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HHS argues new observation-status rule renders lawsuit moot
Modern Healthcare

Lawyers for the federal government say a new Medicare rule intended to clarify when patients ought to be admitted to the hospital or held for outpatient observation justifies dismissing a class-action lawsuit filed by a patient advocacy group challenging Medicare’s payment policies for observational care. Not so, say the plaintiff lawyers at the Center for Medicare Advocacy. They say the new rule, which was published Aug. 19 and effective Oct. 1, will not help Medicare patients avoid paying substantial out-of-pocket amounts for costly skilled nursing care in cases where doctors and hospitals say they’re too unhealthy to go home but not sick enough to qualify for full-fledged inpatient care.