Reliant Reveal Policy Series – Observation Status and the Hill Talking Points

Long term care providers and vendors took the Hill during the NASL Winter conference to refresh legislators’ minds about the importance of dealing with the 3 midnight rule affecting beneficiary access to their Medicare Part A benefits.  While the Notice Act sets precedence for change, no real change can occur until Observation Status is not abused and/or can count full towards the 3 midnight count.  ACOs and other bundling efforts are also setting precedence where waiving 3 midnight rule improves access to care in the LTC setting which has proven key in reducing re-hospitalization.  More work is needed to see this change to the finish line. NASL ask on the Hill was to fully support cosponsoring the Improving Access to Medicare Coverage Act (S. 843/H.R.1571).

In contrast, Modern Healthcare in their article “HHS: Hospitals aren’t gaming readmissions with observation claims”,, points out that research is showing observation stay use is not significant in a hospital’s strategic plan to reduce penalties associated with readmissions.  Controversial findings to say the least. What do you think?

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