Tuesday, July 30, 2019

July 2019 OIG Report and Outpatient Stays Issue

Dana Halvorson

The Office of the Inspector General’s (OIG’s) July 2019 report noted their top unimplemented recommendations which included that the Centers for Medicare and Medicaid Services (CMS) should analyze the potential impacts of counting time spent as an outpatient toward the 3-night requirement for SNF services so that beneficiaries receiving similar hospital care have similar access to these services.  AHCA/NCAL supports efforts and legislation that ensures that time spent under “observation status” in a hospital counts toward satisfying the three-day inpatient hospital requirement for coverage of skilled nursing care services under Medicare.  The observation stays issue is an outdated policy that continues to leave millions of Medicare beneficiaries surprised by thousands of dollars in medical bills and hanging with uncertainty regarding their access to the Medicare coverage they deserve.  For more information about the observation stays issue, please visit the AHCA/NCAL website.         

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