New Medicare Law to Notify Patients of Loophole in Nursing Home Coverage

The NOTICE Act, or Notice of Observation Treatment and Implication for Care Eligibility Act, requires hospitals nationwide to inform Medicare patients when they are receiving care under observation status.

This article in the New York Times does an excellent job of explaining the Notice Act and why it's important.

The Notice of Observation Treatment and Implication for Care Eligibility Act or the NOTICE Act amends title XVIII (Medicare) of the Social Security Act to require a hospital or critical access hospital with an agreement with the Secretary of Health and Human Services to give each individual who receives observation services as an outpatient for more than 24 hours an adequate oral and written notification within 36 hours after beginning to receive them which:

  • explains the individual's status as an outpatient and not as an inpatient and the reasons why;
  • explains the implications of that status on services furnished (including those furnished as an inpatient), in particular the implications for cost-sharing requirements and subsequent coverage eligibility for services furnished by a skilled nursing facility;
  • includes appropriate additional information;
  • is written and formatted using plain language and made available in appropriate languages; and
  • is signed by the individual or a person acting on the individual's behalf (representative) to acknowledge receipt of the notification, or if the individual or representative refuses to sign, the written notification is signed by the hospital staff who presented it.

 

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