Tuesday, July 29, 2014

Observation Stays Issue Remains at the Forefront on Capitol Hill

Dana Halvorson
  
The observation stays issue remains at the forefront before Congress breaks for August recess. The U.S. Senate Special Committee on Aging is holding a hearing today entitled, Admitted or Not? The Impact of Medicare Observation Status on Seniors. Committee Chairman Bill Nelson (D-FL) and Ranking Member Susan Collins (R-ME) will be leading the hearing at 2:00 pm ET in Senate Russell 418, focusing on the observation stays issue. Witnesses will include AHCA/NCAL member Bob Armstrong, Vice President, Elder Care Services, St. Mary’s Health System, Lewiston, Maine. For the witness list, check the website for the Senate Special Committee on Aging
  
Hospital stays classified as observation, no matter how long and no matter the type or number of services provided, are considered outpatient. These hospital stays do not qualify patients for Medicare-covered care in a skilled nursing center.
   
In addition to the hearing today, earlier this week, Congressmen Lloyd Doggett (D-TX-35) and Todd Young (R-IN-9) introduced the Notice of Observation Treatment and Implication for Care Eligibility Act H.R. 5232, also called the NOTICE Act. The legislation requires hospitals to give formal notice to patients within a period of time after classifying them as an inpatient or as an outpatient under observation. The bill is a positive step forward, and raises attention to a complex and critical issue hurting the nation’s seniors. Specifically, the NOTICE Act works to ensure that hospitals notify patients entitled to Medicare part A coverage of their outpatient status within 36 hours after the time of their classification or, if sooner, upon discharge. Often times, patients have no idea what their status is in a hospital or the importance of it. This can lead to thousands of dollars in out-of-pocket medical expenses should they need skilled nursing center care following their hospital stay. The observation stays issue is a financial burden on seniors and their families. It can cause unnecessary spend-down, accelerating the time frame in which seniors will have to turn to programs such as Medicaid to pay for their care.
  
Although the NOTICE Act is an important step in ensuring that beneficiaries understand what is happening to them, the American Health Care Association/National Center for Assisted Living (AHCA/NCAL) and other provider and beneficiary groups continues to advocate for legislation that would address the observation stays issue once and for all. AHCA/NCAL strongly support Reps. Joe Courtney (D-CT) and Tom Latham (R-IA), along with Sen. Sherrod Brown (D-OH) in the legislation they introduced, The Improving Access to Medicare Coverage Act of 2013, which seeks to count all hospital days spent in observation towards the three-day stay requirement. The association also continues to support the Creating Access to Rehabilitation for Every Senior (CARES) Act of 2013, introduced by Rep. Jim Renacci (R-OH), and the Fairness for Beneficiaries Act of 2013, introduced by Rep. Jim McDermott (D-WA).
 
For more information about observation stays, please visit the AHCA/NCAL website
 

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