The Centers for Medicare & Medicaid Services’ (CMS) lack of guidance on a new requirement for hospitals to notify Medicare patients why they are receiving observation care could cause hospitals to lose billing privileges and patients.
Under federal law, hospitals must alert Medicare patients when they are getting observation care and they are not admitted – even if they stay in the hospital for a few nights. Often, seniors found out only when they got surprise bills for services Medicare doesn’t cover for observation patients, including some drugs and expensive nursing home care.
As of March 8th one of the conditions hospitals must meet in order to get paid for treating Medicare beneficiaries, who typically account for about 42% of hospital patients. The new noticed drafted by medicare officials must be provided after the patient has received observation care for 24 hours and not later than 36 hours.
However, doctors and hospital representatives still have questions about how to fill out the new observation care form.