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Courtney pushes bill to fix Medicare quirk that has cost patients dearly

  • by Deirdre Shesgreen
  • April 20, 2011
  • View as "Clean Read" "Exit Clean Read"

Rep. Joe Courtney, D-2nd District, has renewed his push to fix a quirk in the Medicare rules–one that has cost elderly patients thousands of dollars, not to mention considerable stress.

Courtney’s efforts began after he was approached by a constituent, Nancy Renshaw, who got stuck with a nearly $10,000 nursing home bill for her father-in-law after he suffered from a fall. Renshaw thought the care for her 89-year-old father-in-law, Charles Renshaw, would be covered by Medicare because it came after he’d been in Norwich Backus Hospital for more than three days.

Normally, after three-day in-patient hospital, the federal health care program will cover the cost of any skilled nursing care needed for a discharged patient. But she learned-too late-that Charles Renshaw had never been official admitted to the hospital as an in-patient. He was there on “observation status,” which meant his post-hospital care was not covered.

Hospitals across the country have increasingly treated elderly Medicare patients in this kind of limbo status. Critics say they are doing so to avoid getting audited by the federal Center for Medicare and Medicaid, which has sought to control costs and crack down on “overutilization” of hospital services.

Courtney’s bill seeks to address the issue by allowing for the time patients spend in the hospital under “observation status” to count toward the requisite three-day hospital stay for coverage of skilled nursing care. He said it’s a “commonsense change” that will ensure seniors “no longer face thousands of dollars in bills for skilled care because of an arbitrary federal policy.”

He introduced the measure at the end of last year, too late for it to gain any legislative traction. With Congress preoccupied with a major fiscal fight, it’s unclear if the legislation has any increased chances of moving this year.

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