The Hospital Readmissions Reduction Program (HRRP), enacted as part of the Affordable Care Act, imposes penalties against hospitals that have higher-than-expected rates of readmissions of patients with certain conditions. However, HRRP defined … [Read more...] about Increased Use of Observation Stays Undermined Hospital Readmissions Reduction Program
Search Results for: observation
Reminder: Questions or Comments on Proposed Clarification in Hospital “Observation Status” Case Due November 25
In Alexander v. Becerra, a federal court found that certain beneficiaries must be allowed to appeal to Medicare when their hospitalizations are reclassified from “inpatient” to “outpatient receiving observation services.” The Center for Medicare … [Read more...] about Reminder: Questions or Comments on Proposed Clarification in Hospital “Observation Status” Case Due November 25
Wilson Sonsini Firm Honored for its Pro Bono Work on Center’s “Observation Status” Case
The Center for Medicare Advocacy celebrates Wilson Sonsini Goodrich & Rosati’s well-deserved honor as a “Pro Bono Innovator.” This week Bloomberg Law highlighted the firm’s work with the Center and co-counsel Justice in Aging on the nationwide … [Read more...] about Wilson Sonsini Firm Honored for its Pro Bono Work on Center’s “Observation Status” Case
Notice to the Class of a Proposed Clarification in Hospital “Observation Status” Case
In Alexander v. Becerra, a federal court found that certain beneficiaries must be allowed to appeal to Medicare when their hospitalizations are reclassified from “inpatient” to “outpatient receiving observation services.” The Center for Medicare … [Read more...] about Notice to the Class of a Proposed Clarification in Hospital “Observation Status” Case
Medicare Announces Development of Appeal Process for Certain Hospital “Observation Status” Patients
As the result of a court case, the Medicare.gov website now alerts a nationwide class of Medicare beneficiaries that they “have appeal rights” when a hospital changes their status from inpatient to outpatient observation, and that the appeal process … [Read more...] about Medicare Announces Development of Appeal Process for Certain Hospital “Observation Status” Patients
Issue Brief – March 2022 – Litigation Update Including Observation Status, Off label Drugs & Other Issues
LITIGATION UPDATE (Beneficiary Appeals of Observation Status). In November 2011, the Center for Medicare Advocacy and Justice in Aging filed a proposed class action lawsuit on behalf of individuals who have been denied Medicare Part A coverage … [Read more...] about Issue Brief – March 2022 – Litigation Update Including Observation Status, Off label Drugs & Other Issues
Court Upholds Right to Appeal for Certain Medicare Beneficiaries on “Observation Status”
On January 25, 2022, a federal appeals court decided that Medicare must provide appeal procedures for hospitalized beneficiaries who are reclassified from inpatients to “outpatients” receiving “observation services.” The observation designation can … [Read more...] about Court Upholds Right to Appeal for Certain Medicare Beneficiaries on “Observation Status”
Court Upholds Right to Appeal for Certain Medicare Patients on “Observation Status”
A federal appeals court has decided that Medicare must provide appeal procedures for hospitalized beneficiaries who are reclassified from inpatients to “outpatients” receiving “observation services,” a designation that can have severe ramifications. … [Read more...] about Court Upholds Right to Appeal for Certain Medicare Patients on “Observation Status”
HHS Inspector General Calls on CMS to Address Medicare Observation Status
In an annual report, the Department of Health and Human Services (HHS) Office of Inspector General (OIG) identifies 25 top recommendations that it made in prior years about HHS programs that HHS has not implemented. This year’s report on Top … [Read more...] about HHS Inspector General Calls on CMS to Address Medicare Observation Status
Appeals Court Temporarily Pauses Implementation of Observation Status Decision While Considering Government’s Request for a Stay
In March 2020, a nationwide class of hospitalized Medicare beneficiaries who were reclassified from inpatients to “outpatients,” receiving “observation services,” won the right to appeal their designation, which can have severe ramifications for … [Read more...] about Appeals Court Temporarily Pauses Implementation of Observation Status Decision While Considering Government’s Request for a Stay