703-585-5857

Update to the Medicare “Observation Status” Problem

Several months ago, in September 2013 specifically, I wrote about the issue of being under “observation status” when in the hospital.  A problem occurs when a hospital deems a patient “under observation.”  Such a status means just that.  What it does not mean is that the patient has been admitted to the hospital.  The patient may be in the hospital, on a unit, and in a hospital bed in a regular room, even receiving all the routine procedures of a hospitalization, but if they are “under observation,” it can create a problem, especially when the discharge plan is to go to short term rehab in a skilled nursing facility.  Unless the patient was “admitted,” and was in the hospital for at least three days, the rehab stay currently will not be covered by Medicare.  The person’s only option is to pay privately for the rehab stay, or go directly home, if that is possible.

Now, though, efforts are under way to change that.  Congress is addressing this issue through the “Improving Access to Medicare Coverage Act” (HR 1179 and S 569).  If passed and signed into law, the time spent in observation will count toward the three day hospitalization requirement.  Let your representatives know if you support this bill.