Posts filed under ‘Observation’
When it wrote the Medicare law, Congress called Medicare Part A “Hospital Insurance” and Part B “Supplemental Medical Insurance.” Part A is intended to pay for inpatient hospital care. It is a charade to consider people who stay IN the hospital for more than 24 hours “outpatients,” and pay for their care under Part B. This not only conflicts with the Medicare law and Congressional intent, it also harms the older and disabled people – and their families – who depend upon Medicare and for whom the law was written. They lose their right to Part A hospital coverage, are often left with hospital bills they would not have if they were properly admitted, and completely lose their ability to obtain Medicare coverage for post-hospital nursing home care. CMS’s insistence on continuing this policy places hospital payment mechanisms over the interests and rights of older and disabled people.
When Mrs. Lee Barrows was told that her husband Larry, whom she’d been visiting in the hospital for a week was not an in-patient, she asked, then “Who the hell have I been visiting?” This scene in Connecticut is being repeated daily in acute care hospitals all over the country. Medicare beneficiaries – although placed in hospital beds (often, from the emergency room) and given medications, tests, therapies, medical and nursing services, food, and a wrist-band – are told they aren’t in-patients; they’re just receiving observation services as outpatients. Patients often learn about their out-patient status just as they are leaving the hospital for the skilled nursing facility – which won’t be covered by the Medicare program because they weren’t in-patients for three consecutive days!
The Center for Medicare Advocacy has been hearing this story with increasing frequency over the last year. We’ve been writing about it (see our 5/24 post), and now, the media is reporting on it.
Bloomberg News published an article by Drew Armstrong on its website and in Business Week – “Medicare Fraud Effort Gives Elderly Surprise Hospital Bills” (July 12, 2010), http://www.bloomberg.com/news/print/2010-07-12/hospital-fraud-audits-spur-unintended-cash-penalty-to-elderly-on-medicare.html
The Philadelphia Inquirer also addressed this pressing issue in its article “High cost, rigorous rules can trap Medicare patients” (July 4, 2010), http://www.philly.com/inquirer/health_science/daily/20100704_High_cost__rigorous_rules_can_trap_Medicare_patients.html
The Center has lots of information on this issue. Please go to http://www.medicareadvocacy.org/InfoByTopic/ObservationStatus/ObservationMain.htm
And let us hear from you, too! What is happening to you and your friends and relatives in the hospital?