CMA Health Policy Blog

You’re not in the hospital. You’re in observation!

July 13, 2010 at 7:45 pm meshepard 2 comments

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?

Entry filed under: Observation.