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Hospitals' Medicare coding can cost patients thousands in uncovered followup care, report finds

11735-Green-Hospital-Sign-With-A-White-H-Clipart-Illustration@patriciaborns  A new report by the U.S. Department of Health and Human Services’ Office of Inspector General (OIG) found that more than 600,000 Medicare patients had hospital stays in 2012 lasting three nights or more that did not qualify them for follow-up nursing home care, Connecticut Health I-Team reports. 

The HHS report comes after the Center for Medicare Advocacy and National Senior Citizens Law Center filed a nationwide class action lawsuit challenging the policy that allows seniors admitted to hospitals to be considered "observation outpatients," even when they remain there for many days and nights.

The study shows that hospitals "increasingly are designating multi-day stays as outpatient or 'observation status' visits, rather than inpatient admissions." Classifying Medicare patients in this way -- as outpatients rather than inpatients -- disqualifies them for benefits to get follow-up care in a skilled nursing facility under Medicare Part A. 

Medicare beneficiaries had 1.5 million hospital stays in 2012 that were classified as observation visits, with more than a third of them lasting two nights or more."   Read more.


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