A 98-year-old woman’s life savings was wiped out by nursing home stays that weren’t covered by Medicare. A Congressman wants to do something about that.
A Connecticut woman was required to pay tens of thousands of dollars after learning that Medicare would not pay for rehabilitation services at a nursing center that she was referred to after her stay in the hospital, Kaiser Health News reports.
The catch: Her stay in the hospital was considered “observation services” and Medicare won’t pay unless the patient is admitted to the hospital as an “inpatient” for at least three days.
We mentioned the other day that observation status remains a live issue among health care advocates. Now one Congressman wants to address at least the nursing home part of the problem.
Rep. Joe Courtney (D-Conn.) has introduced legislation that would allow days spent in observation care to count toward the current rule that requires patients to be admitted to the hospital for three days.
“The trend of hospitals coding patients as observation is accelerating with every passing year, and the impact on families is financially catastrophic,” said Courtney.
If the bill passes, it would require Medicare to consider patients admitted to the hospital under observation status to be considered “inpatients” for the purpose of Medicare coverage for skilled nursing facilities. The legislation would cover observation stays retroactive to Jan. 1, 2011.
The question of whether a patient is an inpatient or merely under observation can cost a patient while in the hospital as well. A greater burden of a hospital bill is placed on patients admitted to hospitals as under observation and many medications taken while admitted in observation status are not covered by Medicare.
Expect the admission status question to figure prominently in the near future. Several associations, including the American Medical Association and the AARP are throwing their weight behind legislation to amend observation status requirements.