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Senate Takes Testimony on Medicare Observation Status

The Senate Special Committee on Aging  recently heard testimony about the challenges posed by the “observation status” designation conferred on some Medicare patients in hospitals.
Among the concerns raised at the hearing were the financial vulnerability of some seniors hospitalized only under observation and not as inpatients; the possibility that some hospitals may be using observation status to avoid Medicare penalties for readmitting recently discharged payments; the punitive actions of Medicare recovery audit contractors (RAC auditors); and more.  Intertwined with this is Medicare’s two-midnight rule and the challenges the program has faced attempting to implement this rule.
House Chamber of the State HouseTestifying before the committee were representatives of the Medicare Payment Advisory Commission (MedPAC), the Centers for Medicare & Medicaid Services (CMS),  the American Hospital Association, and others.
For a closer look at the hearing, a link to a video of the hearing, and copies of some of the testimony, see this Fierce Healthcare article.

2015-06-01T06:00:59+00:00June 1st, 2015|Medicare|Comments Off on Senate Takes Testimony on Medicare Observation Status

MedPAC Calls for End of “Two-Midnight Rule”

The independent agency that advises Congress on Medicare payment issues has recommended that Medicare eliminate its controversial two-midnight rule.
At its recent meeting in Washington, D.C., the Medicare Payment Advisory Commission (MedPAC) also recommended that Medicare focus RAC (Recovery Audit Contractor) audits on hospitals with the highest numbers of short inpatient stays, shorten the look-back period for audits, modify the three-day rule for skilled nursing facility coverage, and require hospitals to inform patients when their stay has been classified as observation status rather than inpatient status.
Learn more about MedPAC’s recommendation in this Fierce Healthcare news report and go here to see the MedPAC presentation of the recommendations the agency’s board approved.

2015-04-16T06:00:40+00:00April 16th, 2015|Medicare|Comments Off on MedPAC Calls for End of “Two-Midnight Rule”

MedPAC Looks at Short-Stay Issues

The agency that advises Congress on Medicare payment issues is preparing to suggest changes in how Medicare approaches paying for short hospital stays.
At last week’s meeting of the Medicare Payment Advisory Commission (MedPAC), commissioners received a staff presentation on issues surrounding Medicare payments for short hospital stays and discussed possible recommendations for changes in how Medicare pays for those short hospital stays.
Among the possibilities discussed at the recent MedPAC meeting are revising how Medicare’s recovery audit contractors program (RAC audits) looks at short hospital stays; revising the three-day-stay requirement for Medicare to cover post-discharge skilled nursing care; penalizing hospitals found to have unusually large numbers of short stays; and shortening the time-frame during which individual cases are subject to RAC audits.
See the presentation made to MedPAC members here.  Also, see this CQ HealthBeat report presented by the Commonwealth Fund on the MedPAC meeting at which this issue was discussed.

2015-03-11T06:00:18+00:00March 11th, 2015|Uncategorized|Comments Off on MedPAC Looks at Short-Stay Issues
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