NAELA Calls On Centers for Medicare and Medicaid Services (CMS) to Take Action to Protect Older Americans

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Elder and Special Needs Law Attorneys Request CMS to Revise Observation Status

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All too often, NAELA members have found this practice to confront the elderly and people with disabilities at the time they most need Medicare to assist with hospital and nursing home care.

The National Academy of Elder Law Attorneys (NAELA) called on CMS to revise observation status rules in order to protect the financial security of Medicare beneficiaries. In a letter to CMS, NAELA requested immediate changes to ensure that older adults are not unfairly kept from being admitted into hospitals in order to save Medicare dollars.

Observation status refers to the classification of a patient in an acute care hospital as an outpatient, even though, just like an inpatient, the person is placed in a bed in the hospital, stays overnight, and receives medical care. Classification as an outpatient negatively impacts older Americans. Outpatient classification may make a patient ineligible for Medicare coverage of subsequent skilled nursing facility care because Medicare requires three days of inpatient status to qualify for Medicare coverage.

The use of this practice is of great concern to NAELA members as they often represent elderly clients whose hospital stays have been inappropriately classified as observation status. More than 10 percent of Medicare beneficiaries are placed on observation status for more than 48 hours.

“All too often, NAELA members have found this practice to confront the elderly and people with disabilities at the time they most need Medicare to assist with hospital and nursing home care,” stated NAELA President Gregory French, CELA, CAP.    

NAELA answered CMS’ Request for Information and stressed that observation status is making the goal of affordable health care unattainable for many Medicare beneficiaries. Many NAELA members’ clients have either paid the cost of skilled nursing facility care out of their own pockets or gone without the necessary care. Not only is observation status costly for older Americans, classifying patients as outpatient or inpatient is an expensive process for the Medicare system and a waste of the program’s resources.    

NAELA will continue to work with CMS to protect the best interests of older Americans and preserve their right to receive Medicare coverage.

About NAELA
Members of the National Academy of Elder Law Attorneys (NAELA) are attorneys who are experienced and trained in working with the legal problems of aging Americans and individuals of all ages with disabilities. Established in 1987, NAELA is a non-profit association that assists lawyers, bar organizations, and others. The mission of NAELA is to establish NAELA members as the premier providers of legal advocacy, guidance, and services to enhance the lives of people with special needs and people as they age. NAELA currently has members across the United States, Canada, Australia, and the United Kingdom. For more information, visit NAELA.org.

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Abby Matienzo, Communications Specialist
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