Researchers defended nursing homes after a recent government report slammed providers for receiving more than $84 million in overpayments.
Authors in a Monday Health Affairs blog post counterattacked a February report from the Office of the Inspector General on the overpayments, noting the real focus should be on lifting the “antiquated” three-day rule, rather than spending millions more to undertake OIG-suggested fixes. Additionally, the $84 million in erroneous billing is a fraction of the $86 billion paid to SNFs, wrote three physician experts from Geisinger Health System, Johns Hopkins, and the University of Wisconsin.
Instead of zeroing in on the $84 million, the authors urged the House and Senate to take up proposed legislation that would make “observation status” at a hospital eligible to satisfy Medicare’s three-day requirement necessary for skilled nursing coverage.
“A different approach is clearly needed — one that addresses the real underlying problem of a two-tiered billing status for hospitalized patients that has little, if anything, to do with actual patient care,” the piece concludes.
Nursing home advocates said they are in complete agreement.
“This article is right on the money about the anachronism of the in-patient, out-patient, observation status distinction,” Barbara Gay, VP of public policy communications for LeadingAge, told McKnight’s Monday. “We couldn’t agree more.”
