McKnight's January 2, 2024
Medicare patients initially admitted to hospitals as inpatients but later reclassified as outpatients under observation would finally have a process to appeal those decisions, thanks to a long-awaited proposal from the Centers for Medicare & Medicaid Services.
Patients given observation status, even if in the hospital for days, previously had no way to appeal their status. And without a three-day stay, traditional Medicare patients are not eligible for covered post-acute skilled nursing care, long an issue for the sector.
Hospital and SNF patients who had their benefits denied after a change of classification would have multiple ways to appeal the change under the proposed CMS rule, including both a standard and an expedited process.
The expedited process would allow...
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