneficiaries; Observation Status Harms Low-Income Medicare Beneficiaries; Poll: Americans Favor Making the ACA Work

Observational Vs. Admitted: CT Advocates Win Class Status For Suit Challenging Medicare Benefits

The Center for Medicare Advocacy has won class certification for a lawsuit demanding that Medicare beneficiaries be allowed to challenge their patient classification as "observational" rather than "admitted" when hospitalized — a distinction that can cost thousands of additional dollars in hospital, medication and nursing home care.

Court Certifies Nationwide Class in “Observation Status” Case

Decision in Alexander v. Price "Observation Status" case means Medicare patients could gain the right to appeal placement on “Observation Status” and avoid large medical bills.

AGING WELL – Taylor: What is Outpatient Observation Status?

An article from The Citizen, Auburn discusses Outpatient Observation Status. The CMA grant project with The John A. Hartford Foundation is mentioned.

Look for the Moon!

Beginning no later than March 8, 2017, hospitals are required to give written and oral notice to Medicare patients when they are placed in “outpatient” observation status for 24 hours and are not formally admitted as inpatients. The written notice is called the Medicare Outpatient Observation Notice (MOON).

CMS Issues Instructions Regarding the Medicare Outpatient Observation Notice (MOON)

Beginning no later than March 8, 2017, and as required by the Notice of Observation Treatment and Implication for Care Eligibility Act (NOTICE Act), hospitals and critical access hospitals (CAHs) are required to give patients both oral and written notice when they are outpatients and not admitted as inpatients.

Hospitals Must Give Patients Notice of Their Observation Status, Beginning March 8, 2017

Effective August 6, 2016, the Notice of Observation Treatment and Implication for Care Eligibility Act (NOTICE Act) requires acute care hospitals to provide oral and written notification to patients who are classified as outpatients or observation status patients for more than 24 hours.

Observation Status Impedes Access to End-of-Life Skilled Nursing Facility Care

When hospitals classify some or all of their stay as “outpatient,” these patients will often not qualify for Medicare SNF coverage and may forego care.

A Model to Waive the Three-Day Inpatient Hospital Stay Requirement for Care in a Skilled Nursing Facility

The Centers for Medicare & Medicaid Services (CMS) is conducting multiple demonstrations that would waive the three-day inpatient hospital stay requirement entirely. The most recent example is included in proposed rules, published July 15, 2016, that address the three-day waiver for certain Accountable Care Organizations.

Observation Status and the NOTICE Act: Advocates Not Over the MOON

Requiring standardized language about the “reason” for being placed on Observation Status, which CMS has declared by fiat, thwarts the purpose of delivering information.

Office of Inspector General Authorizes Hospitals to Discount or Waive Certain Drug Charges for Patients Classified as “Outpatients”

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 outpatient’s self-administered drugs.

Page 1 of 3 1 2 3