Hospital 'Observation' Status Prompts Federal Class Action Suit

The Center for Medicare Advocacy and the National Senior Citizens Law Center have filed petitions in U.S. District Court against Health and Human Services Secretary Kathleen Sebelius. The lawsuit aims "to end the use of observation status as a way of depriving people of Part A Medicare coverage."

3 comments on "Hospital 'Observation' Status Prompts Federal Class Action Suit"
Janis Jimmie (11/26/2011 at 11:19 PM)

It seems the agency that ensures oversight of care provided to elders continue to complicate the payment system that further complicates the provision of care. What seems to be created is more layers of bureaucracy that ultimately increases cost during the assurance of cost appropriate care!
Janice Noller, RHIA, CCS (11/9/2011 at 2:58 PM)

I agree with Dr. Hirsch - physicians and case managers try to work together to ensure fairness on behalf of the patient and the facility, but the regulations for Observation status are so convoluted and complex, no wonder this happens. The lawsuit may not go anywhere as the article states, but maybe (or not)CMS will open its eyes and simplify the regulations. There is a place for Observation in facilities - just make it easier to use and understand!
Ronald Hirsch, MD (11/9/2011 at 9:32 AM)

It was heartening to see that they chose to file the suit against HHS and not the hospitals. The rules for Observation are ambiguous at best and every day hard working case managers struggle to figure out the "correct" status for patients such as those represented in the lawsuit.


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