DOH: DAL Released to Hospitals Related to Observation Stay Services

Nancy Leveille and Carl Pucci in Clinical & Quality

 

Effective January 19, 2014, hospitals are required to give notice to patients related to their observation status within 24 hours.

The new law, which takes effect January 19, requires hospitals to inform patients when they are placed into observation status. The notice must also include the following information:

  • "A statement that observation status may affect the patient's Medicare, Medicaid, and/or private insurance coverage for the current hospital services, including medications and other pharmaceutical supplies, as well as coverage for any subsequent discharge to a skilled nursing facility or home and community based care; and
  • That the patient should contact his or her insurance plan to better understand the implications of being placed in observation status."

Attached is the "Dear Chief Executive Officer" letter, including the sample notice.

This new law will provide Individuals with a written notice of their observation days  at the hospital for insurance and Medicare eligibility assessment and should assist SNF to determine if a resident has a 3 day qualifying hospital stay for potential Medicare coverage a little easier.

  NYSHFA CONTACTS: Nancy Leveille, RN, MS
Sr. Director, Member Operational Support
518-462-4800 x20
  Carl J. Pucci
Director, Finance & Reimbursement
518-462-4800 x36