Hospital-stay clause irks skilled facilities

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Rep. Joe Courtney (D-CT)
Rep. Joe Courtney (D-CT)
Long-term care lobbyists have intensified the bright light shining into hospitals' practice of classifying more patients as under “observation” status.

 In comments to the Centers for Medicare & Medicaid Services, the American Health Care Association asked the agency to “assure that none of these policies hurts” Medicare beneficiaries.

In August, CMS launched a pilot program that allows 380 participating hospitals the ability to rebill Medicare for observation services if claims for inpatient care are rejected. The hope is this will reduce the rates of seniors being classified as in only for “observation.” Beneficiaries need three days as an inpatient to qualify for follow-up care at inpatient nursing and rehabilitation facilities.

 “When Medicare coverage is denied to those individuals who desperately need skilled nursing care, it forces an unfair decision on those beneficiaries to either to pay for care out of pocket or forgo the care they need to continue their health recovery,” AHCA President and CEO Mark Parkinson said in a statement.
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