A week before a controversial rule on outpatient observation care goes into effect, more than 100 U.S. House members have asked CMS Administrator Marilyn Tavenner to delay its implementation.
Led by U.S. Rep. Allyson Schwartz (D-Pa.), the lawmakers say the so-called “two midnight” rule will subject many Medicare patients to higher out-of-pocket costs for hospitalization and post-acute skilled-nursing care. The reason? The rule presumes that patients expected to be in the hospital for fewer than two days should have been admitted for observation, not inpatient care.
Unlike full-fledged hospitalization, Medicare observation care requires 20 percent per-service co-payments and does not cover post-acute care.
“As it stands now, we are concerned that Medicare beneficiaries could assume a higher financial burden for their care under the new policy,” the letter reads. “Additionally, we are concerned that hospitals in our districts could be undercompensated for providing medically necessary services that do not meet the new criteria spelled out by CMS and face administrative challenges in complying with new requirements.”
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The bipartisan group included five North Texas leaders: Rep. Joe Barton (R-Arlington), Rep. Michael Burgess (R-Lewisville), Rep. Kay Granger (R-Fort Worth), Rep. Eddie Bernice Johnson (D-Dallas), and Rep. Marc Veasey (D-Fort Worth).
Date: September 26, 2013