Medicare patients changed to outpatient “observation status” after they were initially hospitalized would have a chance to appeal this reclassification under a process proposed by the Biden administration Thursday.
The proposed rule (RIN: 0938-AV16) intends to implement a 2020 ruling by the US District Court for the District of Connecticut in a class action. The case involved a dispute over Medicare’s obligation to pay for hospitalizations and long-term care for elderly patients.
Medicare Part A pays for hospitalizations for admitted patients, but not for beneficiaries classified as outpatients receiving observation services. Doctors make the initial decision on whether ...
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