News Headlines Article

CMS Hears Provider Concerns Over ‘Observation’ Status
Health Leaders Media

Hospital and nursing home providers are pleading with the Centers for Medicare & Medicaid Services to dump its 48-hour limit “observation” status—a Medicare billing category for patients not sick enough to qualify for acute admission but too sick to be sent home.

The problem is, after these beneficiaries are discharged, or if they are admitted to the hospital but for less than three consecutive days (the three-day rule), Medicare will not pay for subsequent care in a skilled nursing facility or for self-administered prescription drugs – some of which are extremely expensive.