HHS Inspector General raises concerns about Medicare policy on observation care

Jul 31 2013

The report also finds that policies on admitting patients or keeping them under observation -- a distinction that can have dramatic financial impact on the patients -- varies substantially among hospitals.

Kaiser Health News: HHS Inspector General Scrutinizes Medicare Observation Care Policy
Medicare patients' chances of being admitted to the hospital or kept for observation depend on what hospital they go to -- even when their symptoms are the same, notes a federal watchdog agency in a report to be released today, which also urges Medicare officials to count those observation visits toward the three-inpatient-day minimum required for nursing home coverage (Jaffe, 7/30).

Meanwhile, the observation issue leads to a financial penalty at one major hospital.

Boston Globe: Beth Israel Deaconess Settles With US For $5.3m
Faced with government allegations of improper billing, Beth Israel Deaconess Medical Center paid $5.3 million Monday to settle claims that it overcharged Medicare by admitting patients who should have been treated less expensively as outpatients. The allegations involved patients who were admitted to the Harvard teaching hospital for brief stays between 2004 and 2008 and who were suffering from congestive heart failure, chest pain, gastroenteritis, and nutritional and metabolic disorders, federal officials said in a written statement (Kowalczyk, 7/30).