Observation Stays Appeals Update

Advocacy; CMS; Medicare
 

On July 25th, the Center for Medicare Advocacy (CMA) released an article noting that “the federal judge who found that Medicare is violating beneficiaries’ constitutional rights by disallowing appeals of their placement on ‘observation status’ in hospitals has imposed deadlines and urged Medicare to ‘take all possible steps, as a matter of urgent agency policy’ to expedite implementation of the court-ordered appeals.” 

More specifically, the judge ordered the Centers for Medicare and Medicaid Services (CMS) to publish the final rule implementing the appeals by October 15, 2024; to finalize educational and other instructional materials by November 8, 2024; and to address in its next status report to the court whether outside contractors can be given tight timeframes so that appeals can be made operational by the end of 2024. You can read the full CMA article here

AHCA/NCAL and several coalition partners submitted comments to CMS last December supporting the observation stay appeals process. More details can be found here​