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House to consider bill mandating observation status notice
Heather Stauffer//April 3, 2014
A bill requiring hospitals to explicitly inform patients who are in observation status of what its financial implications are is on second consideration in the Pennsylvania House of Representatives.
“Many insurers (and Medicare) treat observation stays as outpatient care so patients may pay for tests, X-rays, or scans,” Rep. Stan Saylor, (R-94), wrote in the memo of HB 1907, which he sponsored. “However, if the same procedures were done while being admitted to the hospital, the patient might only pay a single co-pay. The stakes become larger for our senior citizens on Medicare since a hospital admission of at least three days is required before Medicare will pay for subsequent skilled nursing care or rehabilitation in a nursing home.
“If a patient is in the hospital for three days before going to a nursing home, and one of those days was on Observation, Medicare will not cover the nursing home expenses.”
On Monday federal legislators, in approving the 17th temporary fix to the Medicare sustainable growth rate problem, also delayed implementation of the Centers for Medicare & Medicaid Services’ new observation status admissions criteria and related policies. Known as the two-midnight rule, it has been widely protested by hospitals and is now delayed into early 2015.
Editor’s note: This story has been modified from its original version to correct that the bill passed the House and is headed to the Senate.
