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As policymakers in Washington, DC and beyond continue a national discussion about the state of long-term care in the United States, a critical component of the discussion is the quality of care provided in nursing homes across the country. The nursing home industry argues that nursing home quality is improving, pointing to higher ratings on the … Read more

While Observation Status continues, recent weeks have seen a great increase in awareness of the problem.  In addition, support for legislation to end Observation Status has grown rapidly. What is Observation Status? Observation Status refers to the classification of hospital patients as "outpatients," even though, like inpatients, observation patients may stay for many days and … Read more

From CMA Press Release, Thursday, August 29, 2013 …[T]he Department of Health and Human Services (HHS) issued a memo clarifying that all beneficiaries in private Medicare plans have access to equal coverage when it comes to care in a nursing home where their spouse lives. This is the first guidance issued by HHS in response … Read more

Effective October 1, 2013, new rules for inpatient hospital reimbursement under the Medicare program[1] make final two sets of proposed rules that the Centers for Medicare & Medicaid Services (CMS) published in the Spring 2013 – the definition of an inpatient hospital stay based on time[2] and a hospital rebilling option.[3]  Neither set resolves the … Read more

Post-Acute Care Post-acute care refers to a range of services that support the individual’s continued recovery from illness or injury, or management of a chronic illness or disability.  On June 19, 2013 the House Ways and Means Committee and Senate Finance Committee issued a letter to key communities requesting information and ideas on the types … Read more

August 19, 2013 Senate Finance Committee House of Representatives, Committee on Ways and Means United States Congress Submitted electronically to: postacutecarereform@finance.senate.gov and postacutecarereform@mail.house.gov Re: Comments on Post Acute Care (PAC) Reform Proposals Dear Committee Members: The undersigned organizations, the Center for Medicare Advocacy, the National Senior Citizens Law Center, the National Committee to Preserve Social Security and Medicare, … Read more

August 16, 2013   Committee on Ways and Means, Subcommittee on Health U.S. House of Representatives 1102 Longworth House Office Building Washington, DC 20515   Dear Committee Member:   On behalf of the Leadership Council of Aging Organizations (LCAO), a coalition of national not-for-profit organizations representing over 60 million older Americans, we are writing to … Read more

On June 26, 2013, the Supreme Court of the United States found a key provision of the Defense of Marriage Act (DOMA) unconstitutional. See U.S. v. Windsor, Executor of the Estate of Spyer, et al (No. 12–307).[1]  In its ruling, the Court stated that Section Three of DOMA is a "deprivation of the equal liberty … Read more

Joining the discussion about hospitals' extended use of observation status, the Department of Health and Human Services' Office of Inspector General (OIG) has issued a memorandum report that describes the nationwide use of observation and outpatient stays in calendar year 2012.  OIG reports that more than 600,000 Medicare beneficiaries had hospital stays lasting at least … Read more

Although a large and increasing number of Senators and Representatives now support bipartisan legislation to solve the problem of Observation Status, many beneficiaries and their families continue to face this outpatient status as a barrier to Medicare coverage of care in a skilled nursing facility.  This Alert describes the continuing problem, Congressional legislation, a survey … Read more