Hospitals can keep patients overnight — even for several nights — for “observation care” without telling the patient that they are officially an out-patient, even though they are in a hospital bed. Medicare patients can then be surpised to receive high bills which which are not covered, but should have been if they had been an in-patient.
It is unconscionable — but unfortunately not so unusual — that at at a time of greatest vulnerability, a patient is on their own to defend themselves against a powerful institution. Here is a link to an article which warns patients who are kept overnight at a hospital that it is essential to verify exactly what their patient status is, since the hospital is not required to tell them.
http://www.kaiserhealthnews.org/Stories/2013/September/04/observation-care-FAQ.aspx
Perverse
I had to read the opening paragraphs pf that article twice.
Observation care patients are brought into the hospital, their presence in the hospital is registered, they are not deemed medically well enough to go home, but, they are not, “admitted” into the hospital. Because they are not admitted into the hospital, they are not eligible for coverage of the care they receive, and they have to pay the expensive bill for being in the hospital.
Obviously, they were admitted. It’s just that they were not admitted.
Not telling poor patients about the costs of hospital procedures in advance is a form of not providing informed care.
Its often said that not
Its often said that not saying something (witholding information) is the same, if not worse, than lying.
The law in Vermont?
It seems Vermont should follow New York’s lead on this one:
>> Medicare doesn’t require hospitals to tell patients if they are merely being observed, which is supposed to last no more than 48 hours to help the doctor decide if someone is sick enough to be admitted. (Starting on Jan. 19, however, New York State will require hospitals to provide oral and written notification to patients within 24 hours of putting them on observation status. Penalties range as much as $5,000 per violation. )
>> To increase the likelihood of being formally admitted, “get yourself in the door before midnight,” advised Dr. Ann Sheehy, division head of hospital medicine at the University of Wisconsin Hospital in Madison, Wisc. A new Medicare regulation — the so-called “pumpkin rule” — requires doctors to admit people they anticipate staying for longer than two midnights, but to list those expected to stay for less time as observation patients.
http://newoldage.blogs.nytimes.com/2014/01/10/fighting-observation-status/?_php=true&_type=blogs&_r=0
Here’s the article from VT Digger:
http://vtdigger.org/2014/05/26/medicare-rules-can-leave-seniors-unexpected-costs/