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September 22, 2015

NPAF Applauds Bill to Bolster Medicare Patients' Hospital Rights

2015-09-22 | August 1, 2015

(Washington, DC)  National Patient Advocate Foundation (NPAF) today applauded Congress for passing legislation that will require hospitals to tell Medicare patients when they receive observation care but have not been admitted to the hospital.  Called theNotice of Observation Treatment and Implication for Care Eligibility Act or simply the NOTICE Act, the law requires  hospitals to provide written notification to patients 24 hours after receiving observation care, explaining that they have not been admitted to the hospital, the reasons why, and the potential financial implication.

The distinction between admittance and observation could mean a huge price difference for patients.  George Dahlman, Executive Vice President of NPAF, noted that under Medicare rules, comprehensive coverage doesn’t apply under observation care, and these patients may also subsequently not qualify for Medicare’s limited nursing home benefit later on.

“Hospital bills are an overwhelming source of debt for the patients we serve,” said Dahlman.  “We applaud this step towards transparency, and hope it translates into savings– and less surprises– for patients.”

Without that coverage, patients could pay thousands of dollars out of pocket, both for their hospital stay and for subsequent nursing home care.

According to data from the Centers for Medicare and Medicaid, hospital claims for observation care have increased 91 percent since 2006.  In 2013, Medicare officials attempted to control the use of observation care by requiring hospitals to admit patients who doctors expected to stay at least two midnights, but Congress delayed enforcement after hospitals said the rule was “confusing and arbitrary.”