Senate OKs Bill To Notify Medicare Beneficiaries of Observation Care
On Monday, the Senate unanimously approved legislation (HR 876) that requires hospitals to notify Medicare beneficiaries when they receive observation care but have not been admitted to the hospital, Kaiser Health News reports.
Observation care refers to when a patient is not well enough to go home but not ill enough to be admitted (Jaffe, Kaiser Health News, 7/29).
The amount of time spent under outpatient observation can affect whether a patient is eligible to receive Medicare coverage for post-acute care (Mongan, McKnight's, 7/28).
To be eligible for Medicare's nursing home coverage, beneficiaries must spend three consecutive midnights admitted in a hospital, not counting observation days.
Observation care is provided on an outpatient basis, meaning that patients also often have copayments for doctors' fees and individual hospital services. They also have to pay the hospital's fees for routine drugs, as well as those for chronic conditions.
Several states already require observation care notices, including:
- New York;
- Pennsylvania; and
However, Medicare has been hesitant to enforce similar rules.
In 2013, Medicare aimed to control observation care by issuing the "two-midnight" rule. However, Congress delayed enforcement of the rule after facing opposition from hospitals (Kaiser Health News, 7/29).
Under the Notice of Observation Treatment and Implication for Care Eligibility Act, or NOTICE Act, hospitals must provide written notification to Medicare beneficiaries within 24 hours after receiving observation care. The notification must explain:
- Denial of admission;
- Potential financial implications; and
- Reasons for denial of admission (Kaiser Health News, 7/29).
The measure already has passed in the House (McKnight's, 7/28). The bill's House sponsor, Rep. Lloyd Dogget (D-Texas), said President Obama is expected to sign the legislation (Kaiser Health News, 7/29).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.