It’s Halloween time and the smell of pumpkin is in the air. You can’t step inside a coffee shop, bakery, or candle store this time of year without a waft of pumpkin spice greeting you at the door. Pumpkin’s everywhere! Including… Medicare?
Back in August 2013, the Centers for Medicare and Medicaid Services (CMS) issued a new Medicaid rule changing the way hospitals admit incoming patients. Under the new rule, any patient expected to spend more than two midnights must be admitted as “inpatient” rather than for “observation.” Given its Cinderella-ish parameters, the new edict quickly became known as “The Pumpkin Rule.”
But hospitals don’t like it. Once upon a time, they could classify an elderly patient as an “observation,” even if that person spent multiple nights in the hospital’s care — and charge them higher co-pays accordingly.
The Pumpkin Rule would change all that. Unfortunately, as the Guardian Liberty Voice reports, lobbying by the hospital industry has pushed enforcement back to March 2015.
What does that mean for elderly patients in Massachusetts between now and then? Well, things may not change in time for this Halloween — but the hospital experience could be a little fairer by the time we all say “trick or treat” next year.
More information on Admission vs. Observation Status in a Hospital Setting:
Medicare Booklet: https://www.medicare.gov/Pubs/pdf/11435.pdf
Medicare Advocacy Group: Self Help Packets for Consumers http://www.medicareadvocacy.org/take-action/self-help-packets-for-medicare-appeals/