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Title : Class-Action Lawsuit and Observation Stays Issue
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Class-Action Lawsuit and Observation Stays Issue

Dana Halvorson

Earlier this week, Kaiser Health News published an article entitled, Class-Action Lawsuit Seeks To Let Medicare Patients Appeal Gap in Nursing Home Coverage, by Susan Jaffe.  In the article, Susan noted, “Monday [August 12], a trial begins in federal court in Hartford, Conn., where patients who were denied Medicare’s nursing home benefit are hoping to force the government to eliminate that exception.  A victory would clear the way for appeals from hundreds of thousands of people.  The class-action lawsuit was filed in 2011 by seven Medicare observation patients and their families against the Department of Health and Human Services.  Seven more plaintiffs later joined the case.”  Susan goes on to include that, “If they win, people with traditional Medicare who received observation care services for three days or longer since Jan. 1, 2009, could file appeals seeking reimbursement for bills Medicare would have paid had they been admitted to the hospital.  More than 1.3 million observation claims meet these criteria for the 10-year period through 2017, according to the most recently available government data.”  More on AHCA/NCAL’s work around the observation stays issue in general can be found here.

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