by Webmaster
Published on Aug 03, 2015

"Did you know that it is illegal to serve margarine to prisoners in Wisconsin? Yep, that’s the law. And once President Obama signs the Notice Act, passed last week by Congress, it will be the law that hospitals must notify patients that they are receiving observation services. I compare the two laws because they are both just plain silly. The two midnight rule, if followed properly, has eliminated the long observation stays that led to this act and the act omits the one thing that would have actually made it worthwhile- giving patients immediate appeal rights."**

Dr. Hirsch has a point.  Congress unanimously approved the NOTICE act that requires hospitals across the country to tell Medicare patients when they receive observation care but aren't actually admitted to the facility--a difference that most patients miss until they receive their medical bills. Currently, a hospital may either admit a patient as an inpatient or keep the patient under observation.  While the distinction is often impossible to determine, particularly by the beneficiary and especially if the beneficary is placed in an acute care inpatient bed on a regular medical unit, the economic implications can be extreme if the patient later requires care in a skilled nursing facility.

H.R. 876 amends title XVIII of the Social Security Act to require hospitals to provide written and oral notification to patients who are in the hospital under observation for more than 24 hours.  Within 36 hours, the hospital is required to provide notification which: 1) explains the individual’s status as an outpatient under observation and not as an inpatient; 2) explains the reason for that classification; 3) explains the implications of that outpatient status on eligibility for Medicare coverage of items and services as well as cost-sharing requirements; 4) includes the name and title of the hospital staff who gave an oral notification and its date and time; and 5) is signed by the individual to acknowledge its receipt.

** Ronald Hirsch, MD, FACP, CHCQM  is the Vice President, Regulations and Education Group, AccretivePAS                                                                                This is a portion of the transcript from Dr. Hirsch's RACMonday broadcast on 8/3/15.  To learn more about what Dr. Hirsch has to say about HR876, check out his article which will be published Thursday, 8/6/15 on RACmonitor.com