Judge to rule whether Medicare patients can appeal observation-outpatient charges

In some instances, Medicare beneficiaries are hospitalized and placed "under observation" as outpatients. This can potentially mean higher out-of-pocket costs for follow-up care such as skilled nursing, reports The New York Times.

The report states Medicare patients currently can't appeal observation status. However, such appeals could be allowed in the future depending on the result of a class-action lawsuit. Earlier this summer, a federal judge in Connecticut decided Medicare beneficiaries who have been hospitalized and placed under observation as outpatients since Jan. 1, 2009 may join a suit against CMS seeking the ability to appeal their observation-outpatient stays, according to the report. A trial on the lawsuit is anticipated in 2018.

"People call in dire situations, and we have to tell them there's no way to challenge this," Alice Bers, Center for Medicare Advocacy litigation director, which brought the lawsuit with Justice in Aging and Palo Alto, Calif.-based law firm Wilson Sonsini Goodrich & Rosati, told NYT. "Now we can tell them, 'You're a member of the class, so stay tuned.'"

Medicare administrators declined to comment to NYT citing ongoing litigation.

Read the full report here.


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