EDITORIAL: Care fairness

March 15--It might seem odd that you could spend a few nights in a hospital without being admitted, but that circumstance has resulted in many thousands of Medicare patients receiving big bills for care that they had believed to be covered by their insurance.

Those patients were under "observation" as doctors tried to determine whether their conditions warranted admission. Under Medicare, observation is treated as outpatient service, for which patients must pay for part of every test, treatment and service.

And if a patient moves from observation to a nursing home, Medicare does not pay because it requires a hospital admission as a precursor to a nursing home admission.

A new law requires hospitals to notify patients when they are classified as being under observation rather than as admitted, which certainly is better than finding out when the bill arrives.

Congress and Medicare should further amend the rules, however, setting specific time limits on observation status before requiring admission and requiring early tests whenever possible to reduce the likelihood of a patient staying overnight on observation status.

Regarding long-term care, they should eliminate the distinction as to whether the patient was transferred following hospital admission or observation. The issue is whether the patient needs the care, not how that was determined.

___

(c)2017 The Times-Tribune (Scranton, Pa.)

Visit The Times-Tribune (Scranton, Pa.) at thetimes-tribune.com

Distributed by Tribune Content Agency, LLC.