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Medicare Observation Status

Medicare requires 3 days of inpatient placement requirement to qualify for Part A coverage of post acute rehab in a skilled nursing facility.  However, Medicare policies enacted a few years ago dictate that hospitals place many  older persons staying overnight  into “outpatient observation status”  instead of admitting them that thus they areunable to meet the 3 day requirement.  This places them at risk for paying the full cost of such care.

StateWide has been working on this issue for several years, and is delighted that Congress has introduced legislation to address the problem by counting any days spent in a hospital toward the 3 day requirement.  The Senate bill is S568  introduced by US Senator Sherrod Brown.  It is the same as House bill HR 1421. New York Congressmembers Crowley, Higgins,  Jeffries, S. Maloney, & Stefanik are co-sponsoring the House bill.  WE URGE MEMBERS TO: Write to your Congressmembers to ask them to support these legislative proposals.

Medicare Outpatient Observation Notice (MOON) As of March 2017 all hospitals are required to notify Medicare beneficiaries when they are placed into observation.  The following links provide copies of the Medicare Outpatient Observation Notice (MOON) and instructions:

Are you an Inpatient or and OutpatientThis link to the CMS publication intended to help patients understand if they are an inpatient or and outpatient:

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