Monitor Mondays

Observation and Outpatient Status: Heading for Another Court Fight

April 08, 2019
Monitor Mondays
Observation and Outpatient Status: Heading for Another Court Fight
Chapters
Monitor Mondays
Observation and Outpatient Status: Heading for Another Court Fight
Apr 08, 2019
Chuck Buck | Ronald Hirsch, MD | Knicole Emanuel, Esq. | David Glaser, Esq. | William Dombi, Esq. | Ellen Fink-Samnick | Judith A. Stein, JD
The use and apparent abuse of observation and outpatient status are expected to have its day in court – again.
Show Notes

The use and apparent abuse of observation and outpatient status are expected to have its day in court – again. 

That’s because a federal judge has denied the government’s bid to put a stop to a landmark class-action lawsuit centering on patient status, paving the way for a trial expected to begin later this year. As reported by RACmonitor, in the court case Alexander v. Azar, the plaintiffs allege they were forced to pay up to $30,000 apiece for skilled nursing facility (SNF) care after being designated outpatients in observation status rather than inpatients, according to a press release on the matter by the Center for Medicare Advocacy (CMA). 

Reporting on this important story during this edition of Monitor Mondays will be Judith A. Stein, the founder of CMA. She has extensive experience with Medicare advocacy projects, representing Medicare beneficiaries, producing educational materials, teaching, and consulting. She has been lead or co-counsel in numerous federal class-action and individual cases challenging improper Medicare policies and denials.

Other segments to appear on the broadcast include:

  • Monday Focus: The Medicare Home Health Review Choice Demonstration is expected to start in Illinois on June 1. The president and CEO for the National Association of Home Care and Hospice, William Dombi, reports on this latest news, which was announced on Wednesday. 

  • Social Determinants of Health: A nationally recognized authority on the social determinants of health (SdoH), Ellen Fink-Samnick, returns to Monitor Mondays to report on the American Medical Association (AMA) and UnitedHealthcare agreeing to work together to support creating 23 new ICD-10 codes to report SDoH needs. 

  • Risky Business: Healthcare attorney David Glaser returns to Monitor Mondays with his popular segment, in which he reports on problematic issues facing providers. 

  • Monday Rounds: Ronald Hirsch, MD, vice president of R1 RCM, makes his Monday Rounds with another installment of his popular segment.


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