On December 27, 2023, The Centers for Medicare & Medicaid Services (CMS) issued a
proposed rule titled
Medicare Program: Appeal Rights for Certain Changes in Patient Status. This establishes court-ordered appeals processes for Medicare beneficiaries admitted as hospital inpatients but later reclassified as outpatients receiving observation services during their hospital stay.
AHCA/NCAL
submitted comments last month that support the proposed policies overall but requested some technical modifications related to certain proposed timelines. Additionally, the Association disagreed with the proposal to exclude SNFs from acting as an authorized representative for a beneficiary in the proposed retrospective appeals process, as this would differ from the longstanding claims appeals process that permits SNF representation.
AHCA/NCAL also partnered with several national organizations, including but not limited to, the American Geriatrics Society, American Medical Association, American Association of Post-Acute Care Nursing (AAPACN), Catholic Health Association, Center for Medicare Advocacy, Justice in Aging, and the Medicare Rights Center and sent a
coalition comment letter to CMS on this matter that offers similar beneficiary protection support comments and strongly urged CMS to finalize and implement this rule as quickly as possible.