We need to do all we can to make Medicare more affordable and easier to use for Ohio seniors. One way we do that is by fixing the so-called “observation status” loophole that leaves too many seniors with bills they can’t afford.
Under current law, Medicare will only cover skilled nursing care if the patient was in the hospital for three consecutive days and was admitted as an inpatient. But hospitals are increasingly classifying Medicare patients under “observation status,” rather than as “inpatients.”
The problem occurs when the patients – who were admitted under "observation status" rather than as “inpatients” – need further care or rehab at a nursing home after their hospital stay. These patients end up having to foot hefty nursing facility bills to receive the care they need.
We’ve made some progress toward fixing this problem. Beginning last week, hospitals are now required to notify patients of their status – whether they’re admitted to a hospital or nursing facility under “observation status” or as an “inpatient.”
That’s a good first step, but it doesn’t go nearly far enough – if a patient is receiving important care and she is notified that she is only under “observation status,” the patient can’t just check herself out of the hospital to avoid a bill.
Last week I spoke to Edie, from Lakewood, who wrote to me after her 90-year-old mother was rushed to the emergency room in an ambulance, and then hospitalized for four nights. But because the hospital cared for her under “observation status,” Medicare wouldn’t pick up the tab for the nursing home care she needed after she was discharged from the hospital. She and her family were left to deal with an exorbitant bill.
And there are far too many stories like this one.
That's why last week I reintroduced the Improving Access to Medicare Coverage Act, to allow Medicare beneficiaries to count hospital observation stays toward Medicare's 3-day inpatient hospital requirement to cover skilled nursing facility costs. It has the support of Democrats and Republicans alike, in both the House and the Senate.
It's a simple fix and the least we can do to protect our seniors from outrageous medical costs over which they have no control. It improves access to the medical care seniors need, and saves money on hospital readmission costs.
Seniors and their family members should be able to focus on their recovery, instead of billing technicalities and sky high medical bills, or worse yet – trying to recover without the medical care they need because they can’t afford it. This is an opportunity to update and strengthen the Medicare guarantee, and make it even stronger for its next fifty years.