Honored Social Butterfly

MEDICARE - Class Action Lawsuit - Hospital Observation Status and Covered Services - Filing an Appea

Read all about current actions on this Class-Action Lawsuit that was filed against Medicare for just this (Observation classification and Medicare payment) condition and this other twist:
Patients who might want to file an appeal, as they can with many other Medicare decisions. But that is not allowed if the dispute involves observation care.

(08/12/2019) 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.

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.

WOW - if they win, as well they may - OPEN your pockets real wide ! ! !

Sometimes I feel like the Medicare system is controlled by just one term - GOTCHA !

Class-Action Lawsuit Seeks To Let Medicare Patients Appeal Gap in Nursing Home Coverage

It's Always Something . . . . Roseanna Roseannadanna
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