Wednesday, November 4, 2015

Observation Stays Related Letter Sent to Secretary Burwell

Dana Halvorson 

One of our Congressional leaders and advocates on the observation stays issue, U.S. Representative Joe Courtney (D-CT 2nd District), recently sent a letter to the U.S. Secretary of Health and Human Services, Sylvia Burwell, relating to Medicare Part B Premiums and deductibles and the observation stays issue. (The full letter is available here.)

As you know, “Observation status” in a hospital does not count toward satisfying the three-day inpatient hospital requirement for coverage of skilled nursing care services under Medicare. Often, patients remain under ‘‘observation status’’ in the hospital for several days. These days are not counted toward the three-day inpatient stay requirement because they are considered outpatient. Increasingly, patients have no idea what their status is in a hospital, or the importance of it, which can lead to thousands of dollars in out-of-pocket medical expenses should they need skilled nursing center care following their hospital stay. In addition to placing a financial burden on seniors and their families, this anomaly in Medicare rules 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. AHCA/NCAL is part of the observation stays Coalition, which currently consists of 27 national organizations such as AARP, the National Committee to Preserve Social Security & Medicare, and the Catholic Health Association of the United States.

The Coalition supports the bipartisan Improving Access to Medicare Coverage Act (S. 843/H.R. 1571) that would count a patient’s time in observation toward the 3-day hospital inpatient stay requirement. (The updated observation stays Coalition one-pager can be found here.)

For more information about observation stays and the three-day stay requirement, please visit the AHCA/NCAL website.

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