Medicare’s decision to not apply observation time to the 3-day rule is longstanding policy that was unsuccessfully challenged in a 2008 federal court ruling. Nonetheless, ACEP has strongly urged the CMS to change this rule for the past 5 years, and perhaps the recent national attention, particularly from beneficiary advocates, will provide an impetus for change. Further, the CMS must reconcile its coverage policies with its auditing and program integrity policies to avoid unintended negative consequences for beneficiaries and providers.
Explore This Issue
ACEP News: Vol 29 – No 12 – December 2010For more on reimbursement for observation care, visit the ACEP Web site Practice Resources section and click on Reimbursement FAQs. Under that tab, choose Observation – Physician Coding, and Observation Care Payments to Hospitals FAQ.
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