Another “Change in the Law” Alert for the Over-65 Consumer! 

Keeping abreast of law changes for the over-65 consumer can be quite the challenge.  Changes are often too easy to ignore, thinking that this will “never apply to me” but this change is one you need to take note of and remember. 

Medicare recipients:  please pay attention!  One “thorn in the side” of Long Term Care planners such as myself involves Seniors not recognizing that, when they go to the hospital with a medical emergency, the “status” attached to them as a patient can adversely affect their “coverage” in a skilled nursing facility if indeed it is recommended that they require rehabilitation or further services in the nursing home environment.  Too often patients  are tagged as “observation status” patients, not realizing that this label prevented them from receiving Medicare benefits in the skilled nursing home. 

The change:  Effective March 8, 2017 hospitals and critical access hospitals must provide a Notice of Observation status to Medicare beneficiaries receiving observation services as an outpatient for more than 24 hours.  This notice is called the MOON Notice (Medicare Outpatient Observation Notice).  The MOON notice must be provided no later than 36 hours from the time the beneficiary begins receiving outpatient observation status.  The MOON must be accompanied by an oral explanation of the information in the form and must be signed by the beneficiary or the beneficiary’s representative.  Failure to provide the MOON to applicable beneficiaries is considered a violation of the hospital’s Medicare provider agreement and could result in termination of the hospital’s Medicare provider agreement. 

 What to do if you receive the MOON notice and it looks like you or your loved one is heading to the nursing home?  This is the time you must lobby for yourself or your loved one requesting that you be admitted to the facility.  It takes three overnights in admission status to receive continued Medicare coverage in a skilled nursing home.  Consumer Beware!

    --   Nancy Nawrocki