The U.S. District Court for the District of Connecticut must review whether Medicare beneficiaries challenging the Centers for Medicare & Medicaid Services’ use of observation status have a property interest under the federal Due Process Clause in being admitted to their hospitals as inpatients, the U.S. Court of Appeals for the 2nd Circuit ruled yesterday. “The District Court erred in concluding that plaintiffs lacked a property interest in being treated as ‘inpatients,’ because, in so concluding, the District Court accepted as true the Secretary’s assertion that a hospital’s decision to formally admit a patient is ‘a complex medical judgment’ left to the doctor’s discretion,” the ruling states. “That conclusion, however, constituted an impermissible finding of fact, which in any event is inconsistent with the complaint’s allegations that the decision to admit is, in practice, guided by fixed and objective criteria set forth in ‘commercial screening guides’ issued by the Centers for Medicare & Medicaid Services.” In a friend-of-the-court brief filed last February, AHA shared its perspective on why CMS’s ambiguous policy regarding “observation” stays is a difficult issue for hospitals and hence beneficiaries.

Related News Articles

Headline
A Health Affairs study published Sept. 2 found that less than 40% of Medicare beneficiaries with opioid use disorder received standard care in alignment with…
Headline
The Federal Trade Commission Sept. 4 released a request for information on noncompete agreements. The agency said it seeks to “better understand the scope,…
Headline
The AHA and other national hospital organizations Sept. 5 urged Senate and House leadership to act on preventing Medicaid Disproportionate Share Hospital…
Perspective
Public
Congress returns to Washington, D.C., this week facing a long list of things to do, including several that will impact hospitals’ ability to provide access to…
Headline
The Department of Health and Human Services Sept. 4 announced new hardship exemption guidance that would allow consumers ineligible for premium tax credits or…
Headline
The AHA Sept. 4 expressed support for the Hospitals As Naloxone Distribution Sites Act (H.R. 5120), legislation that would require Medicare and Medicaid to…