Group To Sue Federal Government on Behalf of Medicare Enrollees
On Thursday, the Center for Medicare Advocacy plans to file a lawsuit against the federal government alleging that CMS forces beneficiaries to pay for their nursing home care by defining prior hospitalizations as outpatient procedures, the Hartford Courant reports.
The Connecticut-based group plans to seek class-action status on behalf of the state's residents who are age 65 and older and qualify for Medicare.
Toby Edelman, a senior policy attorney for the group, said the "difference in terminology makes all the difference in the world," adding, "Inpatients qualify for Medicare coverage of their nursing home care; outpatients don't."
Last month, Rep. Joe Courtney (D-Conn.) held a congressional briefing on the issue, according to the Courant. Courtney's office said that hospitals increasingly provide patients with complete medical care, which includes diagnostic tests, treatments, services, food and even a wrist band, but they call them "observation" outpatients rather than inpatients (Sturdevant, Hartford Courant, 11/2).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.