Senators Schumer and Brown Introduce Bill to Eliminate “Observation” Loophole to Care in Nursing Home
- At March 06, 2013
- By admin
- In Professional News
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Many seniors do not realize that they can be sent to a hospital emergency room and kept their overnight or even for several days, and never be classified as admitted to the hospital. Even though the senior was in the hospital, he or she is classified as an “outpatient” for Medicare billing services. This is because the patient is in “observation” status. This is the period of time that the doctor is evaluating whether or not to actually admit the patient to the hospital. Why is this so important?
Improvement Standard Struck Down
- At February 16, 2013
- By admin
- In Professional News
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For over a dozen years, patients have been denied Medicare coverage because of the “improvement standard.” This was the illegal denial of coverage because a patient’s condition was stable, not improving, chronic and requiring only maintenance services. Jimmo v. Sebelius, No. 11-cv-17 (D.Vt.), filed January 18, 2011, was a lawsuit brought on behalf of six individual Medicare recipients and seven organizations representing persons with chronic conditions, to challenge this standard.
