MedPAC Wants to Eliminate Observation Stays

November 15, 2014
Rick Gawenda

In a November 6, 2014 meeting, the Medicare Payment Advisory Commission (MedPAC) reported that observation stays should be eliminated as a way of classifying patients. In recent years, hospitals have increased the number of observation stays due to increased audits by RACs for one-day inpatient admissions. This significant rise in observation stays has had a negative impact on a Medicare beneficiaries ability to have a skilled nursing facility (SNF) admission covered by the Medicare program.

In order for a SNF admission to be covered under a beneficiaries Part A benefits, they must have had a qualifying 3-day hospital inpatient admission. Days spent in observation status do not count towards any of the required 3 days of hospital inpatient admission. MedPAC determined that 11,000 hospital stays in 2012 were discharged to a SNF without SNF coverage due to not meeting the 3-day threshold of inpatient admission.

MedPAC did provide a policy option to be considered that consists of 3 components:

The content here is for members only log in here or sign up.

All material posted on our website is the intellectual property of Gawenda Seminars & Consulting, Inc. and can’t be used, reproduced, or posted as your own material without the prior written approval of Gawenda Seminars & Consulting, Inc.

This article is not intended to and does not serve as legal advice or as consultative services, but is for general information purposes only.

Leave a Reply

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.