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Congress Acts and Seniors Win!

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Hospitals will not longer be allowed to admit senior patients under "observation status" without notice to  patients and their loved ones.

Both houses of Congress recently passed an amendment free law (how rare is that?) that will require hospitals to notify Medicare recipients if their hospital admission is classified as 'observational status' within 36 hours of admission or upon discharge which ever first occurs.  This new law, known as the Notice of Observation, Treatment and Implication for Care Eligibility Act (NOTICE Act), is a major step forward for seniors because this hospital status has demonstrated enormous hardships for seniors by creating an adverse impact on their eligibility in obtaining Medicare coverage for continuing care.

Imagine for a moment that you are a patient being wheeled into a hospital room in order to receive treatment in that hospital.  Wouldn't you assume that you have been admitted to the hospital? Beware the pitfalls of assumptions! It is possible for the hospital to make a determination that that you are not well enough to go home but not sick enough to be admitted to the hospital and thus you are admitted under "observation status" which is effectively an outpatient classification.  True, your admission status has nothing to do with the care you are provided by hard working doctors, nurses and other hospital caregivers but it could have a huge impact on your wallet. You can be hit with big medical bills after a short stay that you thought was covered by Medicare and your private insurance. Add to that inconvenient truth the fact that this classification does not meet the eligibility requirements needed for Medicare and private insurance to cover your short-term rehab that likely takes place in  a costly nursing home after your discharge from the hospital.  Those rules require a  3-day hospital admission.  

“This is an important step forward," wrote AHCA/NCAL Senior Vice President of Government Relations Clifton J. Porter II. “This legislation is now on its way to being signed into law. That means millions of individuals who leave a hospital, preparing for a short stay in a skilled nursing center, will now know what their hospital status is, which could save them thousands of dollars in out-of-pocket costs.”

Both Mr. Porter and I have noted that this is an important first step.  It does not go far enough in my opinion.  Three days in a hospital cost thousands of dollar so notice after those expenses have been incurred might still prove place a financial burden on families. If you have the time, I encourage you to read the comments at the end of the article I've provided a hyperlink to below. These comments provide a real life stories that illustrate why arming yourself with the knowledge that this is occurring in hospital across our country is so important. My advice?  Know the status of any hospital admission before you agree to stay; other alternatives might be available.

You can learn more about this topic as well as other strategies on our website under the tab entitled: elder law planning in Virginia. Be sure you also sign up for our complimentary e-newsletter so that you may be informed of all the latest issues that could affect you, your loved ones and your estate planning.  However, proper estate planning is not a do-it-yourself project.  Why not call us for a complimentary consultation at 757-259-0707.

Reference: McKnight’s (July 28, 2015) “Senate unanimously passes NOTICE Act, president's signature next” by Emily Mongan 

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