AHA Stat blog: The real reason behind observation status

A recent New York Times article rightly highlights the role of Recovery Audit Contractors in the increase in observation stays, AHA President and CEO Rick Pollack says in an AHA Stat blog post today. “Their constant second-guessing of physician judgement on short hospital stays is the true cause of the increase of observation stays, which some have depicted in an inaccurate way,” Pollack writes. “Allowing RACs to deny the care provided years after the patient was cared for is indefensible, and forced hospitals to be cautious when admitting patients. This is why the Centers for Medicare & Medicaid Services recently took away patient status reviews from the RACs. However, after many abuses and because of the high number of claims denied by the RACs there is a 10-year backlog of appeals as hospitals seek to overturn the inappropriate denials for patient care provided.”