AHA: Observation Status Fears on the Rise

HealthLeadersMedia.com | October 29 – Hospitals are putting more patients into observation status for longer than 48 hours instead admitting them, in part out of fear of what happened at one hospital this month, the American Hospital Association says.

Observation status is a Medicare billing category for patients not sick enough to qualify for acute admission but too sick to be sent home.

Pollack did not name the hospital, but earlier this month DOJ officials announced that El Centro Regional Medical Center, about 100 miles east of San Diego, paid $2.2 million to settle such federal accusations.

According to a DOJ statement on the case, “The government alleges that the 165-bed acute care hospital fraudulently inflated its charges to Medicare patients to obtain larger reimbursements from the federal health care program. The settlement covers claims submitted by the hospital for short inpatient admissions, usually of one day or less, when the services should have been billed on an outpatient ‘observation’ basis or as emergency room visits.”

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