“Class-Action Lawsuit Seeks To Let Medicare Patients Appeal Gap in Nursing Home Coverage”

Class-Action Lawsuit Seeks To Let Medicare Patients Appeal Gap in Nursing Home Coverage,” by Susan Jaffe, Kaiser Health News

“If they win, people with traditional Medicare who received observation care services for three days or longer since Jan. 1, 2009, could file appeals seeking reimbursement for bills Medicare would have paid had they been admitted to the hospital. More than 1.3 million observation claims meet these criteria for the 10-year period through 2017, according to the most recently available government data.”

 

LTC Comment (from Stephen A. Moses, President, Center for Long-Term Care Reform):

The “observation stay” rule never seemed fair. But does loading the insolvent Medicare program with more nursing home costs make sense seven years before it’s due to have to cut benefits?