Aging Options

Judge throws out suit on observation status

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A federal judge threw out a lawsuit brought against Medicare by 14 patients who were denied nursing home coverage based on the fact that their time in the hospital was considered observation care rather than admitted. 

The lawsuit hoped to eliminate the observation classification or at the very least require the hospitals to notify patients when they are under observation status.  The difference can amount to tens of thousands of dollars from the individuals’ own pockets rather than Medicare especially if they are admitted to a nursing home later.  The judge’s decision upheld a 2008 federal court decision that upheld the right of Health and Human Services to let hospitals and doctors make the determination as to when a patient is under observation or has been admitted.  Please read the full text of the article here.

Observation status has been under scrutiny for quite some time but for the patient the only real option is to either chase down the answer about which status the hospital is using (and the status can change so it’s not a done deal if you start out admitted) or to hire someone like a geriatric care manager to pursue all avenues on your status. The decision is supposed to be made within 24 to 48 hours of entering the hospital but from 2006 to 2011, observation status visits exceeding 24 hours nearly doubled.  For additional information on observation status, go here.

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