Berwick Calls on CMS to End “Observation Status” Rule

Former Medicare chief Dr. Donald Berwick said Obama administration
officials should abandon a rule that is leaving many older Americans without
coverage for expensive rehabilitation care after they leave the hospital. The
Medicare rule requires recipients to be admitted as a hospital inpatient for at
least three days before the federal health insurance program for seniors and
the disabled will pay for follow-up nursing home care. The problem is that an
increasing number of patients are spending days in the hospital under
“observation’’ status, often without realizing they were never officially
admitted. “The patient ends up holding the bag and that’s not fair or
appropriate,’’ Berwick said in an interview this week. Berwick said that when
he ran Medicare from July 2010 to December 2011, he discussed scrapping the
three-day rule. But others in the agency worried that without this criteria,
people would emerge from “the woodwork’’ to check into nursing homes without
any review of whether they really need to be there.

Source/more: Boston Globe 
Related: Observation Status: New Final Rules from CMS Do Not Help Medicare
Beneficiaries (via Center for Medicare Advocacy

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