Medicare change.."under observation"..does anyone know

[shraby]

anything about this claim? I got it in an email.

"I saw this on NBC News last night and thought I should send it to all my friends on Medicare as fair warning. I've included the segment for you to view. Basically, if I understand it correctly, do not let the hospital admit you with the words, "Under Observation." Insist on "In-Patient"designation. Otherwise, you will be responsible for the hospital expenses. It might be wise to inform family members too."

[SharonAnn]

1. I believe that it's true, according to several articles, including AARP.

"Under observation" is not a Medicare approved designation as I understand it. Therefore, Medicare doesn't pay any of the costs associated with the hospital stay.

[shraby]

2. I would think then that a hospital would automatically check a person in as a patient

to optimize their bottom line. If under observation would jeopardize them getting the bill paid, I don't see them doing that.

[Motown_Johnny]

3. I saw a news report on it some time ago.

It looks like a way to screw people.


Why the hell Medicare would not cover people who are under observation is beyond me. You would think it would be a way to reduce costs instead of making people be admitted.


You should inform everyone you can. Also check on them if something happens to them. This is exactly the kind of detail you forget about when you are worried about your loved one.

[RebelOne]

4. I am on Medicare and have not heard of this,

but thanks for the heads up.

[Blue Diadem]

5. AKA 2 midnight rule. Link that explains some of it.

http://www.modernhealthcare.com/article/20140203/NEWS/302039975

snip:
Hospitals say they'll lose money on the deal because many procedures are appropriate for short inpatient care and now will be reimbursed only under Medicare's lower outpatient rates.

CMS officials say hospitals actually stand to benefit financially because the two-midnight rule also says hospital visits that cross two midnights will be presumed legitimate if they include adequate physician notes. That should allow hospitals to get full inpatient rates on cases that would have been outpatient in the past, creating an estimated $220 million in new Medicare expenses nationwide, the agency estimated.

The CMS devised the policy in response to complaints that Medicare patients were being exposed to prolonged periods of outpatient observation care in the hospital—which exposes them to 20% co-payments and denies them eligibility for Medicare-covered rehab care upon release.