Medicare Patients’ Suit Over Observation Status Dismissed

A federal judge in Hartford, Conn., has dismissed a suit filed by 14 Medicare beneficiaries seeking coverage after hospital stays classified as observational made them ineligible for Medicare reimbursement for their nursing home care, according to a report in the Hartford Courant.

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Currently, a patient must be in the hospital for three days as an inpatient for Medicare to pick up the tab for nursing home care. Those classified as under observational care are faced with a high copay for nursing home services.

The suit contended there is little difference between an admitted patient and a patient under observation, and argued for a review of the plaintiffs’ observation status. The suit also advocated a change to federal rules so a hospital will be legally obligated to tell patients when they are in the hospital under observation, not as an inpatient, according to the report.

The presiding judge dismissed the case, upholding current law allowing hospitals to decide on patient status, and restricting Medicare coverage for nursing home services to patients admitted to a hospital, according to the report.

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