Tell CMS to change its policies about hospital stays!
Increasingly, Medicare beneficiaries who stay at the hospital for one or more days are placed on observation (outpatient) status. This may feel like a hospital stay and look like a hospital stay, but it is not because, under observation status, the individual is not officially admitted as an inpatient. Why does the difference between observation status and inpatient status matter? Because Medicare will only pay for care in a skilled nursing facility after a hospital stay if a beneficiary spends at least three consecutive days in the hospital as an inpatient (not counting the day of discharge) – the so-called three midnights rule. So while a beneficiary may spend three days or more in the hospital, none of that time counts if he or she is on observation status. The result – these patients do not qualify for Medicare coverage in a skilled nursing facility and must pay thousands of dollars out of their own pockets or return home without receiving the therapy and nursing services they need to recover.
CMS is asking whether it should change this observation status policy.
Tell CMS to count all the time a person spends on observation status toward the 3-day hospital stay requirement! And if you or someone you know has been negatively affected by being placed on observation status, let CMS know (include the state where it occurred, the length of the hospital stay, and, if applicable, the length of time in the skilled nursing facility and what it cost).
To read the proposed rule, click here.
To learn more about this issue, visit the Center for Medicare Advocacy’s resources on Observation Status here. Comments are due September 4, 2012 at 11:59 pm ET.
How to submit a comment: Make sure to refer to file code CMS-1589-P in your comments. You can submit them:
Electronically: Go to http://www.regulations.gov/#!documentDetail;D=CMS-2012-0084-0002 and follow the instructions under the "Comment Now!" tab.
By regular mail: Mail written comments to:
Centers for Medicare & Medicaid Services
Department of Health and Human Services
P.O. Box 8013
Baltimore, MD 21244-1850