Patients left owing thousands because hospitals classify them as outpatients: Support HB 5950

[Mimosa]

http://www.dailyherald.com/article/20101113/news/711149939/


Excerpt:

Dressler said hospitals receive less reimbursement from Medicare for observation patients, which helps keep them under the radar from the Recovery Audit Contractors, which review inpatient claims. Merryweather, however, says fear of audits isn't a factor, because misclassifying a patient can lead to not getting any Medicare payment at all.

Regardless of who's to blame, legislators recognize the problem this is causing for hospital patients nationwide. On July 29, Democratic U.S. Rep. Joe Courtney of Connecticut introduced House Bill 5950, the “Improving Access to Medicare Coverage Act of 2010.”

Now in committee, the bill would require hospitals to classify a patient as “inpatient” if the person is hospitalized for more than 24 hours. It would be retroactive to January 2010.

U.S. Rep. Jan Schakowsky, a recently re-elected Democrat from Evanston, is among the bill's supporters.

“People don't really understand, in the midst of hospitalization, what this is. If I'm not really admitted, what am I doing in the hospital?” Schakowsky said. “I totally understand wanting to save money on Medicare expenditures but this is not the way to do it. You don't want doctors to overtreat people and overcharge Medicare. On the other hand, we can't just leave people, especially older people, in a situation like this.”

[KT2000]

1. have another one

Our hospital - the only one in the area - bills as "outpatient" for doctor visits to the clinics they own. Had to pay the percentage as well as the room charge. The consultation visit cost me so much I had to cancel the procedure that was recommended.
I am not on Medicare either.

[uppityperson]

2. There is a BIG difference between "inpatient" and "observation", as we found recently

Had a relative in the hospital for 3 days after a stroke. Looking around for a Skilled Nursing Facility to go to for rehab and found....the first day was in "observation" status, with 2 day "inpatient" status. Nothing different was done during the 2 different statuses, but in order for Medicare to pay for SNF after discharge, the patient has to have 3 days "inpatient" status.

So relative was sent home. Unable to transfer, walk, swallow, speak clearly, etc etc etc.

I wasn't notified when the relative first went to hospital or I'd have raised hell to get on"inpatient" status as definitely needs rehab adn can't function at home.

They'd rather the person go home, then get readmitted than pay for them to recover.

I'd be really glad to have this changed.

[Mimosa]

3. Why can't we have a system which won't break people's health and finances?

People in other advanced nations don't have to endure this kind of mistreatment!