Last year, the Center for Medicare Advocacy suggested that it was time to repeal the three-day inpatient hospital requirement that is necessary for Part A coverage in the traditional Medicare program.[1] The recent Second Circuit decision in … [Read more...] about It’s Time: Repeal the 3-Day Inpatient Hospital Requirement for Medicare Skilled Nursing Facility Coverage
Acute Hospital Care
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”
CMS Issues Instructions Regarding the Medicare Outpatient Observation Notice (MOON)
Beginning no later than March 8, 2017, and as required by the Notice of Observation Treatment and Implication for Care Eligibility Act (NOTICE Act),[1] hospitals and critical access hospitals (CAHs) are required to give patients both oral and written … [Read more...] about CMS Issues Instructions Regarding the Medicare Outpatient Observation Notice (MOON)
Hospitals Must Give Patients Notice of Their Observation Status, Beginning March 8, 2017
Effective August 6, 2016, the Notice of Observation Treatment and Implication for Care Eligibility Act (NOTICE Act)[1] requires acute care hospitals to provide oral and written notification to patients who are classified as outpatients or observation … [Read more...] about Hospitals Must Give Patients Notice of Their Observation Status, Beginning March 8, 2017
Medicare’s Value-Based Purchasing Program for Hospitals: Paying More to Low-Cost Hospitals That Provide Low Quality Care
In 2012, the Centers for Medicare & Medicaid Services (CMS) announced expansion of Medicare’s Value-Based Purchasing (VBP) Program for acute care hospitals. Beginning in Fiscal Year 2015, and as mandated by Congress in the Affordable … [Read more...] about Medicare’s Value-Based Purchasing Program for Hospitals: Paying More to Low-Cost Hospitals That Provide Low Quality Care
Observation Status and the NOTICE Act: Advocates Not Over the MOON
In proposed rules updating Medicare reimbursement to acute care hospitals,[1] the Centers for Medicare & Medicaid Services (CMS) announces how it intends to implement the Notice of Observation Treatment and Implication for Care Eligibility Act … [Read more...] about Observation Status and the NOTICE Act: Advocates Not Over the MOON
Reducing Hospital Readmissions by Addressing the Causes
Reports that 20% or more of unplanned hospital readmissions are avoidable has led to considerable interest in policymakers in reducing readmissions.[1] Actively reducing hospital readmissions is seen as a route to lower Medicare spending and … [Read more...] about Reducing Hospital Readmissions by Addressing the Causes
Office of Inspector General Authorizes Hospitals to Discount or Waive Certain Drug Charges for Patients Classified as “Outpatients”
The Office of the Inspector General (OIG) of the Department of Health and Human Services (HHS) released a statement on October 30, 2015 that advises hospitals that it will not administratively sanction them if they discount or waive charges for an … [Read more...] about Office of Inspector General Authorizes Hospitals to Discount or Waive Certain Drug Charges for Patients Classified as “Outpatients”
Revisions to “Two-Midnight Rule” Do Not Help Hospitalized Medicare Patients in Observation Status
In 2013, the Centers for Medicare & Medicaid Services (CMS) promulgated the Two-Midnight Rule, which, for the first time in the Medicare program’s 50-year history, determined patient status in a hospital by reference to time.[1] … [Read more...] about Revisions to “Two-Midnight Rule” Do Not Help Hospitalized Medicare Patients in Observation Status
Proposed Revisions to “Two-Midnight” Rule Provide Little, If Any, Relief for Medicare Beneficiaries Stuck in the Hospital in Observation Status
In the annual update to Medicare reimbursement of acute care hospitals for outpatient care (July 8, 2015)[1] the Centers for Medicare & Medicaid Services (CMS) includes proposed revisions to the “Two-Midnight Rule” and its … [Read more...] about Proposed Revisions to “Two-Midnight” Rule Provide Little, If Any, Relief for Medicare Beneficiaries Stuck in the Hospital in Observation Status