Hospitals must notify Medicare patients when care is observation-only

As of March 8, hospitals must alert Medicare patients when they are only under observation care and aren’t being admitted as one of the conditions for facilities to get paid by CMS.

As Kaiser Health News explains, this new requirement, put in place by 2015’s NOTICE Act, may simply “cushion the shock” for patients. Since cost-sharing is higher for Medicare beneficiaries under observation care, the lack of notice may have resulted in surprise bills.

But the standard doesn’t affect care. Medicare still doesn’t cover nursing home care after an observation visit, only after an admission, which CMS had tried, unsuccessfully, to address with the “two-midnight” rule.

“The observation care notice is a step in the right direction, but it doesn’t fix the conundrum some people find themselves in when they need nursing home care following an observation stay,” said Stacy Sanders, federal policy director at the Medicare Rights Center.

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John Gregory, Senior Writer

John joined TriMed in 2016, focusing on healthcare policy and regulation. After graduating from Columbia College Chicago, he worked at FM News Chicago and Rivet News Radio, and worked on the state government and politics beat for the Illinois Radio Network. Outside of work, you may find him adding to his never-ending graphic novel collection.

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