Not necessarily? Define “stay.”
Medicare beneficiaries need to take note of their admittance status when receiving care in a hospital. The Medicare Observation Stay loophole has come to the forefront in the last few years as Medicare recipients and their families were shocked to receive large hospital bills due the loophole few knew existed.
Difference Between Medicare In Patient Status And Medicare Observation Status
In two words. Money and Care.
Patients admitted to the hospital versus being classified under Medicare observation status are billed quite differently under the rules of Medicare and your classification status will affect the type of additional care you are entitled under Medicare.
Under Medicare if you are admitted for three nights, additional skilled care for the next 20 days at 100% payment by Medicare is available under Medicare Part A. Observational status is not classified as inpatient care and puts patients into Medicare Part B which equals a bill you are responsible for while classified as observational/outpatient status versus Medicare in patient status.
A very detailed article by an eldercare attorney details the financial and additional care implications of inpatient/admitted status versus observational/outpatient status.
Closing The Medicare Observation Status Loophole?
It has been a long road in the attempts to modify or close the loophole. The Improving Access to Medicare Coverage Act of 2013, (H.R. 1179) introduced by Joe Courtney (D-CT) and Tom Latham (R-IA) in 2013 failed to garner enough support and failed in 2014. H.R. 1179 would require that the three day hospital stay for patients under observational status would count toward the Medicare insurance requirement to receive additional skilled care post hospitalization.
However while the following legislation would not close the loophole, the transparency of the Medicare insurance loophole would be addressed with a notification requirement.
The Notice of Observation Treatment and Implication for Care Eligibility Act (NOTICE) requires hospitals to notify Medicare patients after 24 hours, but within 36 hours of their hospital stay of their admittance status. The NOTICE Act has passed the Senate and House and became law in 2015; hospitals are required to follow the NOTICE law beginning August 2016.
All Medicare patients who were hospitalized prior to August 2016 would be wise to monitor closely any hospital bills and how the bills were coded by the hospital.
Recommended Reading Medicare Information: