While CMS tries to figure out how to proceed with the manual medical review process, we continue to track our caps and apply our modifiers. In the meantime, has anyone noticed how our typical Medicare Part B patients have become more medically complex than just a few years ago?
Government lawyers and opponents of Medicare's "observation stay loophole" squared off in court on Friday, when a federal judge convened the first hearing in the Bagnall vs. Sebelius case.
Bully for provider groups pulling out the stops to draw attention to the ludicrous mishandling of "observation stay" designations by many hospitals. One prong of the plan is to have providers supply anecdotes about individuals hurt financially and emotionally by the practice.
It was welcome news Tuesday to learn that the confirmation hearing for the person who could officially wind up holding the purse strings for most nursing home payments was civil. Even better was the nominee saying she would look into the ridiculous state of affairs concerning hospital observation stays.
Hospitals have been undergoing more and more restrictions on re-admissions and are now facing financial penalties in some situations. Unfortunately, this has also resulted in more patients not being classified as "admits" or "re-admits," but rather getting coded as "observation" stays.
Provider groups assert regulators should update existing policies when determining hospital inpatient and outpatient admission status.
A long-term care group is urging regulators to continue work on fixing the "observation stay loophole" that makes it harder for Medicare beneficiaries to get nursing home care.
Proponents of a bill to cut out the "observation stay" Medicare loophole got a boost from a House of Representatives member Wednesday.
Physicians and hospitals increasingly are admitting more Medicare beneficiaries for observation stays rather than as hospital inpatients, new research concludes.